Applying a Dynamical Systems Model and Network Theory to Major Depressive Disorder

Characterizing the dynamics, reactivity and controllability of moods in depression with a Kalman filter

BACKGROUND

Mood disorders involve a complex interplay between multifaceted internal emotional states, and complex external inputs. Dynamical systems theory suggests that this interplay between aspects of moods and environmental stimuli may hence determine key psychopathological features of mood disorders, including the stability of mood states, the response to external inputs, how controllable mood states are, and what interventions are most likely to be effective. However, a comprehensive computational approach to all these aspects has not yet been undertaken.

METHODS

Here, we argue that the combination of ecological momentary assessments (EMA) with a well-established dynamical systems framework-the humble Kalman filter-enables a comprehensive account of all these aspects. We first introduce the key features of the Kalman filter and optimal control theory and their relationship to aspects of psychopathology. We then examine the psychometric and inferential properties of combining EMA data with Kalman filtering across realistic scenarios. Finally, we apply the Kalman filter to a series of EMA datasets comprising over 700 participants with and without symptoms of depression.

RESULTS

The results show a naive Kalman filter approach performs favourably compared to the standard vector autoregressive approach frequently employed, capturing key aspects of the data better. Furthermore, it suggests that the depressed state involves alterations to interactions between moods; alterations to how moods responds to external inputs; and as a result an alteration in how controllable mood states are. We replicate these findings qualitatively across datasets and explore an extension to optimal control theory to guide therapeutic interventions.

CONCLUSIONS

Mood dynamics are richly and profoundly altered in depressed states. The humble Kalman filter is a well-established, rich framework to characterise mood dynamics. Its application to EMA data is valid; straightforward; and likely to result in substantial novel insights both into mechanisms and treatments.

Network modeling of major depressive disorder symptoms in adult women

BACKGROUND

Major depressive disorder (MDD) is one of the growing human mental health challenges facing the global health care system. In this study, the structural connectivity between symptoms of MDD is explored using two different network modeling approaches.

METHODS

Data are from 'the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD)'. A cohort of N = 2163 American Caucasian female-female twins was assessed as part of the VATSPSUD study. MDD symptoms were assessed using personal structured clinical interviews. Two network analyses were conducted. First, an undirected network model was estimated to explore the connectivity between the MDD symptoms. Then, using a Bayesian network, we computed a directed acyclic graph (DAG) to investigate possible directional relationships between symptoms.

RESULTS

Based on the results of the undirected network, the depressed mood symptom had the highest centrality value, indicating its importance in the overall network of MDD symptoms. Bayesian network analysis indicated that depressed mood emerged as a plausible driving symptom for activating other symptoms. These results are consistent with DSM-5 guidelines for MDD. Also, somatic weight and appetite symptoms appeared as the strongest connections in both networks.

CONCLUSIONS

We discuss how the findings of our study might help future research to detect clinically relevant symptoms and possible directional relationships between MDD symptoms defining major depression episodes, which would help identify potential tailored interventions. This is the first study to investigate the network structure of VATSPSUD data using both undirected and directed network models.

Extracting Nonlinear Dynamics from Psychological and Behavioral Time Series Through HAVOK Analysis

Analytical methods derived from nonlinear dynamical systems, complexity, and chaos theories offer researchers a framework for in-depth analysis of time series data. However, relatively few studies involving time series data obtained from psychological and behavioral research employ such methods. This paucity of application is due to a lack of general analysis frameworks for modeling time series data with strong nonlinear components. In this article, we describe the potential of Hankel alternative view of Koopman (HAVOK) analysis for solving this issue. HAVOK analysis is a unified framework for nonlinear dynamical systems analysis of time series data. By utilizing HAVOK analysis, researchers may model nonlinear time series data in a linear framework while simultaneously reconstructing attractor manifolds and obtaining a secondary time series representing the amount of nonlinear forcing occurring in a system at any given time. We begin by showing the mathematical underpinnings of HAVOK analysis and then show example applications of HAVOK analysis for modeling time series data derived from real psychological and behavioral studies.

Anticipating the direction of symptom progression using critical slowing down: a proof-of-concept study

BACKGROUND

As complex dynamic systems approach a transition, their dynamics change. This process, called critical slowing down (CSD), may precede transitions in psychopathology as well. This study investigated whether CSD may also indicate the direction of future symptom transitions, i.e., whether they involve an increase or decrease in symptoms.

METHODS

In study 1, a patient with a history of major depression monitored their mental states ten times a day for almost eight months. Study 2 used data from the TRAILS TRANS-ID study, where 122 young adults at increased risk of psychopathology (mean age 23.64±0.67 years, 56.6% males) monitored their mental states daily for six consecutive months. Symptom transitions were inferred from semi-structured diagnostic interviews. In both studies, CSD direction was estimated using moving-window principal component analyses.

RESULTS

In study 1, CSD was directed towards an increase in negative mental states. In study 2, the CSD direction matched the direction of symptom shifts in 34 individuals. The accuracy of the indicator was higher in subsets of individuals with larger absolute symptom transitions. The indicator's accuracy exceeded chance levels in sensitivity analyses (accuracy 22.92% vs. 11.76%, z=-2.04, P=.02) but not in main analyses (accuracy 27.87% vs. 20.63%, z=-1.32, P=.09).

CONCLUSIONS

The CSD direction may predict whether upcoming symptom transitions involve remission or worsening. However, this may only hold for specific individuals, namely those with large symptom transitions. Future research is needed to replicate these findings and to delineate for whom CSD reliably forecasts the direction of impending symptom transitions.

The futility of long-term predictions in bipolar disorder: mood fluctuations are the result of deterministic chaotic processes

BACKGROUND

Understanding the underlying architecture of mood regulation in bipolar disorder (BD) is important, as we are starting to conceptualize BD as a more complex disorder than one of recurring manic or depressive episodes. Nonlinear techniques are employed to understand and model the behavior of complex systems. Our aim was to assess the underlying nonlinear properties that account for mood and energy fluctuations in patients with BD; and to compare whether these processes were different in healthy controls (HC) and unaffected first-degree relatives (FDR). We used three different nonlinear techniques: Lyapunov exponent, detrended fluctuation analysis and fractal dimension to assess the underlying behavior of mood and energy fluctuations in all groups; and subsequently to assess whether these arise from different processes in each of these groups.

RESULTS

There was a positive, short-term autocorrelation for both mood and energy series in all three groups. In the mood series, the largest Lyapunov exponent was found in HC (1.84), compared to BD (1.63) and FDR (1.71) groups [F (2, 87) = 8.42, p < 0.005]. A post-hoc Tukey test showed that Lyapunov exponent in HC was significantly higher than both the BD (p = 0.003) and FDR groups (p = 0.03). Similarly, in the energy series, the largest Lyapunov exponent was found in HC (1.85), compared to BD (1.76) and FDR (1.67) [F (2, 87) = 11.02; p < 0.005]. There were no significant differences between groups for the detrended fluctuation analysis or fractal dimension.

CONCLUSIONS

The underlying nature of mood variability is in keeping with that of a chaotic system, which means that fluctuations are generated by deterministic nonlinear process(es) in HC, BD, and FDR. The value of this complex modeling lies in analyzing the nature of the processes involved in mood regulation. It also suggests that the window for episode prediction in BD will be inevitably short.

A Systematic Review of Momentary Assessment Designs for Mood and Anxiety Symptoms

Background: Altering components of ecological momentary assessment (EMA) measures to better suit the purposes of individual studies is a common and oftentimes necessary step. Though the inherent flexibility in EMA has its benefits, no resource exists to provide an overview of the variability in how convergent constructs and symptoms have been assessed in the past. The present study fills that gap by examining EMA measurement design for mood and anxiety symptomatology. Methods: Various search engines were used to identify 234 relevant studies. Items administered, data collection schedules (i.e., beeps per day), response scales (i.e., Likert), data collection platforms (i.e., apps), and psychometric properties (i.e., reliability) were extracted. Results: Study designs varied greatly in all aspects across the identified papers. Over 4,600 extracted items were qualitatively analyzed, resulting in the identification of 12 themes. The most EMA items focused on affect, with categories such as "happiness" and "tension" appearing most frequently. We provide all of our data extraction in the format of an open-source database. Limitations: Despite our best attempts to include as much of the relevant literature as possible, this review and the accompanying database are not exhaustive, but can easily be built upon to include other, newer studies. Conclusions: The fact that the affect theme featured both positive and negative emotional constructs highlights the dichotomous focus on valence and affect within the literature surrounding anxious and depressive symptomatology. We hope that our database will act as a helpful design decision-making resource for researchers studying this kind of symptomatology in the future. Systematic Review Registration: PROSPERO (CRD42019139409).

Modeling the onset of a depressive episode: A self-regulation perspective

Major depression is an episodic disorder which, for many individuals, has its onset in a distinct change of emotional state which then persists over time. The present article explores the utility of combining a dynamical systems approach to depression, focusing specifically on the change of state associated with episode onset, with a self-regulation perspective, which operationalizes how feedback received in the ongoing process of goal pursuit influences affect, motivation, and behavior, for understanding how a depressive episode begins. The goals of this review are to survey the recent literature modeling the onset of a depressive episode and to illustrate how a self-regulation perspective can provide a conceptual framework and testable hypotheses regarding episode onset within a dynamical systems model of depression.

The Continuum Between Temperament and Mental Illness as Dynamical Phases and Transitions

The full range of biopsychosocial complexity is mind-boggling, spanning a vast range of spatiotemporal scales with complicated vertical, horizontal, and diagonal feedback interactions between contributing systems. It is unlikely that such complexity can be dealt with by a single model. One approach is to focus on a narrower range of phenomena which involve fewer systems but still cover the range of spatiotemporal scales. The suggestion is to focus on the relationship between temperament in healthy individuals and mental illness, which have been conjectured to lie along a continuum of neurobehavioral regulation involving neurochemical regulatory systems (e.g., monoamine and acetylcholine, opiate receptors, neuropeptides, oxytocin), and cortical regulatory systems (e.g., prefrontal, limbic). Temperament and mental illness are quintessentially dynamical phenomena, and need to be addressed in dynamical terms. A meteorological metaphor suggests similarities between temperament and chronic mental illness and climate, between individual behaviors and weather, and acute mental illness and frontal weather events. The transition from normative temperament to chronic mental illness is analogous to climate change. This leads to the conjecture that temperament and chronic mental illness describe distinct, high level, dynamical phases. This suggests approaching biopsychosocial complexity through the study of dynamical phases, their order and control parameters, and their phase transitions. Unlike transitions in physical systems, these biopsychosocial phase transitions involve information and semiotics. The application of complex adaptive dynamical systems theory has led to a host of markers including geometrical markers (periodicity, intermittency, recurrence, chaos) and analytical markers such as fluctuation spectroscopy, scaling, entropy, recurrence time. Clinically accessible biomarkers, in particular heart rate variability and activity markers have been suggested to distinguish these dynamical phases and to signal the presence of transitional states. A particular formal model of these dynamical phases will be presented based upon the process algebra, which has been used to model information flow in complex systems. In particular it describes the dual influences of energy and information on the dynamics of complex systems. The process algebra model is well-suited for dealing with the particular dynamical features of the continuum, which include transience, contextuality, and emergence. These dynamical phases will be described using the process algebra model and implications for clinical practice will be discussed.

Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study

AIMS

To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors.

METHODS

Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition.

RESULTS

Almost 85% of participants showed no depression, but prevalence became lower over time (B = -0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93).

CONCLUSIONS

The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence.

Applying a Dynamical Systems Model and Network Theory to Major Depressive Disorder

Mental disorders like major depressive disorder can be modeled as complex dynamical systems. In this study we investigate the dynamic behavior of individuals to see whether or not we can expect a transition to another mood state. We introduce a mean field model to a binomial process, where we reduce a dynamic multidimensional system (stochastic cellular automaton) to a one-dimensional system to analyse the dynamics. Using maximum likelihood estimation, we can estimate the parameter of interest which, in combination with a bifurcation diagram, reflects the expectancy that someone has to transition to another mood state. After numerically illustrating the proposed method with simulated data, we apply this method to two empirical examples, where we show its use in a clinical sample consisting of patients diagnosed with major depressive disorder, and a general population sample. Results showed that the majority of the clinical sample was categorized as having an expectancy for a transition, while the majority of the general population sample did not have this expectancy. We conclude that the mean field model has great potential in assessing the expectancy for a transition between mood states. With some extensions it could, in the future, aid clinical therapists in the treatment of depressed patients.