Intervening on psychopathology networks: Evaluating intervention targets through simulations.

Identifying the different influences of symptoms in dynamic psychopathology models may hold promise for increasing treatment efficacy in clinical applications. Dynamic psychopathology models study the behavioral patterns of symptom networks, where symptoms mutually enforce each other. Interventions could be tailored to specific symptoms that are most effective at lowering symptom activity or that hinder the further development of psychopathology. Simulating interventions in psychopathology network models fits in a novel tradition where symptom-specific perturbations are used as in silico interventions. Here, we present the NodeIdentifyR algorithm (NIRA) to identify the projected most efficient, symptom-specific intervention target in the Ising model. This algorithm is implemented in a novel and freely available R package. The technique studies the projected effects of symptom-specific interventions by simulating data while symptom parameters (i.e., threshold parameters) are systematically altered. The projected effect of these interventions is defined in terms of the expected change in overall symptom activity across simulations. With this algorithm, it is possible to study (1) whether symptoms differ in their projected influence on the behavior of the symptom network, and, if so, (2) which symptom has the largest projected effect in lowering and increasing overall symptom activation. As an illustration, we apply the algorithm to an empirical dataset containing assessments of PTSD symptoms in a sample that experienced the Wenchuan earthquake in 2008. The most important limitations of the method are discussed, as well as recommendations for future research, such as shifting towards modeling individual processes to validate these types of simulation-based intervention methods.