TRAILS TRANS-ID: Tracking transitions across diagnostic boundaries of psychopathology, a daily diary study in the TRAILS clinical cohort

The period of young adulthood is a critical time for changes in psychiatric
complaints. Pathways of symptom enhancement or symptom improvement may differ
largely between individuals, and involve dynamic processes spanning multiple
psychopathological domains. To improve our understanding of these changes, we
are in need of transdiagnostic, personalized models to capture the
within-person dynamics of symptoms over time for each individual. We propose to
use two novel approaches to improve prediction of future courses of symptoms:
i) identifying early warning signals (EWS) that anticipate transitions and ii)
mapping the underlying dynamic structure of psychopathology using network
analysis.

The aim of this project is to map the full process of change within individuals
in a fine-grained and detailed way across a wide range of psychopathological
symptoms. Using (i) early warning signals and (ii) networks, we hope to reveal
underlying mechanisms of change and improve personalized prediction of future
course of psychopathology.
Additionally, secondary objectives are a) to examine whether there are
symptom-specific patterns of EWS that differentiate the direction of the type
of psychopathology that an individual is most likely to make a transition to,
b) to evaluate whether comorbidity is indeed accompanied by network connections
between symptoms across these disorders, as is predicted by the network theory,
c) to identify empirically-driven subgroups of individuals with similar symptom
network characteristics, and d) to investigate whether EWS and symptom specific
patterns of transition, and individual differences in network characteristics
can be understood from early patterns of psychopathology and environmental
circumstances since age 11

Participants will report their day-to-day symptoms, some context variables and
daily functioning (maximum 5 minutes per day) for six consecutive months on
their smartphone. Symptomatology and functioning will be assessed directly
before and after the ambulatory assessment period, and during follow-up about
12 months after the ambulatory assessment has ended.

There are no risks involved in participating in the study. The burden
associated with participation consists of: (i) an interview before (baseline;
ca. 2 hours) and after (expected duration ca. 60 min) the ambulatory assessment
period, (ii) filling in a questionnaire using a smartphone every evening for
six months (maximum of 5 minutes per day), and (iii) an one follow-up interview
of ca. 30-60 minutes. Benefits are a financial compensation up to 200 euros and
the opportunity for participants to get insight in their personal, daily
symptoms over time. Participants, who appreciate this will be guided through
their study assessments, including descriptive graphs of their completed
questions directly at the end of the ambulatory assessment period. To be clear,
participants will not receive any personal models of prediction or other
personalized analyses based on their data. They will only be able to see an
overview of the crude data of their daily responses.