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Evaluation ViewAttendees 5

Research Methods and Statistics
Symposia

Symposium 127 - Advancing treatment personalization by identifying and targeting idiographic psychopathological mechanisms

Sunday, November 17, 2024
10:30 AM – 12:00 PM EST
Location: Grand Ballroom G/H, Level 5, Downtown Marriott
CE: 1.5

Keywords: Research Methods, Clinical Decision Making, Change Process / Mechanisms
Level of Familiarity: Basic to moderate
Recommended Readings: Fisher, A. J., & Boswell, J. F. (2016). Enhancing the Personalization of Psychotherapy With Dynamic Assessment and Modeling. Assessment. https://doi.org/10.1177/1073191116638735,  



Butler, R. M., Ortiz, A. M. L., Pennesi, J.-L., Crumby, E. K., Cusack, C. E., & Levinson, C. A. (2023). A pilot randomized controlled trial of transdiagnostic network-informed personalized treatment for eating disorders versus enhanced cognitive behavioral therapy. International Journal of Eating Disorders, 56(8), 1674–1680. https://doi.org/10.1002/eat.23982

 





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Frumkin, M. R., Piccirillo, M. L., Beck, E. D., Grossman, J. T., & Rodebaugh, T. L. (2021). Feasibility and utility of idiographic models in the clinic: A pilot study. Psychotherapy Research, 31(4), 520–534. https://doi.org/10.1080/10503307.2020.1805133

,   Deisenhofer, A.-K., Barkham, M., Beierl, E. T., Schwartz, B., Aafjes-van Doorn, K., Beevers, C. G., Berwian, I. M., Blackwell, S. E., Bockting, C. L., Brakemeier, E.-L., Brown, G., Buckman, J. E. J., Castonguay, L. G., Cusack, C. E., Dalgleish, T., de Jong, K., Delgadillo, J., DeRubeis, R. J., Driessen, E., … Cohen, Z. D. (2024). Implementing precision methods in personalizing psychological therapies: Barriers and possible ways forward. Behaviour Research and Therapy, 172, 104443. https://doi.org/10.1016/j.brat.2023.104443,  

Traditionally, research on psychopathology has adopted a nomothetic approach, wherein samples are recruited based on diagnostic groups, and participant data is aggregated and analyzed to draw conclusions about the general population. Nomothetic methods assume that variables of interest do not significantly differ across individuals and that they remain mostly stable over time and context (Beltz et al., 2016). Consequently, many evidence-based interventions are designed as one-size-fits-all treatments for the 'average' patient. However, evidence suggests a substantial degree of heterogeneity in presentation, symptom dynamics, and treatment response among individuals with the same categorical diagnosis (Fisher, 2015). Therefore, optimal treatment may vary significantly across individuals, and delivering the same intervention to all could diminish its efficacy and efficiency.
Idiographic methods are an alternative research approach which treat each patient in a sample as a distinct individual. These methods measure variability in factors of interest over time and across context using intensive longitudinal data, making them better equipped to attend to psychopathological heterogeneity. These data can then be used to create personalized models for individual patients which highlight key mechanisms maintaining symptoms that can then be used to tailor interventions to each patient to create an effective and efficient treatment plan. For example, if a patient reports anxiety symptoms, one may collect data on putative transdiagnostic mechanisms of anxiety disorders, such as aversive reactivity to emotions, cognitive inflexibility, and intolerance of uncomfortable physiological sensations. Following assessment, if their model suggests cognitive inflexibility is a central maintenance factor, the clinician may use this information to select an intervention such as cognitive restructuring designed to foster cognitive flexibility.
While idiographic psychopathology research has accumulated rapidly over the last decade, it remains unclear how best to assess and identify mechanisms maintaining symptoms of psychopathology at the individual level. Furthermore, determining how to effectively apply this information to treatment planning poses a challenge. These talks will review research evaluating various methods for assessing and identifying idiographic mechanisms, and effectively applying this information to personalize treatments.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Define idiographic methods and explain how they differ from nomothetic approaches
  2. Describe the potential clinical utility of idiographic assessment to personalize evidence-based treatments
  3. List out and describe multiple emerging idiographic assessment approaches
  4. Explain how to use idiographic assessment data to identify key psychopathological mechanisms in a variety of clinical populations
  5. Describe how person-specific psychopathological mechanisms can be used to personalize treatment and improve its efficiency and efficacy

Presentations:

  • 10:30 AM – 12:00 PM EST
    (SYM 127) Personalized Mechanistic Network Models of Borderline Personality Disorder Symptoms

    Speaker: Madeline Kushner, B.A. (she/her/hers) – University of Kentucky

    Co-author: Matthew W. Southward, Ph.D. (he/him/his) – University of Kentucky

    Co-author: Shannon Sauer-Zavala, Ph.D. (she/her/hers) – University of Kentucky

  • 10:30 AM – 12:00 PM EST
    (SYM 127) Leveraging Intensive Longitudinal Data to Understand Within-person Treatment Effects During a Cognitive-behavioral Opioid Taper Support Intervention for Adults with Chronic Pain

    Speaker: Madelyn Frumkin, Ph.D. (she/her/hers) – Massachusetts General Hospital

    Co-author: Bryn Evohr, BA – Massachusetts General Hospital Center For Addiction Medicine

    Co-author: Julia Jashinski, MSW, LCSW – Massachusetts General Hospital Center For Addiction Medicine

    Co-author: Cori Cather, MD – Massachusetts General Hospital Center Of Excellence For Psychosocial And Systemic Research

    Co-author: Gladys Pachas, MD – Massachusetts General Hospital Center for Addiction Medicine

    Co-author: A. Eden Evins, MD, MPH – Massachusetts General Hospital Center For Addiction Medicine

    Co-author: Jodi Gilman, PhD – Massachusetts General Hospital Center for Addiction Medicine

  • 10:30 AM – 12:00 PM EST
    (SYM 127) The Impact of Personalized Treatment for Individuals with the Same Disorder: A Case Series

    Speaker: Anna Marie Ortiz, Ph.D. (she/her/hers) – University of Louisville

    Co-author: Rachel M. Butler, Ph.D. (she/her/hers) – Transylvania University

    Co-author: Cheri Levinson, Ph.D. (she/her/hers) – University of Louisville

  • 10:30 AM – 12:00 PM EST
    (SYM 127) Using a New Conceptual Framework for Measuring Active Elements of Cognitive-behavioral Therapies to Support Idiographic (and Nomothetic) Targeting in Precision Digital Therapy

    Speaker: Zachary D. Cohen, Ph.D. (he/him/his) – University of Arizona

    Co-author: Nora Barnes-Horowitz, M.A. (she/her/hers) – University of California, Los Angeles

    Co-author: Courtney Forbes, PhD (she/her/hers) – UCLA

    Co-author: Nathaniel Choukas, BS (he/him/his) – U Arizona

    Co-author: Torsa Chattoraj, MA (she/her/hers) – U Arizona

    Co-author: Kate Wolitzky-Taylor, Ph.D. – UCLA School of Medicine

    Co-author: Michelle G. Craske, Ph.D. – University of California, Los Angeles