Centre for Urban Mental Health, University of Amsterdam, The Netherlands; Department of Psychiatry, Amsterdam UMC location AMC, University of Amsterdam, The Netherlands.
Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong; The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
J Affect Disord. 2024 Feb 15;347:352-363. doi: 10.1016/j.jad.2023.11.060. Epub 2023 Nov 20.
Complexity science perspectives like the network approach to psychopathology have emerged as a prominent methodological toolkit to generate novel hypotheses on complex etiologies surrounding various mental health problems and inform intervention targets. Such approach may be pivotal in advancing early intervention of suicidality among the younger generation (10-35 year-olds), the increasing burden of which needs to be reversed within a limited window of opportunity to avoid massive long-term repercussions. However, the network approach currently lends limited insight into the potential extent of proposed intervention targets' effectiveness, particularly for target outcomes in comorbid conditions.
This paper proposes an in silico (i.e., computer-simulated) intervention approach that maps symptoms' complex interactions onto dynamic processes and analyzes their evolution. The proposed methodology is applied to investigate potential effects of changes in 1968 community-dwelling individuals' distress symptoms on their suicidal ideation. Analyses on specific subgroups were conducted. Results were also compared with centrality indices employed in typical network analyses.
Findings concur with symptom networks' centrality indices in suggesting that timely deactivating hopelessness among distressed individuals may be instrumental in preventing distress to develop into suicidal ideation. Additionally, however, they depict nuances beyond those provided by centrality indices, e.g., among young adults, reducing nervousness and tension may have similar effectiveness as deactivating hopeless in reducing suicidal ideation.
Caution is warranted when generalizing findings here to the general population.
The proposed methodology may help facilitate timely agenda-setting in population mental health measures, and may also be augmented for future co-creation projects.
复杂性科学视角,如精神病理学的网络方法,已成为生成关于各种心理健康问题复杂病因的新假设并为干预目标提供信息的重要方法工具。这种方法对于推进年轻一代(10-35 岁)自杀意念的早期干预可能至关重要,因为需要在有限的机会窗口内扭转这一不断增加的负担,以避免长期的巨大影响。然而,目前网络方法对于所提出的干预目标效果的潜在程度提供的见解有限,特别是对于共病情况下的目标结果。
本文提出了一种基于计算机模拟的干预方法,该方法将症状的复杂相互作用映射到动态过程并分析其演变。所提出的方法应用于研究改变 1968 名社区居民的痛苦症状对自杀意念的潜在影响。对特定亚组进行了分析。并将结果与典型网络分析中使用的中心性指数进行了比较。
研究结果与症状网络的中心性指数一致,表明及时减轻痛苦个体的绝望感可能有助于防止痛苦发展为自杀意念。此外,它们还描绘了中心性指数提供的细微差别,例如,在年轻人中,减轻紧张和紧张可能与解除绝望一样有效,从而减少自杀意念。
当将这里的发现推广到一般人群时应谨慎。
所提出的方法可以帮助促进人群心理健康措施的及时议程设定,并且也可以为未来的共同创造项目提供补充。