On the transience or stability of subthreshold psychopathology

• Published in: Scientific reports Vol. 11; no. 1; pp. 23306 - 7
• Main Authors: Schreuder, Marieke J., Wigman, Johanna T. W., Groen, Robin N., Wichers, Marieke, Hartman, Catharina A.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.12.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/553/2393; 631/553/2701; 692/699/476; Adult; Age Factors; Diagnostic and Statistical Manual of Mental Disorders; Female; Humanities and Social Sciences; Humans; Male; Mental disorders; Mental Disorders - diagnosis; Mental Disorders - psychology; Mental Health; multidisciplinary; Patient Acuity; Psychopathology; Regression Analysis; Risk Factors; Science; Science (multidisciplinary); Sensitivity analysis; Young Adult; Young adults
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-02711-3

Symptoms of psychopathology lie on a continuum ranging from mental health to psychiatric disorders. Although much research has focused on progression along this continuum, for most individuals, subthreshold symptoms do not escalate into full-blown disorders. This study investigated how the stability of psychopathological symptoms (attractor strength) varies across severity levels (homebase). Data were retrieved from the TRAILS TRANS-ID study, where 122 at-risk young adults (mean age 23.6 years old, 57% males) monitored their mental states daily for a period of six months (± 183 observations per participant). We estimated each individual’s homebase and attractor strength using generalized additive mixed models. Regression analyses showed no association between homebases and attractor strengths (linear model: B = 0.02, p = 0.47, R 2  < 0.01; polynomial model: B < 0.01, p = 0.61, R 2  < 0.01). Sensitivity analyses where we (1) weighed estimates according to their uncertainty and (2) removed individuals with a DSM-5 diagnosis from the analyses did not change this finding. This suggests that stability is similar across severity levels, implying that subthreshold psychopathology may resemble a stable state rather than a transient intermediate between mental health and psychiatric disorder. Our study thus provides additional support for a dimensional view on psychopathology, which implies that symptoms differ in degree rather than kind.