An adaptation of Perceived Causal Networks for Children and Adolescents (PECAN-CA): An Evaluation of its Reliability and Feasibility

Introduction: Network theory of psychopathology offers a promising framework for personalizing psychotherapy based on personalized symptom networks. However, the estimation of these networks representing an individual's mental disorder is methodologically challenging. The recently developed method of perceived causal relations (PECAN), in which relations between symptoms are determined on the basis of the individual's perception, represents a promising method of network creation. However, no child- or adolescent-sensitive PECAN version exists.Methods: This study adapted PECAN for individuals aged 10-21 (PECAN-CA) and evaluated its reliability and feasibility. A total of N = 75 sub-clinically socially anxious children and adolescents (10–21years; M=15.23, SD=4.07) created personalized symptom networks based on PECAN-CA for a past social situation. Retest reliability was tested immediately and after four weeks, comparing results to prior studies applying PECAN to adults and adolescents. Exploratory analyses examined factors influencing reliability and feasibility.Results: Participants generally rated PECAN-CA as feasible. Networks generated were comparably reliable to those from PECAN studies with adults and more reliable than those from PECAN studies with adolescents. Centrality measures, critical for clinical decisions, showed high reliability (r=.89–.95). Older age and greater comprehension of network theory concepts enhanced feasibility and reliability. Selecting fewer symptoms improved reliability.Conclusion: Overall, PECAN-CA enables the creation of reliable networks in childhood and adolescence. Psychoeducation on concepts of network theory seems important for effective implementation. For younger individuals, PECAN-CA may not work in some cases or only if the number of symptoms included in the network is reduced to a minimum.