Perceived Causal Symptom Network of Adolescent Mental Health Issues

Adolescent mental health is difficult to capture in categories such as depression or specific anxiety disorders. An alternative is to approach psychiatric symptoms as causal networks, potentially revealing feedback-loops that maintain a pathological state. One method to create such networks is by asking adolescents about their perceptions of the causes to their symptoms. For this purpose, a transdiagnostic item-list was created, and adolescents screening positive for depression (n = 55) completed a survey quantifying perceptions of causality between psychiatric problems, twice in two weeks. The averaged network was reliable and revealed three strong feedback loops: The first loop running through stress, insomnia, fatigue, procrastination, and back to stress; a second loop between stress and overthinking, and a third between stress and procrastination. Although adolescents were included based on screening positive for depression, symptoms of depression were not particularly central to the network. Instead, the most central symptoms were procrastination and stress. The average test-retest reliability for individual networks was low, limiting clinical applications. In conclusion, PECAN was found to be reliable and useful when creating a group-level network of adolescent mental health problems. The method should be improved before it can be used to inform treatment for individual patients.