The future of case formulation in clinical psychology:advancements in network modeling and simulation-based science

Case formulations are explanations co-created by clinician and client for the client’s psychological, social, and behavioral problems. In clinical practice, case formulations are used to tailor interventions to the specific problems, needs, and resources of the client. However, the process of creating case formulations is complex and requires integrating a broad range of information about the client’s experiences. The PhD thesis therefore aims to facilitate and advance this process by using statistical network models of psychological symptoms and computer simulations. It discusses how statistical networks are estimated from smartphone data, how clinical reasoning and theory are integrated with such networks, and demonstrates how these models can be used to inform case formulations. It showcases how computer simulations can be used to improve the accuracy and predictions of case formulations. The thesis applies these methods to a range of psychological problems, including depression, generalized anxiety disorder, eating disorder, obsessive-compulsive disorder, and panic disorder. It ends with a discussion on the feasibility of these methods in clinical practice, and the steps that are required to introduce them into therapy

Bias-Reduction in Variational Regularization

The aim of this paper is to introduce and study a two-step debiasing method for variational regularization. After solving the standard variational problem, the key idea is to add a consecutive debiasing step minimizing the data fidelity on an appropriate set, the so-called model manifold. The latter is defined by Bregman distances or infimal convolutions thereof, using the (uniquely defined) subgradient appearing in the optimality condition of the variational method. For particular settings, such as anisotropic $\ell^1$ and TV-type regularization, previously used debiasing techniques are shown to be special cases. The proposed approach is however easily applicable to a wider range of regularizations. The two-step debiasing is shown to be well-defined and to optimally reduce bias in a certain setting. In addition to visual and PSNR-based evaluations, different notions of bias and variance decompositions are investigated in numerical studies. The improvements offered by the proposed scheme are demonstrated and its performance is shown to be comparable to optimal results obtained with Bregman iterations.Comment: Accepted by JMI

Integrating clinician and patient case conceptualization with momentary assessment data to construct idiographic networks:Moving toward personalized treatment for eating disorders

Eating disorders are serious psychiatric illnesses with treatments ineffective for about 50% of individuals due to high heterogeneity of symptom presentation even within the same diagnoses, a lack of personalized treatments to address this heterogeneity, and the fact that clinicians are left to rely upon their own judgment to decide how to personalize treatment. Idiographic (personalized) networks can be estimated from ecological momentary assessment data, and have been used to investigate central symptoms, which are theorized to be fruitful treatment targets. However, both efficacy of treatment target selection and implementation with ‘real world’ clinicians could be maximized if clinician input is integrated into such networks. An emerging line of research is therefore proposing to integrate case conceptualizations and statistical routines, tying together the benefits from clinical expertise as well as patient experience and idiographic networks. The current pilot compares personalized treatment implications from different approaches to constructing idiographic networks. For two patients with a diagnosis of anorexia nervosa, we compared idiographic networks 1) based on the case conceptualization from clinician and patient, 2) estimated from patient EMA data (the current default in the literature), and 3) based on a combination of case conceptualization and patient EMA data networks, drawing on informative priors in Bayesian inference. Centrality-based treatment recommendations differed to varying extent between these approaches for patients. We discuss implications from these findings, as well as how these models may inform clinical practice by pairing evidence-based treatments with identified treatment targets

Within- and across-day patterns of interplay between depressive symptoms and related psychopathological processes:a dynamic network approach during the COVID-19 pandemic

Background In order to understand the intricate patterns of interplay connected to the formation and maintenance of depressive symptomatology, repeated measures investigations focusing on within-person relationships between psychopathological mechanisms and depressive components are required. Methods This large-scale preregistered intensive longitudinal study conducted 68,240 observations of 1706 individuals in the general adult population across a 40-day period during the COVID-19 pandemic to identify the detrimental processes involved in depressive states. Daily responses were modeled using multi-level dynamic network analysis to investigate the temporal associations across days, in addition to contemporaneous relationships between depressive components within a daily window. Results Among the investigated psychopathological mechanisms, helplessness predicted the strongest across-day influence on depressive symptoms, while emotion regulation difficulties displayed more proximal interactions with symptomatology. Helplessness was further involved in the amplification of other theorized psychopathological mechanisms including rumination, the latter of which to a greater extent was susceptible toward being influenced rather than temporally influencing other components of depressive states. Distinctive symptoms of depression behaved differently, with depressed mood and anhedonia most prone to being impacted, while lethargy and worthlessness were more strongly associated with outgoing activity in the network. Conclusions The main mechanism predicting the amplifications of detrimental symptomatology was helplessness. Lethargy and worthlessness revealed greater within-person carry-over effects across days, providing preliminary indications that these symptoms may be more strongly associated with pushing individuals toward prolonged depressive state experiences. The psychopathological processes of rumination, helplessness, and emotion regulation only exhibited interactions with the depressed mood and worthlessness component of depression, being unrelated to lethargy and anhedonia. The findings have implications for the impediment of depressive symptomatology during and beyond the pandemic period. They further outline the gaps in the literature concerning the identification of psychopathological processes intertwined with lethargy and anhedonia on the within-person level

Debugging Woven Code

The ability to debug woven programs is critical to the adoption of Aspect Oriented Programming (AOP). Nevertheless, many AOP systems lack adequate support for debugging, making it difficult to diagnose faults and understand the program's structure and control flow. We discuss why debugging aspect behavior is hard and how harvesting results from related research on debugging optimized code can make the problem more tractable. We also specify general debugging criteria that we feel all AOP systems should support. We present a novel solution to the problem of debugging aspect-enabled programs. Our Wicca system is the first dynamic AOP system to support full source-level debugging of woven code. It introduces a new weaving strategy that combines source weaving with online byte-code patching. Changes to the aspect rules, or base or aspect source code are rewoven and recompiled on-the-fly. We present the results of an experiment that show how these features provide the programmer with a powerful interactive debugging experience with relatively little overhead

Using clinical expertise and empirical data in constructing networks of trauma symptoms in refugee youth

Background: In recent years, many adolescents have fled their home countries due to war and human rights violations, consequently experiencing various traumatic events and putting them at risk of developing mental health problems. The symptomatology of refugee youth was shown to be multifaceted and often falling outside of traditional diagnoses. Objective: The present study aimed to investigate the symptomatology of this patient group by assessing the network structure of a wide range of symptoms. Further, we assessed clinicians’ perceptions of symptoms relations in order to evaluate the clinical validity of the empirical network. Methods: Empirical data on Post-Traumatic Stress Disorder (PTSD), depression and other trauma symptoms from N = 366 refugee youth were collected during the routine diagnostic process of an outpatient centre for refugee youth in Germany. Additionally, four clinicians of this outpatient centre were asked how they perceive symptom relations in their patients using a newly developed tool. Separate networks were constructed based on 1) empirical symptom data and 2) clinicians’ perceived symptom relations (PSR). Results: Both the network based on empirical data and the network based on clinicians’ PSR showed that symptoms of PTSD and depression related most strongly within each respective cluster (connected mainly via sleeping problems), externalizing symptoms were somewhat related to PTSD symptoms and intrusions were central. Some differences were found within the clinicians’ PSR as well as between the PSR and the empirical network. Still, the general PSR-network structure showed a moderate to good fit to the empirical data. Conclusion: Our results suggest that sleeping problems and intrusions play a central role in the symptomatology of refugee children, which has tentative implications for diagnostics and treatment. Further, externalizing symptoms might be an indicator for PTSD-symptoms. Finally, using clinicians’ PSR for network construction offered a promising possibility to gain information on symptom networks and their clinical validity

'Sawfish' Photonic Crystal Cavity for Near-Unity Emitter-to-Fiber Interfacing in Quantum Network Applications

Photon loss is one of the key challenges to overcome in complex photonic quantum applications. Photon collection efficiencies directly impact the amount of resources required for measurement-based quantum computation and communication networks. Promising resources include solid-state quantum light sources, however, efficiently coupling light from a single quantum emitter to a guided mode remains demanding. In this work, we eliminate photon losses by maximizing coupling efficiencies in an emitter-to-fiber interface. We develop a waveguide-integrated 'Sawfish' photonic crystal cavity and use finite element simulations to demonstrate that our system transfers, with 97.4% efficiency, the zero-phonon line emission of a negatively-charged tin vacancy center in diamond adiabatically to a single-mode fiber. A surrogate model trained by machine learning provides quantitative estimates of sensitivities to fabrication tolerances. Our corrugation-based design proves robust under state-of-the-art nanofabrication parameters, maintaining an emitter-to-fiber coupling efficiency of 88.6%. To demonstrate its potential in reducing resource requirements, we apply the Sawfish cavity to a recent one-way quantum repeater protocol.Comment: Main part: 16 pages, 7 figure

A scientific information extraction dataset for nature inspired engineering

Nature has inspired various ground-breaking technological developments in applications ranging from robotics to aerospace engineering and the manufacturing of medical devices. However, accessing the information captured in scientific biology texts is a time-consuming and hard task that requires domain-specific knowledge. Improving access for outsiders can help interdisciplinary research like Nature Inspired Engineering. This paper describes a dataset of 1,500 manually-annotated sentences that express domain-independent relations between central concepts in a scientific biology text, such as trade-offs and correlations. The arguments of these relations can be Multi Word Expressions and have been annotated with modifying phrases to form non-projective graphs. The dataset allows for training and evaluating Relation Extraction algorithms that aim for coarse-grained typing of scientific biological documents, enabling a high-level filter for engineers.Comment: Published in Proceedings of the 12th Conference on Language Resources and Evaluation (LREC 2020). Updated dataset statistics, results unchange