Gravitation grant for team captains Bernet Elzinga and Andrea Evers
Although depression looks different for each person, the treatment is the same for everyone. At the same time, the treatment of psychological issues in most cases is insufficient. A research consortium hopes to change this, with the help of the Gravitation programme grant. Co-applicants Bernet Elzinga en Andrea Evers are two of the captains of the six teams, all led by main applicant Anita Jansen, Maastricht University.
Mind – Body Interface team
Evers’ part in this team relates to the physical aspects of mental disorders. She is aiming for her Mind – Body Interface team to follow patients with chronic physical symptoms over a long period, looking at the overlap with emotions and further unravelling them in an experimental study. Evers explains: ‘We approach a patient as an individual. What we’re doing is turning the entire DSM – the current categorisation system for psychological disorders – upside down.’ For Evers, the time for compartmentalisation in psychiatry is over. She wants to apply much more customised treatments for psychological disorders, using a diagnostic process that is tailored to the individual. ‘We don’t want to pigeonhole people; we want to treat them based on their own individual risk profile.’
Dynamic of mixed teams
‘The DSM is too focused on categories,’ Evers continues. ‘When you’re dealing with physical symptoms like pain, itching and fatigue, there’s a big overlap with mental symptoms like anxiety or depression. There’s often a link between those physical symptoms and emotions, such as feelings of depression. But the question is which came first. The goal now is to identify those symptoms using interactive research over a longer period, to develop better interventions for individual treatments.’
One distinctive aspect of the research consortium that Evers highlights is the dynamic of the mixed teams, with a relatively large proportion of young researchers and a major focus on training. ‘That makes it a good “step up” for talented young researchers, and it’s good news for the whole department of Health, Medical and Neuropsychology and Clinical Psychology.’
Communications Networks team
Bernet Elzinga and her Communications Networks team also focus on the symptoms rather than the diagnosis. Elzinga explains: ‘Two people with an anxiety disorder can have different symptoms. One of them might fret a lot and avoid everything, while the other suffers from unpredictable panic attacks. And symptoms can also influence each other. Thanks to recent digital and statistical developments, we can now measure these symptoms in day-to-day life, too, and analyse the cohesion between them on a large scale. To collect that data, people keep electronic diaries on their mobile phones: “Have you had trouble sleeping? What’s your mood like?” That helps us identify the symptoms and create a personalised symptom profile.’
In her Vici research on parent-child interactions in situations where young people have symptoms of depression, Elzinga has already been able to coordinate the mobile phones of the parents and the child. They receive questions on their phones that are directly linked to a contact moment, such as: ‘How was the contact? What is your mood like now?’ The researchers collect data from the perspective of both parent and child: how do they each assess the contact, and how predictive is this information for the development of symptoms of depression?
Something that adds further complexity in Communications Networks is the interaction in which parents and children respond to each other. Elzinga explains: ‘How do a child’s specific symptoms affect the parents, and how does that in turn influence the child’s mood? Does one parent respond critically, and then the child withdraws? Does the other parent respond empathetically? What works better? These kinds of interactions have an important influence on one another in a home context. A lot of psychological symptoms are produced by this kind of system of interactions. That’s why both the parents and the child keep an electronic diary. As well as being innovative, it’s also a big statistical challenge.’
Data analysis of networks
That’s when the importance of a multidisciplinary team becomes clear. Together with Elko Fried, Elzinga will look in close detail at how all the symptoms in this kind of network of interactions influence each other during the parent-child contact. Fried is also part of Evers’ Mind – Body Interface team, as an expert in data analysis of networks, as well as being a member of the overarching project that is being coordinated from Maastricht University with the principal applicant Anita Jansen. ‘Anita is a really extraordinary scientist with big ambitions,’ says Elzinga. ‘And she’s also good at facilitating group processes, which is something a team needs if you want to achieve something special, learn a lot from each other and come up with new ideas.’
New Science of Mental Disorders
Amount awarded: 19.3 million euros
Worldwide, one in four adults and one in ten children suffer from mental illness at any given moment. Mental illnesses cause considerable suffering, and our best treatments only work for about 40% of patients. We think that mental illnesses reflect dynamic and complex networks of interacting symptoms. The proposal is to study the complex dynamics of these networks, the transdiagnostic processes that drive the connectivity between symptoms, and the effect of network-based interventions tailored for the individual patient.
Communications Networks team, among others:
- Bernet Elzinga, captain
- Eiko Fried
- Bart Verkuil
Mind – Body Interface team, among others:
- Andrea Evers, captain
- Antoinette van Laarhoven
Other universities involved: Maastricht University (Main applicant) and Universiteit van Amsterdam