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Examining the utility of process-focused data driven psychological networks for individualizing psychological treatment in chronic pain: A single case experiment testing the centrality hypothesis
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0001-5704-7991
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0002-7032-1614
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
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2026 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 17, article id 1809958Article in journal (Refereed) Published
Abstract [en]

Introduction:

Idiographic network analysis, where associations between multiple nodes are estimated, can potentially guide choice of interventions in psychological treatment. In this single case experiment using ecological momentary assessment data to estimate continuous time network models, we aimed to test the so-called centrality hypothesis. We did so by comparing effects of interventions guided by the most central node to those guided by the least central node. We used the composite level psychological inflexibility processes lack of openness, lack of awareness, and lack of engagement, alongside an interference outcome, as network nodes. Effects on pain interference, motivation, and pain intensity were examined.

Method:

We employed a multiple baseline design across six participants. Therapists and participants were blinded to participants' treatment conditions. Baseline length and order of treatment phases were randomized.

Results:

Four participants had an overall treatment effect on pain interference, but it was generally not possible to discern that one particular phase was more beneficial than another. For three participants, the picture was somewhat clearer, indicating one of the treatment phases as more beneficial, although the results for these participants were not consistently in line with hypotheses. Retrospectively examining other potential guidance methods for these three participants, we saw a potential in discrete time contemporaneous network models.

Discussion:

Current results are not in line with previous assumptions or research on idiographic network models for treatment personalization, although the previous research in this area is scarce. Future research should investigate alternative network models or estimation choices to determine the potential utility of data driven idiographic networks.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2026. Vol. 17, article id 1809958
Keywords [en]
acceptance and commitment therapy, ecological momentary assessment, idiographic, network analysis, process-based therapy, single case design
National Category
Public Health, Global Health and Social Medicine Applied Psychology
Identifiers
URN: urn:nbn:se:uu:diva-586501DOI: 10.3389/fpsyg.2026.1809958ISI: 001755980000001PubMedID: 42094330OAI: oai:DiVA.org:uu-586501DiVA, id: diva2:2061093
Available from: 2026-05-20 Created: 2026-05-20 Last updated: 2026-06-22Bibliographically approved
In thesis
1. Individualizing psychological treatment for chronic pain: Can network analysis bridge the scientist-practitioner gap?
Open this publication in new window or tab >>Individualizing psychological treatment for chronic pain: Can network analysis bridge the scientist-practitioner gap?
2026 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Psychological treatment for chronic pain can generally help people improve their functioning and well-being. Still, there is room for improvement in terms of overall effect sizes. There is also a need to address the gap between scientists, often focusing treatment on standardized manuals for treatment, and clinicians, often aiming to individualize treatment. One suggested step forward is to adopt the clinician’s agenda for individualization, but in a systematic fashion ensuring a scientific approach. The aim of this thesis was to examine the clinical utility of one method suggested to be useful for systematic individualization; individual level network analysis. Both study I and II tested the clinical utility of using so-called network centrality for treatment guiding, where centrality reflects how well connected one network node is to other nodes. Specifically, we tested whether interventions guided by the most central node were more beneficial for the individual compared with interventions guided by the least central node. In study I, we tested this by using networks based on participants’ one-time ratings of how aspects of psychological inflexibility and pain interference were perceived to cause each other. Results were promising in that individual level treatment effects most often occurred when treatment was guided by the most central node. Study II replicated study I, but networks were instead estimated using repeated measures of the network variables. Results did not indicate utility of guiding treatment based on centrality in such a data driven network. Study III demonstrated that individual level networks can give us information that may be lost in group level networks, but that there are group level connections that are generalizable to many individuals. Such generalizable connections can be used to generate initial hypotheses for individual level treatment, but may not be valid for everyone – prompting us to continue the evaluation of systematic methods for individualization. Further, individual level network connectivity was correlated with depression and pain interference, but did not contribute with unique explained variance in the outcomes when controlling for baseline levels of the outcomes. Finally, overall network connectivity did not predict pain interference or depression on the individual level.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2026. p. 86
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 245
Keywords
ergodicity, single case design, network analysis, chronic pain, individualization
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-591557 (URN)978-91-513-2892-8 (ISBN)
Public defence
2026-09-08, Humanistiska teatern, Thunbergsvägen 3C, Uppsala, 13:15 (English)
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Supervisors
Available from: 2026-08-18 Created: 2026-06-22 Last updated: 2026-08-18

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Lavefjord, AmaniSundström, Felicia T. A.Forslund, SannaClason van de Leur, JakobBuhrman, MonicaMcCracken, Lance

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