Maintaining mechanisms of depressive symptomatology
The main purpose of the present study was to examine the within-person relationships present in the temporal and contemporaneous models of depressive symptoms and its constituents. As these networks model average within-person connections between nodes, they provide insight into potential mechanisms of change involved in the amplification and impediment of depressive symptomatology, providing directions toward further study and identification of targets for interventions aimed at alleviating these detrimental mental health problems.
Although all depressive symptoms were well-connected on a between-subject level and further interacted within the same window of measurement, the findings of present study indicate that interactions between depressive symptoms to a greater extent are separated and uniquely coupled across days. Specific across-day connections were identified between anhedonia and the somatic symptom lethargy, while two cognitive-affective symptoms, perceptions of worthlessness and depressed mood, were more strongly interconnected on an across-day basis. Additionally, the relationship between these symptoms were directed, revealing the predominant temporal influence of lethargy on anhedonia, and worthlessness on depressed mood. These findings have implications for efforts aimed at impeding escalations of depressive states, suggesting that lethargy and worthlessness have a greater likelihood of contributing as catalysts in the escalation of deleterious depressive states from one day to the next. As a key feature putting individuals at risk of developing depressive syndrome involves the prolonged constellation and experience of multiple symptoms [
40], insight into the specific symptoms that more likely yield carry-over effects across time is of importance from an epidemiological and clinical perspective in more successfully preventing the development of a depressive state. The present study identifies that the two most prominent depressive symptoms that may be involved in such detrimental carry-over effects in the non-clinical population are worthlessness and lethargy. This finding is consistent with cross-sectional network studies identifying worthlessness and lethargy as central nodes in depressive states [
16,
17], with the present study advancing insight concerning the directed temporal involvement and coupled interaction between these symptoms.
This investigation further extended the applications of network theory through the introduction of relevant psychopathological mechanisms and contextual factors in the networks, yielding novel insights concerning the specific patterns that these processes exhibit in their interactions with depressive symptomatology. Loneliness, helplessness, and in-person social contact had the greatest outward temporal influence (i.e., outstrength centrality) on the other variables in the network on an across-day basis. Studies during the present pandemic have found undirected associations between loneliness and depressive symptomatology in the general population [
55,
56]. The present longitudinal study advances the literature by identifying the direction of this association, further identifying that loneliness interacts with depression through its directed association with the depressed mood component of depression, carrying over across days.
The main psychopathological mechanism temporally associated with the maintenance and amplification of depressive dynamics on an across-day basis was helplessness. Accordingly, when an individual reported being more helpless than their own average at a given day, they reported within-person increases in depressed mood, rumination, and worthlessness at the consecutive day. This finding provides support for helplessness as an important mechanistic variable in the maintenance and change of depressive symptoms in the general population. This is consistent with the learned helplessness theory of depression [
26], postulating that when an individual comes to believe that their efforts to modify their circumstances are ineffective, developed perceptions of helplessness may incite depressive symptomatology. The finding is further consonant with a central meta-theory of psychopathology proposed by Jerome Frank, suggesting that demoralization (i.e., experienced helplessness or inability to cope) is a key aggravator of psychiatric symptomatology [
57]. As perceptions of helplessness are theorized by several scholars to be the main reason for individuals seeking psychiatric treatment [
57,
58], directing efforts toward reducing helplessness may be warranted. The present study provides preliminary indications that such efforts may have the ability to impede deleterious depressive states, although such assertions warrant further investigation using controlled designs.
Aside from being uniquely associated with within-person increases in key depressive symptoms and rumination at the next day, helplessness was further engaged in a vicious cycle with emotional regulation difficulties across days, with emotion regulation problems also associated with heightening of depressed mood from one day to the next within individuals. Combined with the finding that emotion regulation difficulties were the most central psychopathological process in the contemporaneous network, revealing strong interactions with depressive symptoms within a day, this finding suggests it may be important to devote simultaneous attention toward the detrimental role that emotional regulation difficulties may play in depressive mental health states. Notably, this study provides indications that the interaction between depressive symptoms and emotional regulation difficulties may predominantly operate on a faster time scale than helplessness with depressive symptoms. This finding is meaningful, given that emotional regulation problems likely are more situationally contingent and probable of occurring within a more encapsulated time period. Consequently, these findings distinguish between the proximal role that emotion regulation difficulties play in its interaction with depressive symptoms, while identifying helplessness as having a more prominent role in terms of prolonged depressive symptom experience. More granular approaches are called for in future studies to refine the understanding of the possible directed role that emotion regulation difficulties may play within a day.
Among the aforementioned psychopathological mechanisms, rumination was peripheral and did not have any notable interaction with depressive symptomatology on an across-day basis. This finding is consistent with a previous study [
59] identifying rumination to be on the receiving end of predictive temporal relationships in a network of mechanistic variables, in addition to another study not finding any temporal relationship between rumination and depressive symptoms [
60]. In the present study, the only notable connection with rumination included a directed effect from helplessness predicting rumination at the consecutive day. This finding suggests that helplessness may play a more prominent role in the maintenance and across-day constellation of depressive symptomatology in the non-clinical population, consistent with the goal progress theory of rumination proposing rumination to be a response to failure in achieving a certain task rather than an outgoing mechanistic process [
61]. Consistent with existing studies [
16], rumination revealed undirected associations to some symptoms of depression (e.g., weaker associations with worthlessness) on both a between-subject level and within a day. However, the present findings in combination with findings from directed network studies investigating within-day relationships involving depression and rumination [
59,
60] provide indications that these associations may to a greater extent be indicative of rumination being an influenced node rather than the influencing node, with implications for interventive efforts aimed at alleviation of depressive symptoms. This finding is further partially consistent with metacognitive perspectives on depression [
25], postulating rumination to be a process
ensuing depressive symptoms as a reactional attempt to understand the reason for their presence and in attempts of identifying solutions to the problem. However, the present study does find indications of rumination subsequently influencing depressive symptoms in turn, which is also postulated by the theory. Still, given the multimodal complexity of rumination [
62,
63], the literature will benefit from further temporal examinations of depressive symptoms simultaneously investigating rumination along with other psychopathological mechanisms of relevance, to better understand its specific as well as comparative interaction with depressive components.
The findings of the present study further shed some light on the interactions between depressive symptomatology and mechanistic processes that operate on a faster time scale than an across-day basis. In the present study, this reflects the identified interactions in the contemporaneous network, which cautiously provide indications of associations among nodes that may occur within person during a given day. Meaningful connections emerged between lethargy within individuals in its association with reduced sleep satisfaction within the same time window, while being more productive than usual was associated with lower anhedonia and lethargy. Loneliness was a central node with important connections to depressive symptoms and contextual variables across all three networks. On a within-person level, loneliness displayed its largest connectivity within a day, with the findings indicating that while individuals felt greater loneliness than their own average, this was associated with greater within-person intensity of depressed mood and anhedonia. Consistent with a study by Fried and colleagues [
44] on the student population, the present study found higher within-person levels of loneliness to be associated with reduced relatedness and in-person contact. The present study supports and adds to these findings by extending the time period of investigation to later stages of the pandemic and a broader demographic composition of participants, in addition to identifying detrimental associations between loneliness and depressed mood.
Notably, on the within-person level, the three psychopathological processes (i.e., helplessness, rumination, and emotion regulation difficulties) only exhibited interactions with the depressed mood and worthlessness component of depression, being unrelated to lethargy and anhedonia. These findings highlight the connection between these aforementioned cognitive-affective mechanisms with particular depressive components, providing important insights on the patterns of interaction between depressive symptoms and mechanistic processes. Simultaneously, they also leave important gaps in the literature concerning the identification of pathological processes more closely intertwined with lethargy and anhedonia on the within-person level.
Risk factors associated with depressive symptoms across subjects
Across subjects, in-person social contact was revealed as the type of social interaction with the strongest association with relatedness, with those who reported being more frequently engaged with such face-to-face contact compared to their peers also reporting greater relatedness. Moreover, individuals who on average felt more connected to their peers during the pandemic reported greater levels of productivity, further mirrored by within-person relationships to outline several beneficial associations of relatedness. However, although relatedness was connected to anhedonia on a between-subject level, this connection was not present in any of the within-person networks (i.e., temporal and contemporaneous network). This demonstrates the importance of separating between- and within-person effects [
8,
11,
12,
14], with this finding implying that it is unlikely that relatedness is directly associated with anhedonia. Rather, as also revealed by the within-person networks, relatedness is more indirectly connected to depressive symptoms through its association with loneliness.
Between-person associations were further identified between information access and sleep, with those who on average reported sufficient access to information about the pandemic situation reporting greater sleep satisfaction compared to their peers. Still, no within-person relationships emerged for this association. Moreover, no social contact component other than in-person social contact revealed notable beneficial associations across any of the investigated networks, with other social contact components additionally portraying detrimental associations to depressive states. Specifically, consistent with previous findings [
31,
64], individuals who compared to their peers who were more engaged in passive social media use had a greater risk of being associated with higher levels of anhedonia, in addition to lower productivity. Yet, again, however, no meaningful within-person detrimental association emerged between social media use and anhedonia, suggesting the limited likelihood of this factor being associated with within-person fluctuations in depressive states when controlling for all other variables in the network. Additionally, no beneficial within-person associations were identified with digital social contact. Taken together, these findings highlight solely in-person social contact as having a potentially important role on a within-person basis through this variable association with loneliness and relatedness. As loneliness is an important problem in itself [
36] and further was found to be connected to depressed mood across days on the within-person level in this study, this finding implies that attempts to find an optimal balance between strength of viral mitigation protocols and appropriate levels of in-person social contact, the latter of which the present findings reveal to be hard to substitute by other social contact types, may be of utility in combating the concurrently ubiquitous presence of loneliness. Clever behavioral interventions at the population level, including the use of social bubbles, may serve as utile strategies that can simultaneously reap the psychological benefits of reduced loneliness while maintaining control over viral spread [
65]. As for depressive symptoms, however, the present study does not identify any direct within-person relationship between social contact and depressive symptomatology, suggesting that efforts toward alleviation of depressive symptoms may be more fruitful when aimed at other identified mechanistic and contextual variables.
Other notable findings
The social contact components were negatively associated in the contemporaneous network, reflecting that while an individual is engaged in a greater extent of in-person social contact than their own average, they are less involved in digital social contact within the same window of time. This stands in informative contrast with the positive associations between these components in the between-subject network, which highlights that people who on average are more engaged with in-person social contact compared to their peers likely also are people who to a greater extent are engaged in both social media use and digital social contact. In other words, social individuals are sociable, likely to report higher levels of engagement compared to their peers among a wide range of social activities (i.e., between-subject network), but being engaged with one social activity in a given time window reduces the opportunities of being engaged with another social activity within the same time window (i.e., contemporaneous network). This contrasting finding between the two networks highlights the importance and utility of disentangling between within-person and between-person relationships. This is further emphasized through the positive connection identified between emotion regulation difficulties and worthlessness on a within-person level, while this relation was absent across individuals. In other words, while individuals experienced greater emotional regulation difficulties than their own average, this was associated with increased feelings of worthlessness during that day (i.e., a within-person effect). However, individuals who have greater emotion regulation difficulties compared to their peers are not likely to be individuals who feel worthlessness. Within-person and between-person relationships are not necessarily coherent, and the inappropriate generalizations from the between- to the within-level has been referred to as ecological fallacy [
8,
66]. In its investigation of within-person relationships among multiple theorized detrimental processes, the present study fills the gaps [
7,
17] in progressing the understanding of psychopathological mechanisms connected to depressive symptomatology in the general population.
Moreover, physical activity and digital social contact were consistently among the least central and influential node across all networks, outlining their limited relevance and involvement in depressive states when controlling for all other nodes in the network during the present pandemic context. Specifically, as no particularly notable within-person relationship was present between these variables and depressive symptoms, the present findings suggest that future efforts toward identification of variables that may impede deleterious symptoms within subjects best are aimed at other central components of symptom maintenance, such as helplessness and emotion regulation skills building. The findings of the present study thus imply that promising interventive targets warranting investigation in future controlled studies may include testing whether and how techniques such as cognitive restructuring and behavioral activation may temporally interact and impact perceptions of helplessness and lethargy, respectively.
Finally, this study introduces the usage and utility of radar plots in visualizing key information about network centrality metrics, with the results of the temporal network model outlining the comparative extent of involvement of a given node as an outgoing node at an across-day basis versus as a node more strongly tied to being influenced from other nodes at the previous day. Both loneliness, helplessness, and lethargy had greater strength as outgoing nodes in contrast to being influenced. As relationships in temporal networks are indicative of Granger causal effects, these findings preliminary indicate the greater likelihood that helplessness, loneliness, and lethargy may play in serving as engines in the network, to a greater extent being associated with activation of other nodes. However, as Granger causal effects do not necessarily equate true causal processes and only satisfy its temporal criterion, these findings warrant further investigation in future studies. Other drastic differences were found for in-person social contact in terms of its relative position as an influential node versus being influenced, a finding which is meaningful in the present pandemic setting.
Both anhedonia and depressed mood were more likely to be impacted by other nodes at the previous day than having across-day carry-over effects. Across three of four centrality estimations (i.e., with the exception of outstrength centrality), depressed mood and anhedonia were the most central nodes in the networks, which provides support for their position as the key identifiers of depression [
40]. Importantly, however, these findings illuminate their more limited outgoing involvement in depressive states, highlighting lethargy and worthlessness to have stronger outgoing impact on other symptoms.
Strengths and limitations
The present paper consists of several limitations. First, the conclusions of this paper have to be interpreted in light of the underlying assumptions of the statistical model. More specifically, we interpreted a lack of relationships in the temporal network as indicative of potentially faster interactions between depressive symptoms and related components [
24]. This interpretation assumes that meaningful interactions can in principle be captured using linear lag-1 models. An alternative explanation for the lack of detected temporal relationships is that these could be nonlinear or time-varying [
67‐
70], which calls for further investigations using other modeling approaches. Furthermore, although the study investigated some of the most central theorized mechanisms in the psychopathological literature, the edge weights were generally smaller in the temporal network than the other networks, as commonly the case in multi-level network analytic studies [
44,
52]. This further highlights the necessity of advancing current and building novel theories through formalization and incorporation of the time-scales which phenomena may operate on [
70,
71]. Finally, the modeled relationships in the present paper are on the average within-person level, calling for idiographic efforts [
72] in inspecting how closely such within-person aggregations correspond to the level of the individual.
This study consists of several strengths, including that it was pre-registered with a clear rationale preceding the selection of variables. Additional strengths include the use of validated measures, its focused time window of measurement corresponding to the DSM-V depressive symptom endorsement assessment, longitudinal design, broad demographic composition of participants, and conducted sensitivity analyses on a fully representative sample replicating the main findings. Moreover, the robustness and replicability of the network models and their corresponding estimated parameters were assessed across four additional subsamples, revealing high robustness of the results. Importantly, the investigation of psychopathological mechanisms in a non-clinical population provides insight into the processes that may be involved in the formation and maintenance of detrimental depressive states which may turn to more enduring problems. A major strength of the present study includes the focus on within-person rather than between-person relationships. This is an asset because theories in psychopathology concern how within-person change in a mechanism variable relates to within-person change in symptoms. Important differences were identified between these two divergent types of relationships, providing clearer directions concerning promising targets for intervention that should be investigated in future studies. The present study is among the largest intensive longitudinal investigations of psychopathology in the adult population, contributing to the stability of its results. Further efforts to assess the replicability of the presented findings in independent samples and in the clinical population would benefit the literature. Finally, the use of longitudinal data and multi-level approach is powerful and overcomes many of the short-comings experienced in dynamic modeling.