Toward empirical process-based case conceptualization : An idionomic network examination of the process-based assessment tool

Background: Syndromal classification has failed to produce a progressive science of case conceptualization for mental and behavioral health issues. An idiographic application of processes of change can provide a viable empirical functional analytic alternative if it could be linked to an idionomic approach, modeling idiographic effects first, and retaining nomothetic findings if they improve idiographic fit. Method: The present study examined this possibility by using the Process-Based Assessment Tool (PBAT), a new assessment tool linked to the Extended Evolutionary Meta-Model (EEMM) of Process-Based Therapy. The PBAT and items assessing common clinical outcomes were assessed repeatedly in 50 individuals in an experience sampling format over a 35 day period yielding at least 60 measurement occasions per person. These data were then analyzed in an idionomic fashion using Group Iterative Multiple Model Estimation (GIMME). Results: Analyses showed that the PBAT related to common clinical outcomes for virtually all participants in the individual complex networks identified by GIMME. Data showed that relationships had to be studied using an idionomic approach because participants’ responses violated the ergodic assumptions underlying classical normative statistics. No overall group patterns were found. Subgroup relations did emerge for three common outcomes (sadness, anxiety, and life satisfaction) but most process to outcome relationships were idiographic. Idiographic networks were interpretable, however, using the broadened psychological flexibility approach of the EEMM. Conclusion: Idionomic network analysis of processes of change may provide a replicable form of empirical functional analysis and process-based case conceptualization.