The associations of Positive and Negative Valence Systems, Cognitive Systems and Social Processes on disease severity in anxiety and depressive disorders

Bernd R Förstner; Sarah Jane Böttger; Alexander Moldavski; Malek Bajbouj; Andrea Pfennig; André Manook; Marcus Ising; Andre Pittig; Ingmar Heinig; Andreas Heinz; Klaus Mathiak; Thomas G Schulze; Frank Schneider; Inge Kamp-Becker; Andreas Meyer-Lindenberg; Frank Padberg; Tobias Banaschewski; Michael Bauer; Rainer Rupprecht; Hans-Ulrich Wittchen; Michael A Rapp; Mira Tschorn

doi:10.3389/fpsyt.2023.1161097

The associations of Positive and Negative Valence Systems, Cognitive Systems and Social Processes on disease severity in anxiety and depressive disorders

Front Psychiatry. 2023 Jun 16:14:1161097. doi: 10.3389/fpsyt.2023.1161097. eCollection 2023.

Authors

Bernd R Förstner¹, Sarah Jane Böttger¹, Alexander Moldavski², Malek Bajbouj³, Andrea Pfennig⁴, André Manook⁵, Marcus Ising⁶, Andre Pittig^{7

8}, Ingmar Heinig⁷, Andreas Heinz⁹, Klaus Mathiak^{10

11}, Thomas G Schulze^{12

13

14}, Frank Schneider^{10

15}, Inge Kamp-Becker¹⁶, Andreas Meyer-Lindenberg², Frank Padberg¹⁷, Tobias Banaschewski¹⁸, Michael Bauer⁴, Rainer Rupprecht⁵, Hans-Ulrich Wittchen^{7

17}, Michael A Rapp¹, Mira Tschorn¹

Affiliations

¹ Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany.
² Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany.
³ Charité-Universitätsmedizin Berlin, Department of Psychiatry, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
⁴ Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
⁵ Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
⁶ Max Planck Institute of Psychiatry, Munich, Germany.
⁷ Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany.
⁸ Translational Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany.
⁹ Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
¹⁰ Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.
¹¹ JARA-Brain, Research Center Jülich, Jülich, Germany.
¹² Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.
¹³ Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.
¹⁴ Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, United States.
¹⁵ University Hospital Düsseldorf, Medical School, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
¹⁶ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University Marburg, Marburg, Germany.
¹⁷ Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
¹⁸ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany.

Abstract

Background: Anxiety and depressive disorders share common features of mood dysfunctions. This has stimulated interest in transdiagnostic dimensional research as proposed by the Research Domain Criteria (RDoC) approach by the National Institute of Mental Health (NIMH) aiming to improve the understanding of underlying disease mechanisms. The purpose of this study was to investigate the processing of RDoC domains in relation to disease severity in order to identify latent disorder-specific as well as transdiagnostic indicators of disease severity in patients with anxiety and depressive disorders.

Methods: Within the German research network for mental disorders, 895 participants (n = 476 female, n = 602 anxiety disorder, n = 257 depressive disorder) were recruited for the Phenotypic, Diagnostic and Clinical Domain Assessment Network Germany (PD-CAN) and included in this cross-sectional study. We performed incremental regression models to investigate the association of four RDoC domains on disease severity in patients with affective disorders: Positive (PVS) and Negative Valance System (NVS), Cognitive Systems (CS) and Social Processes (SP).

Results: The results confirmed a transdiagnostic relationship for all four domains, as we found significant main effects on disease severity within domain-specific models (PVS: β = -0.35; NVS: β = 0.39; CS: β = -0.12; SP: β = -0.32). We also found three significant interaction effects with main diagnosis showing a disease-specific association.

Limitations: The cross-sectional study design prevents causal conclusions. Further limitations include possible outliers and heteroskedasticity in all regression models which we appropriately controlled for.

Conclusion: Our key results show that symptom burden in anxiety and depressive disorders is associated with latent RDoC indicators in transdiagnostic and disease-specific ways.

Keywords: RDoC; Research Domain Criteria; anxiety disoders; depression; disease severity; transdiagnostic.

Copyright © 2023 Förstner, Böttger, Moldavski, Bajbouj, Pfennig, Manook, Ising, Pittig, Heinig, Heinz, Mathiak, Schulze, Schneider, Kamp-Becker, Meyer-Lindenberg, Padberg, Banaschewski, Bauer, Rupprecht, Wittchen, Rapp and Tschorn.