Belli, Stefano;
(2025)
Using Network Analysis to Identify Processes of Change in Low-Intensity CBT Interventions for Emotional Disorders.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
This thesis comprises three parts. Part 1 is a systematic literature review and meta-analysis. It reviewed 68 cross-sectional network studies which measured anxious symptoms using the Generalised Anxiety Disorder Questionnaire (GAD-7). The review considered studies’ sample characteristics as well as how networks were estimated, analysed and reported, with reference to established reporting standards. Correlation matrices were extracted from studies and used to estimate a Meta-Analytic Gaussian Network Aggregation (MAGNA). “Uncontrollable worry” was the most influential node in the MAGNA (N = 298, 212), and networks were extremely similar across clinical and non-clinical samples. Clinical implications are discussed, as well as research implications of having a robust reference meta-network of anxious symptoms. Part 2 is an empirical project using network analysis to explore processes of change during successful low-intensity CBT for depression, generalised anxiety disorder and panic disorder. NHS data (N = 12, 550) were analysed in nine Gaussian graphical models (GGMs): during three time-phases across treatment, separately for each disorder. Each GGM included 19 nodes (nine depressive items from the PHQ-9, seven anxious items from the GAD-7 and three phobic items), and used residual scores as indices of change for each node. Networks of symptom change were similar between disorders, and over the course of therapy. Shared and distinct features across the nine networks are discussed in regard to clinical and research implications. Part 3 is a critical appraisal of the work involved in this thesis and includes reflections on the process as a whole.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | Using Network Analysis to Identify Processes of Change in Low-Intensity CBT Interventions for Emotional Disorders |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| Keywords: | Agoraphobia, Anxiety, Anxious symptoms, CBT, Clinical Psychology, Cognitive Behavioural Therapy, Depression, GAD, GAD-7, Generalised Anxiety Disorder, MAGNA, Meta-analysis, Network analysis, Network meta-analysis, Panic Disorder, PHQ-9, Psychology, Systematic Review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10213924 |
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