Rigidity in psychiatric disorders

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In the past decades, it has been proven difficult to predict the course of psychiatric disorders, because the mechanisms underlying their development and recovery process remain poorly understood. UMCG researcher and Health Psychologist Michelle Servaas and colleagues propose to adopt a transdiagnostic, cross- level, mechanistic approach informed by clinical observations on rigidity in psychiatric patients to improve the prediction of course of illness.

More rigid cognitions, emotions and behavior during the progression of psychiatric disorders

Clinicians frequently observe that patients, regardless of their diagnostic label, develop more rigid cognitions, emotions and behavior during the progression of their psychiatric disorder. Although content is clearly important for patients, these observations suggest that the degree of perseveration of cognitions, emotions and behavior could be more relevant when searching for mechanisms underlying the course of psychiatric disorders. 

Prolonged rigidity in these domains may ultimately result in the development of maladaptive schemas and traits, which in themselves increase the risk for psychiatric chronicity. Hence, rigidity may be an informative concept on the position of a patient on a transdiagnostic continuum of severity of psychiatric symptoms.

Investigating the concept of rigidity

Servaas and colleagues propose to devote research efforts to investigating the concept of rigidity, defined as an inability to flexibly adapt cognitions, emotions and behavior in response to changes in the environment. Specifically, they suggest to study: 

  1. Aforementioned domains dynamically using repeated measurements over time during daily life (psychological level),
  2. how this form of psychological rigidity is related to rigidity in dynamic functioning of the brain (biological level), 
  3. how associations between these two rigidity measures dynamically change during illness progression and recovery to uncover markers regarding course of illness.

‘We expect this approach to be of great benefit to the clinic, beyond the boundaries of specific diagnoses. For example, we could find 'markers' that are important to identify upcoming recovery or a relapse on time. Or we can use these markers to improve the efficacy of specific treatments that target rigidity. This can lead to important clinical innovations that hopefully ensures people will have less frequent and long-lasting psychiatric complaints.’ said Michelle Servaas. 

Servaas her comment ‘Trapped: rigidity in psychiatric disorders’ has been published in the Lancet Psychiatry. 
Read the article

Rigidit-i research project

Furthermore, Servaas and colleagues received funding from the PPO research fund to work on a research project called Rigidit-i. ‘In this study we will investigate whether there is indeed more rigidity in thoughts, feelings and behavior, when patients experience more severe depressive symptoms. The next step is to investigate if this rigidity in thoughts, feelings and behavior can predict the severity of depressive symptomatology during a six-month follow-up. 

Rigidit-i is an independent substudy of the research project Therap-i and will continue until 2025. You can stay updated on the outcomes of this study and related studies on the department page from the University Center of Psychiatry.