Transdiagnostic approaches to mental health after traumatic brain injury

Psychopathology is a prevalent yet inadequately addressed feature of traumatic brain injury (TBI). The current approach to classifying psychopathology in individuals with TBI is guided by traditional categorical diagnoses within the Diagnostic and Statistical Manual of Mental Disorders, (DSM) but this approach possesses well-established challenges. Numerous reviews have identified transdiagnostic approaches to psychiatric classification as a promising way of enhancing our understanding and treatment of post-TBI psychopathology. However, there has been minimal empirical research on this topic. In this talk, Jai will present three studies from his PhD focused on using transdiagnostic approaches to characterize psychopathology after moderate-severe TBI.
The first study demonstrates an issue with traditional categorical diagnoses: individuals with the same diagnosis can exhibit different sets of symptoms. We investigate this issue in the context of the traditional diagnosis of ‘major depressive disorder’, a widely studied construct in individuals with TBI.

The second study employs psychometric network analysis, a transdiagnostic approach, to shift the focus away from heterogenous diagnostic categories of psychopathology towards the unique roles of individual symptoms. Specifically, this study examines the connections between individual symptoms of anxiety and depression after moderate-severe TBI, as well as the pathways linking these symptoms to injury-related factors.

The third study provides one of the most detailed characterisation of post-TBI psychopathology to date. Using a latent variable modelling approach, this study constructs an empirical, dimensional-hierarchical model of psychopathology following TBI based on the Hierarchical Taxonomy of Psychopathology (HiTOP). The resulting model offers a tailored empirical classification system for psychopathology after TBI, encompassing 57 psychiatric symptoms and traits. This approach moves beyond the confines of the DSM and can overcome its limitations.
The talk will conclude with an overarching discussion about the potential utility of transdiagnostic approaches for individuals with TBI and obstacles to clinical translation.