Beyond symptom severity: Prognostic information from subjective person‐specific problem networks in young people

Abstract Background Person‐specific network models are increasingly proposed to support personalized assessment and psychotherapy, but it remains unclear whether the information they contain is prospectively informative in young people. We tested whether characteristics derived from a brief perceived causal network (PECAN), particularly its perceived relational structure, provided prognostic information about subsequent psychopathology beyond baseline symptom severity. Methods Participants were 361 children, adolescents, and young adults assessed by self‐report or parent‐report. At baseline, participants selected personally relevant problems, rated their severity, and indicated how they perceived these problems to be related. Psychopathology was assessed with the pediatric symptom checklist (PSC‐D) at baseline and approximately 4, 8, and 12 weeks later. Linear mixed‐effects models examined prospective associations of PECAN characteristics with psychopathology. Exploratory post hoc analyses additionally examined problem breadth, defined as the number of personally relevant problems selected. Results Global characteristics of perceived problem relations showed little consistent incremental prognostic information beyond baseline psychopathology and problem breadth. Mean perceived causal strength and maximum normalized weighted outdegree were not associated with subsequent psychopathology, while an inverse association with network density emerged only in self‐report and was not robust across sensitivity analyses. In exploratory analyses, greater problem breadth was associated with higher subsequent psychopathology in both self‐report and parent‐report, and these associations remained essentially unchanged after adjustment for conventional PSC‐D symptom breadth. Conclusion The first prospective evaluation of PECANs provided limited support for incremental prognostic information contained in global perceived relational characteristics. Exploratory analyses nevertheless identified problem breadth as a potentially informative compositional characteristic of personalized problem representations. These findings suggest that different components of person‐specific models should be evaluated separately and highlight the need for confirmatory replication before they inform personalized clinical decisions.