The dynamics of psychosocial crises: time courses and causal models

The time courses of 34 psychosocial crises were studied at an inpatient psychiatric crisis intervention unit. For data acquisition, patients were instructed to rate their tension, activity, and mood in self-report scales, three times a day. The onset of crises before index admission was assessed by retrospective interviews. A combination of pre/post comparisons and time series analyses was used to evaluate the effectiveness of crisis intervention and to specify typologies of crises. Although distinct crisis trajectories were found at the group level that clearly reflect global treatment effects, there was little indication of specificity using a pre/post design. Consequently, the use of more find-grained longitudinal methods is proposed. Time series models of individual patients (single systems approach) are helpful in designing appropriate therapeutic strategies. Agglutination of single case models points to distinct crisis courses, in which a cluster of depressive reactions is prominent. Consequently, a dynamic systems approach is suggested for application in psychiatry and psychology.