Why do we sometimes overcome stressful events with ease, while we in other periods experience difficulties in response to such adversities? Why do individuals react differently to the same event?

The Critical Incidents and Psychological Adaptation (CIPA) study is a nationally representative, longitudinal investigation of mental health in the general population in Norway.

By monitoring 5.5 million individuals through registries and over 20,000 participants via self-report over a 15-year time period, encompassing impactful events in their daily lives in addition to incidents of national and international significance, the CIPA study aims to elucidate the complex interplay between these critical events and individual susceptibilities in increasing the risk of developing common mental health disorders.

A longitudinal investigation across different time scales

The CIPA study investigates fluctuations in mental health as they manifest across different timescales, ranging from hourly and daily occurrences to longitudinal shifts spanning months and years.

The first temporal component of the study encompasses the monitoring of close to 20,000 participants through longitudinal panel measurements, providing assessments across a range of monthly and annual time scales.

The second temporal component of the study includes the examination of a sub-sample of over 3,500 individuals using an Ecological Momentary Assessment (EMA) design. This approach entails collecting four daily measurements per participant for a continuous 30-day period, culminating in 120 assessments per individual to yield a total of 420,000 intensive longitudinal observations of mental health symptoms and accompanying psychological processes across the sub-sample.

Third, access to electronic health records and population registries from 1970 to date, enables a comprehensive investigation of time trends and changes in mental disorder prevalences over the past decades.

Random probability sample obtained from population registries

The CIPA study embodies a random probability sample of the population through the retrieval of population lists from Norwegian registries. This enables the inclusion and representation of diverse subgroups of the population to facilitate a comprehensive examination of the population under investigation.

Multimodal data sources and a dynamical systems approach

The CIPA study combines four sources of information to augment our understanding of how common mental health disorders arise and are maintained in the population.

1. Access to electronic health record or registry data provides the study with objective and clinician-rated data, such as hospital visitations and medical history. Beyond the availability of registry data in the 20,000 participants of the study, registry data are retrieved for ~ 5.5 million, including adults, children and adolescents, representing the full Norwegian population.

2. Longitudinal assessments on longer time scales through its 15-year period provide information about changes in mental health on the population and individual level across personal and (inter)national critical events that arise over time.

3. Ecological Momentary Assessment (EMA) data equips the study with the ability to divert a granular focus toward how psychopathology forms on an individual and population level.

4. Natural language data are collected to enable an unrestricted and open assessment of changes in mental health over time.

A systems-based approach
Leveraging these different data sources, the CIPA study employs a dynamical systems approach to understand how contextual risk factors and biopsychosocial processes interact to form common mental health disorders.

Toward a more precise understanding of mental disorder formation and resilience

The rich demographic information available in the study enables an investigation of individual differences in how distinct patterns of interplay between contextual variables and biopsychosocial processes can promote resilience against, or contribute to the manifestation of mental health disorders.

Ethical approval

The study has been ethically approved by the Regional Committee for Medical and Health Research Ethics (reference: 522020).

Inquiries about the CIPA study

Questions about the CIPA study can be directed to its Principal Investigators.