Dynamic Time Warp (DTW) as a scalable, data-efficient, and clinically relevant analysis of dynamic processes in patients with psychiatric disorders: a tutorial

Journal of Eating Disorders, vol. 13, pp. 230

Abstract

Dynamic Time Warping (DTW) is an emerging analytic technique that offers a flexible approach to modeling symptom dynamics in psychological and psychiatric research. Unlike traditional network models, which often rely on linear associations, DTW aligns symptom trajectories even when changes unfold at slightly different speeds or time intervals. This tutorial offers a brief introduction into DTW and demonstrates how to apply DTW to panel or time series data. We illustrate the workflow using clinical case data from patients with eating disorders, to capture temporal patterns that cannot be detected with conventional network analysis techniques, as these require more intensive time-series data. Key advantages include its applicability to non-stationary data, flexibility in handling irregular time intervals, and reduced reliance on frequent assessments, which patients often cannot maintain due to the burden. We also discuss some of the limitations such as noise, scaling decisions and lack of Granger causality associations. Finally, we outline directions for future research. By expanding the methodological toolkit available for studying therapy processes, DTW holds promise for advancing both research and clinical practice in personalized mental health care.

Authors 2

1. Maren C. G. Kopland corresponding

   University of Oslo

   Affiliation as printed

   Department of Psychology, University of Oslo, Oslo, Norway. marencgk@gmail.com

   Modum Bad Psychiatric Hospital, Badeveien 287, 3370, Vikersund, Norway. marencgk@gmail.com

   Department of Psychology, University of Oslo, Oslo, Norway

   Modum Bad Psychiatric Hospital, Badeveien 287, 3370, Vikersund, Norway

2. Erik J. Giltay Aachen Department of Psychiatry, Leiden University Medical Center Health Campus The Hague

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, the Netherlands

   Health Campus The Hague, Leiden University, The Hauge, The Netherlands