Mechanisms of change in psychosis: Bridging the gap between symptom formation and interventions within the context of daily life.

精神病症状的有效治疗很重要，因为它们对主观幸福感有深远的负面影响，而且精神病与预期寿命缩短有关。此外，这些症状造成的高经济成本使得非常有必要采取有效的干预措施。为了改善精神病症状的心理治疗方法，有希望的是：a)在症状变化机制的知识基础上建立干预措施；b)以更灵活和更容易获得的方式实施这些干预措施。这两个挑战的解决方案可以在生态瞬时干预（EMI）的可能性中寻求。EMI主要基于智能手机，随时可用，任何人都可以使用价格相对较低的技术设备。尽管潜力巨大，但这种方法也有提供不充分或不科学干预的风险，很容易通过应用程序传播。为了负责任地在精神疾病中实施这些技术，我们希望形成一个研究人员的国际合作。在这个网络中，来自核心精神病症状的基础和干预研究的深厚知识，以及关于电磁干扰方法和在更广泛的精神障碍领域实施的专家知识被结合在一起。科学网络有两个主要目标。首先，我们希望提高对精神病症状改变机制的理解。这些机制包括先于精神病核心症状的认知、情绪和生理因素，可能与症状的形成和维持有因果关系，是有希望的干预目标。其次，我们希望从对目标机制的理解中推导和发展EMI。然后，通过优化的决策规则和算法，将干预措施与日常生活症状评估结合起来进行试验，并通过成功监测进行评估。拟议中的科学网络主要由处于早期职业水平的成员组成，从而使其能够与已有的专家成员和嘉宾进行交流，并在一个蓬勃发展的领域实施国际和国家合作。网络成果的具体目标是：就有希望的环境监测目标机制达成协议；同意研究人员将在未来研究中应用的评估工具，以便更好地比较该领域的未来结果；开展针对不同目标机制的试点研究和针对不同症状域的电磁干扰设计；联合出版物;并为继续开展国际和国家合作准备资助提案。为此，计划举行五次网络会议以及在Universität汉堡举行的最后一次会议上向公众介绍结果和未来目标的专题讨论会。

An effective treatment of psychotic symptoms is important because of their profound negative impact on subjective well-being and because psychotic disorders are associated with a diminished life expectancy. Furthermore, high economic costs caused by these symptoms make accessible and efficient interventions highly warranted. In order to improve psychological approaches to psychotic symptoms, it is promising to a) establish interventions on the basis of knowledge on mechanisms of change in symptoms and to b) implement these interventions in a more flexible and accessible manner. Solutions for both of these challenges may be sought in the possibilities of ecological momentary interventions (EMI). The EMI, mostly smartphone based, are readily available at all times and can reach anyone with the according, comparatively low priced, technical equipment. Despite its enormous potential, this approach also bears the risk of providing insufficient or non-scientific interventions, easily spreadable via apps. To responsibly implement these technologies in psychotic disorders, we want to form an international collaboration of researchers. In this network, profound knowledge from basic and intervention research for core psychotic symptoms, as well as expert knowledge on EMI methods and on the implementation in the broader field of mental disorders are combined. There are two main goals of the scientific network. First, we want to improve the understanding of mechanisms of symptom change in psychosis. These mechanisms include cognitive, emotional, and physiological factors that precede the core symptoms of psychosis, are likely to be causally involved in the formation and maintenance of symptoms, and are promising targets for interventions. Second, we want to derive and develop EMI from this understanding of target mechanisms. The intervention will then be trialled in combination with daily life symptom assessment via optimised decision rules and algorithms and evaluated via success monitoring. The proposed scientific network comprises mainly members at an early career level – enabling the exchange with established expert members and guests and the implementation of international and national collaborations in a prospering field. Specific goals for outcomes of the network are: agreement on promising target mechanisms for EMI; consent on assessment tools that the researchers will apply in future studies to enable a better comparison of the future results in the field; the conduction of pilot studies for different target mechanisms and EMI design for different symptom domains; joint publications; and preparation of funding proposal(s) to continue the international and national collaboration. For this, five meetings of the network as well as a symposium with the presentation of results and future aims to the public at the final meeting at the Universität Hamburg are planned.