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是重要的，因为它们对主观幸福感有深刻的负面影响，而且精神病性障碍与预期寿命缩短有关。此外，这些症状造成的高昂经济成本使得有必要采取有效的干预措施。为了改善精神病症状的心理学方法，有希望的是：a）在了解症状变化机制的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。EMI，主要是基于智能手机，随时可用，可以达到任何人与相应的，相对较低的价格，技术设备。尽管有巨大的潜力，但这种方法也有提供不充分或非科学干预的风险，很容易通过应用程序传播。为了负责任地将这些技术应用于精神疾病，我们希望建立一个国际研究人员合作组织。在这个网络中，核心精神病症状的基础和干预研究的深刻知识，以及EMI方法和在更广泛的精神障碍领域的实施方面的专家知识相结合。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变化机制的理解。这些机制包括先于精神病核心症状的认知、情感和生理因素，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，我们希望从对靶机制的理解中推导和发展EMI。然后将通过优化的决策规则和算法结合日常生活症状评估进行干预试验，并通过成功监测进行评估。拟议的科学网络主要由早期职业水平的成员组成-使其能够与既定的专家成员和嘉宾进行交流，并在生物技术领域开展国际和国家合作。该网络成果的具体目标是：就有希望的EMI目标机制达成一致;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;对不同目标机制进行试点研究，并为不同症状领域设计EMI;联合出版物;并编制供资提案，以继续开展国际和国家合作。为此，计划在汉堡大学举行五次网络会议以及一次专题讨论会，在最后一次会议上向公众介绍成果和未来目标。

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.