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

• Applicant: Professorin Dr. Annika Clamor
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: since 2020
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 446018838

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.

• DFG Programme: Scientific Networks
• Co-Investigator: Professorin Tania Marie Lincoln, Ph.D.