title: Ecological Interventionist Causal Models in Psychosis: Targeting Psychological Mechanisms in Daily Life.
abstract: Integrated models of psychotic disorders have posited a number of putative psychological mechanisms that may contribute to the development of psychotic symptoms, but it is only recently that a modest amount of experience sampling research has provided evidence on their role in daily life, outside the research laboratory. A number of methodological challenges remain in evaluating specificity of potential causal links between a given psychological mechanism and psychosis outcomes in a systematic fashion, capitalizing on longitudinal data to investigate temporal ordering. In this article, we argue for testing ecological interventionist causal models that draw on real world and real-time delivered, ecological momentary interventions for generating evidence on several causal criteria (association, time order, and direction/sole plausibility) under real-world conditions, while maximizing generalizability to social contexts and experiences in heterogeneous populations. Specifically, this approach tests whether ecological momentary interventions can (1) modify a putative mechanism and (2) produce changes in the mechanism that lead to sustainable changes in intended psychosis outcomes in individuals' daily lives. Future research using this approach will provide translational evidence on the active ingredients of mobile health and in-person interventions that promote sustained effectiveness of ecological momentary interventions and, thereby, contribute to ongoing efforts that seek to enhance effectiveness of psychological interventions under real-world conditions.
authors.affiliation: Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; u.reininghaus@maastrichtuniversity.nl.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Reininghaus
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA; VA San Diego Healthcare System, San Diego, CA;
authors.forename: Colin A
authors.initials: CA
authors.lastname: Depp
authors.affiliation: Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven, Belgium.
authors.forename: Inez
authors.initials: I
authors.lastname: Myin-Germeys
mesh_terms: D006801:Humans; D008960:Models, Psychological; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D012559:Schizophrenia / Q000503:physiopathology* / Q000628:therapy; D012565:Schizophrenic Psychology
keywords: causal criteria; ecological momentary intervention; experience sampling methodology; psychological intervention; schizophrenia