Tania M Lincoln

• Phd
• Head of Department at Hamburg University

Psychosocial Approaches to Negative Symptoms in Psychosis provides cutting edge information about psychotherapeutic intervention and assessment of negative symptoms. Negative symptoms are known to be the most debilitating aspect of psychotic disorders and are difficult to treat. Psychopharmacological interventions have been shown to have little imp...

Purpose To present a treatment protocol for Relating Therapy—a novel psychological intervention which supports adults to respond assertively to their distressing voice hearing experiences. Method This paper reports the background to the development of Relating Therapy. Thereafter, the four phases of the therapy are described: (1) exploring the hea...

Der Krankheitsbegriff “Schizophrenie”, abgeleitet aus den altgriechischen Wörtern schizein („spalten, zersplittern“) und phrēn („Geist, Seele“), geht auf den Schweizer Psychiater Eugen Bleuler (1911) zurück, der genaugenommen bereits den Plural Schizophrenien vorschlug. Im Vergleich zu dem zuvor von Emil Kraepelin (1896) verwendeten Begriff „Dement...

Background Prediction models that can detect the onset of psychotic experiences are a key component of developing Just-In-Time Adaptive Interventions (JITAI). Building these models on passively collectable data could substantially reduce user burden. In this study, we developed prediction models to detect experiences of auditory verbal hallucinatio...

Fear learning processes are often considered underlying mechanisms in the development and maintenance of various anxiety- and stress-related disorders. However, limited attention has been paid to whether these changes are shared across disorders or certain symptoms. In this context, transdiagnostic research on symptom dimensions is especially relev...

Background: Although meta-analyses suggest comparable efficacy of cognitive-behavioral therapy (CBT) in older adults compared to working-age adults, little is known about its effectiveness in naturalistic settings across different age groups. Hence, this study compared symptom change, attrition rates, and treatment duration in outpatient CBT betwee...

Prior psychologically traumatic experiences have been linked to increased risk for mental health conditions. However, there remain questions about the relationship between prior interpersonal trauma, particularly that of neglect and abuse, and transdiagnostic dimensions such as intolerance of uncertainty (IU: the tendency to find uncertainty aversi...

The degree to which numerous existing models of delusion formation disagree or propose common mechanisms remains unclear. To achieve a comprehensive understanding of delusion aetiology, we summarised 53 theoretical models of delusions extracted from a systematic literature search. We identified central aspects and unique or overarching features of...

Many decisions entail the updating of beliefs about the state of the environment by accumulating noisy sensory evidence. This form of probabilistic reasoning may go awry in psychosis. Computational theory shows that optimal belief updating in environments subject to hidden changes in their state requires a dynamic modulation of the evidence accumul...

Purpose Emotion regulation is a complex process that often involves the presence of others, also known as interpersonal emotion regulation (IER). However, little is known about how psychotic symptoms relate to IER. We investigated whether young adults with elevated psychosis proneness engage in IER less frequently and find it less helpful than thos...

Introduction: There is a significant demand for interventions that reduce distress related to auditory verbal hallucinations (AVHs). AVH distress is associated with the way voice hearers relate with AVHs. We aimed to establish the feasibility of a randomized controlled trial to demonstrate that adding "Relating Therapy" (RT) to treatment as usual (...

Intolerance of uncertainty (IU; the tendency to find uncertainty aversive) and paranoia (e.g., excessive mistrust of others), are both associated with anxiety and depression symptoms. While previous research has primarily focused on IU and paranoia separately, there is recent evidence to suggest that IU and paranoia are linked and may interact to i...

Mental time travel utilizes mental imagery to recollect past experiences and to prospect hypothetical future events. This elicits anticipatory affect responses that are pivotal to motivate goal-directed behavior towards pleasurable and away from threatening experiences. However, the temporal dynamics of neural, physiological and affective processin...

Mental time travel utilizes mental imagery to recollect past experiences and to prospect hypothetical future events. This elicits anticipatory affect responses that are pivotal to motivate goal-directed behavior towards pleasurable and away from threatening experiences. However, the temporal dynamics of neural, physiological and affective processin...

Effort-based decision making (EBDM) is fundamental to human motivation. This cognitive process weighs the effort required to obtain a reward against the magnitude of the reward and the probability of obtaining it. Research suggests both transdiagnostic and disorder-specific patterns of maladaptive EBDM in people with schizophrenia spectrum (SSD) or...

The degree to which numerous existing models of delusion formation disagree or propose common mechanisms remains unclear. To achieve a comprehensive understanding of delusion aetiology, we summarised 52 theoretical models of delusions extracted from a systematic literature search. We identified central aspects and unique or overarching features of...

Emotion regulation is a complex process that often involves the presence of others, also known as interpersonal emotion regulation (IER). Nevertheless, studies on emotion regulation difficulties in psychosis and psychosis risk states have neglected IER. This study investigated whether young adults with elevated psychosis proneness engage in IER les...

Aging is accompanied by a decline of working memory, an important cognitive capacity that involves stimulus-selective neural activity that persists after stimulus presentation. Here, we unraveled working memory dynamics in older human adults (male and female) including those diagnosed with mild cognitive impairment (MCI) using a combination of beha...

Recent research suggests that cognitive deficits in individuals with psychotic disorders could be overestimated because poor cognitive test performance is partly attributable to non-cognitive factors. To further test this, we included non-hospitalized individuals with psychotic disorders (PSY, n = 38), individuals with attenuated psychotic symptoms...

Prior traumatic experiences have been linked to increased risk for mental health conditions. However, there remain questions about the relationship between prior interpersonal trauma, particularly that of neglect and abuse, and transdiagnostic dimensions such as intolerance of uncertainty (IU: the tendency to find uncertainty aversive). To address...

Predictive processing accounts of psychosis conceptualize delusions as overly strong learned expectations (prior beliefs) that shape cognition and perception. Paranoia, the most prevalent form of delusions, involves threat prior beliefs that are inherently social. Here, we investigated whether paranoia is related to overly strong threat prior belie...

Intolerance of uncertainty (IU: the tendency to find uncertainty aversive) and paranoia (e.g., excessive mistrust of others), are both associated with anxiety and depression symptoms. While previous research has primarily focused on IU and paranoia separately, there is recent evidence to suggest that IU and paranoia are linked and may interact to i...

Background Biases in risk perception (e.g. excessive attribution of likelihood of negative events happening to oneself, or perceived harm of neutral events) have been suggested as risk factors for psychopathologies such as generalised anxiety and persecutory ideation, although this line of research is limited by small samples and a lack of a suitab...

We examined the association between causal attributions and self-reported motivational negative symptoms (amotivation) in a German online community sample (n = 251). Bivariate correlations revealed significant associations between amotivation and attribution of success to external, variable, and specific causes. No associations between amotivation...

Background With efforts increasing worldwide to understand and treat paranoia, there is a pressing need for cross-culturally valid assessments of paranoid beliefs. The recently developed Revised Green et al., Paranoid Thoughts Scale (R-GPTS) constitutes an easy to administer self-report assessment of mild ideas of reference and more severe persecut...

Background Suicidal ideation is a major concern in clinical practice. Yet, little is known about prevalence rates of suicidal ideation in patients undergoing outpatient psychotherapeutic treatment. Therefore, the aim of the current study is to assess the prevalence of suicidal ideation in a large sample of psychotherapy outpatients in Germany. The...

Decreased sleep spindle activity in individuals with psychotic disorders is well studied, but its contribution to psychotic symptom formation is not well understood. This study explored potential underlying mechanisms explaining the association between decreased sleep spindle activity and psychotic symptoms. To this end, we analysed the links betwe...

Many decisions entail the updating of beliefs about the state of the environment, a process that may go awry in psychosis. When environments are subject to hidden changes in their state, optimal belief updating requires non-linear modulation of sensory evidence, which may be subserved by pupil-linked, phasic arousal. Here, we analyzed behavior and...

Although mostly considered distinct, conspiracy mentality and paranoia share conceptual similarities (e.g., persecutory content, resistance to disconfirming evidence). Using self-report data from a large and multinational online sample (N = 2510; from the UK, the US, Hong Kong, Germany, and Australia), we examined whether paranoia and conspiracy me...

Background. Meta-analyses indicate superiority of antipsychotic maintenance treatment over discontinuation within up to 24 months after treatment initiation for patients with schizophrenia-spectrum disorders. In terms of functional recovery, long-term trials show improved functioning after discontinuation, suggesting a time-dependent effect of anti...

Purpose Beliefs that emotions can be changed (i.e., malleability beliefs) are relevant to emotion regulation. Emotion regulation plays a crucial role in severe mental health symptoms, such as paranoid delusions, but it remains unknown to which extent malleability beliefs contribute to a dysfunctional pattern of emotion regulation in individuals exp...

Wahnüberzeugungen können das Leben massiv einschränken. Sie sind oft mit starken negativen Emotionen verbunden, erschweren zwischenmenschliche Kontakte und können die Betroffenen dazu bringen, ihren Alltag ganz nach ihnen auszurichten. In den letzten Jahren haben sich psychotherapeutische Ansätze als wesentliche Bausteine der Behandlung erwiesen. D...

Importance Psychotic symptoms are associated with subjective reports of aberrant emotion, such as excessive fear or anhedonia, but whether these aberrations reflect aberrant emotional experience of normative stimuli is uncertain both for individuals with schizophrenia and those at risk for psychosis. Objective To provide a meta-analysis of study s...

Aging is accompanied by a decline of multiple cognitive capacities, including working memory: the ability to maintain information online for the flexible control of behavior. Working memory involves stimulus-selective neural activity, persisting after stimulus presentation in widely distributed cortical areas. Here, we unraveled the mechanisms of w...

Deficits in sleep spindle activity in individuals with psychotic disorders could represent a neurobiological marker of (premorbid) attentional deficits and perceptual distortions that ultimately add to psychotic symptom formation. We analysed the links between sleep spindle activity and psychotic experiences and probed for the mediating roles of at...

Background The reduction of goal-directed behavior is the main characteristic in motivational negative symptoms of psychosis as it accounts for the long-term decline in psychological well-being and psychosocial functioning. However, the available treatment options are largely unspecific and show only small effects on motivational negative symptoms....

Background: Prior research has shown that negative emotion constitutes a trigger for psychosis. This effect is further amplified by using maladaptive emotion regulation strategies. In contrast, the role of adaptive emotion regulation strategies is less clear despite its potential for informing interventions and prevention efforts. In this study, w...

Background: Paranoia is higher in minority group individuals, especially those reporting intersecting aspects of difference. High negative and low positive self and other beliefs, and low social rank, are predictive of paranoia overtime; however, data are typically from majority group participants. This study examined whether social defeat or heal...

Objectives Subclinical psychotic, depression, and anxiety symptoms form a transdiagnostic ‘at‐risk state’ for the development of mental disorders. Emotion regulation has been identified as a transdiagnostic factor relevant to the formation of these symptoms that can be successfully addressed in clinical interventions. Here, we tested whether a grou...

Abnormalities in stress responsivity have been frequently reported for patients with psychosis. Since neuroimaging and animal studies suggest a connection between antipsychotic medication and reduced stress responsivity, we investigated the effects of 300 mg Amisulpride versus placebo on stress responses in healthy volunteers in a double-blind plac...

Background Anhedonia is a frequent cause of functional impairment in psychosis. Although it is plausible that medication-induced D2 receptor blockade could diminish hedonic responding, there is little experimental research testing this hypothesis in humans. Methods To inspect possible effects of partial D2 blockade on hedonic experiences, we admin...

The UCLA Loneliness Scale (ULS-20) and its short version (ULS-8) are widely used to measure loneliness. However, the question remains whether or not previous studies using the scale to measure loneliness are measuring the construct equally across countries. The present study examined the measurement invariance (MI) of both scales in Germany, Indone...

Zusammenfassung. Theoretischer Hintergrund: Das BDI-II ist ein Selbstbeurteilungsinstrument zur Erfassung des Schweregrads einer Depression. Es liegen kaum Analysen mit Modellen aus der Item-Response-Theorie (IRT) vor. Fragestellung: Wie hoch ist die Messgenauigkeit des BDI-II über die unterschiedlichen Ausprägungen des latenten Traits (Depressivit...

Background Although motivational negative symptoms account for reduced functioning and quality of life in individuals with psychotic disorders, the underlying mechanisms are yet not fully understood. Neuroimaging studies suggest that an impaired perception of reward cues could result in a lack of incentive value that then leads to a decrease in goa...

For a long time, psychotic symptoms were seen as too different from normal experiences to be explicable by psychological theories, let alone modifiable by psychological therapy. In the 1990s, the epidemiological research pointing to a continuum of psychotic symptoms and the clinical success in using cognitive approaches for psychosis strongly chall...

Psychotic experiences have been associated with distortions in affective functioning, including aberrancies in affect dynamics. However, it remains unclear whether the two principal symptom dimensions of psychosis, namely paranoid ideation and hallucination spectrum experiences, are differently associated with affect dynamics, and whether associati...

Objectives Amotivation is a common symptom in various mental disorders, including psychotic or depressive disorders. Effort‐based decision‐making (EBDM)‐tasks quantifying amotivation at a behavioral level have been on the rise. Task performance has been shown to differentiate patient groups from healthy controls. However, findings on indicators of...

Background: Anhedonia is a frequent cause of functional impairment in psychosis. Although it is plausible that medication-induced D2 receptor blockade could diminish hedonic responding, there is little experimental research testing this hypothesis in humans. Methods: To inspect possible effects of partial D2 blockade on hedonic experiences, we ad...

Background The term ‘pandemic paranoia’ has been coined to refer to heightened levels of mistrust and suspicion towards other people specifically due to the COVID-19 pandemic. In this study, we examine the international prevalence of pandemic paranoia in the general population and its associated sociodemographic profile. Methods A representative i...

Background and Hypothesis Heightened stress levels in individuals with psychosis (PSY) are associated with psychotic symptom occurrence and may be partially attributed to well-established deficits in resting-state heart rate variability (HRV) and emotion regulation. In healthy participants, resting-state HRV and self-reported emotion regulation ski...

Affective disturbances in psychosis are well-documented but our understanding of their phenotypic nature in everyday life remains limited. Filling this gap could advance mechanistic models of the affective pathway to psychosis and pave the ground for new research avenues. Therefore, this study focused on temporal affect dynamics in psychosis, i.e.,...

Background: The reduction of goal-directed behavior is the core issue in motivational negative symptoms of psychosis as it accounts for the long-term decline in psychological wellbeing and psychosocial functioning. However, the available treatment options are largely unspecific and show only small effects on motivational negative symptoms. Interven...

Background and objectives Engaging in goal-directed activities is a core difficulty of people with negative symptoms in schizophrenia. A previously developed goal pursuit model of negative symptoms (Schlier et al. 2017) postulates that negative symptom severity correlates with a tendency to set more avoidance- than approach-oriented goals. This shi...

People with schizophrenia and negative symptoms show diminished net positive emotion in low-arousing contexts (diminished positivity offset) and co-activate positive and negative emotion more frequently (increased ambivalence). Here, we investigated whether diminished positivity offset and increased ambivalence covary with negative symptoms along t...

Background During the COVID-19 pandemic, an increase in paranoid thinking has been reported internationally. The development of the Pandemic Paranoia Scale (PPS) has provided a reliable assessment of various facets of pandemic paranoia. This study aimed to (i) identify classes of individuals with varying levels of general paranoia and pandemic para...

Aberrant emotional processes are evident in various mental disorders. This raises the question of whether specific difficulties in regulating emotions are a driving factor of psychopathology and thus a worthwhile transdiagnostic treatment target. In this Review, we provide an overview of theoretical models of emotion regulation, research on emotion...

Understanding factors driving vaccine hesitancy is crucial to vaccination success. We surveyed adults (N = 2510) from February to March 2021 across five sites (Australia = 502, Germany = 516, Hong Kong = 445, UK = 512, USA = 535) using a cross-sectional design and stratified quota sampling for age, sex, and education. We assessed willingness to tak...

Background: Although motivational negative symptoms account for reduced functioning and quality of life in individuals with psychotic disorders, the underlying mechanisms are yet not fully understood. Neuroimaging studies suggest that an impaired perception of reward cues could result in a lack of incentive value that then leads to a decrease in go...

Background Negative affect reliably predicts paranoid thoughts. Previous studies point to the importance of emotion regulation for paranoid thoughts but have not yet focused on effects of acute increases and variability in strategy use. Methods We conducted an experience-sampling study for one week in a subclinical sample. Acute increases in the i...

Emotion evaluations are assumed to play a crucial role in the emotion regulation process. We tested a postulate from our framework of emotion dysregulation (Nowak, U., Wittkamp, M. F., Clamor, A., & Lincoln, T. M. [2021]. Using the Ball-in-Bowl metaphor to outline an integrative framework for understanding dysregulated emotion. Frontiers in Psychia...

Kognitive Verhaltenstherapie für psychotische Störungen ist eine störungsspezifische Weiterentwicklung der kognitiven Therapie. Die Interventionen basieren auf empirischem Wissen über die Entstehung und Aufrechterhaltung psychotischer Störungen. Kernelemente der kognitiven Verhaltenstherapie bei Psychosen sind eine entpathologisierende Haltung, ind...

Background To offer support for patients who decide to discontinue antipsychotic and antidepressant medication, identifying which potentially modifiable factors correlate with discontinuation success is crucial. Here, we analyzed the predictive value of the professional support received, circumstances prior to discontinuation, a strategy of discont...

Background: Globally, the COVID-19 pandemic has created an interpersonally threatening context within which other people have become a source of possible threat. This study reports on the development and validation of a self-report measure of pandemic paranoia; that is, heightened levels of suspicion and mistrust towards others due to the COVID-...

Psychological models of the consequences of ostracism (i.e. being socially excluded and ignored) and negative symptoms in schizophrenia suggest that repeatedly experiencing ostracism can lead to elevated levels of amotivation, anhedonia, and asociality (i.e. negative symptoms). We tested this assumption in a prospective study, following up a large...

Background: A significant proportion of patients with affective and psychotic disorders show a marked reduction in goal-directed behaviour, which is also reflected in the behavioural outcomes of effort-based decision-making paradigms. The factors underlying this reduction are not yet fully understood. Reward salience and reward expectancy have been...

It has been proposed that stigmatizing attitudes toward a family member with schizophrenia are less prevalent in low- and middle-income countries (LAMIC) than in high-income countries (HIC). Furthermore, studies from HIC have shown that labeling increases certain aspects of stigma. This raises concerns about an export of this Western psychiatric la...

Background Cognitive Behavior Therapy for psychosis (CBTp) effectively reduces positive symptoms, but the effects for delusions are small. Using approaches that focus on improving putative causal factors of delusions (emotion regulation (ER) and negative self-schemata) may be a way to improve CBTp for delusions. Objectives To pilot an emotion-focu...

Based on findings from cognitive science, it has been theorized that the reductions in motivation and goal-directed behavior in people with psychosis could stem from impaired episodic memory. In the current meta-analysis, we investigated this putative functional link between episodic memory deficits and negative symptoms. We hypothesized that epi-s...

Affective functioning is compromised in people who develop persecutory delusions, but the specifics of these affective disturbances remain unclear. To better understand the precise nature of affective disturbances in this group, it could prove helpful to focus not only on average or momentary affect intensities but also on the dynamic properties of...

Cognitive behavior therapy for psychosis is a specific adaptation of Beck’s cognitive therapy. The interventions address both the psychotic symptoms themselves and the factors involved in their development and maintenance. The core features of cognitive behavior therapy for psychosis includea normalizing attitude of the therapist, and individualize...

Background Difficulties in the ability to adapt beliefs in the face of new information are associated with psychosis and its central symptom – paranoia. As cognitive processes and psychotic symptoms are both known to be sensitive to stress, the present study investigated the exact associations between stress, adapting of beliefs [reversal learning...

Objectives The need for a brief screening tool for psychosis is widely recognized. The Community Assessment of Psychic Experiences (CAPE) is a popular self‐report measure of psychosis, but a cut‐off score that can detect those most likely to fulfill diagnostic criteria for psychotic disorder is not established. Methods A case–control sample from t...

Dysregulated emotion plays an important role for mental health problems. To elucidate the underlying mechanisms, researchers have focused on the domains of strategy-based emotion regulation, psychophysiological self-regulation, emotion evaluations, and resulting emotion dynamics. So far, these four domains have been looked at in relative isolation...

Understanding factors driving vaccine hesitancy is crucial to vaccination success. We surveyed adults (N=2510) from February to March 2021 across five sites (Australia=502, Germany=516, Hong Kong=445, UK=512, USA=535) using a cross-sectional design and stratified quota sampling for age, sex, and education. We assessed willingness to take a vaccine...