{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:15:00Z","timestamp":1789150500525,"version":"build-2803163510"},"reference-count":52,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"unspecified","delay-in-days":153,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726104681_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Safety behaviors are a common response to persecutory ideation in psychosis. They potentially contribute to the maintenance and exacerbation of symptoms and emotional distress and are therefore a promising treatment target. However, empirical evidence for this hypothesized maintenance role is scarce. We therefore examined cross-sectional and micro-longitudinal associations between safety behaviors, negative affect, and persecutory ideation in the daily lives of individuals with psychotic disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104681_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We assessed safety behaviors, persecutory ideation, and negative affect at baseline and 10 times\/day during one week of Ecological Momentary Assessment (EMA) in\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a064 participants with persecutory ideation and a psychotic disorder.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104681_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, safety behaviors were positively correlated with persecutory ideation (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0.47), depression (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0.67), and anxiety (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0.69). Safety behaviors assessed at baseline and safety behaviors assessed in daily life showed a moderate correlation (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0.56). Multilevel analyses of the longitudinal EMA data revealed persecutory ideation (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0.16) and negative affect (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0.11) to predict subsequent use of safety behaviors. Momentary use of safety behaviors predicted subsequent persecutory ideation (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0.13) and negative affect (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0.18).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104681_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results provide evidence for a vicious cycle of maintenance involving persecutory ideation, negative affect, and safety behaviors. Targeting safety behaviors with ecological momentary interventions in daily life could be a promising approach to interrupt this cycle.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726104681","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:22:49Z","timestamp":1780471369000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Safety behaviors maintain persecutory ideation in individuals with psychotic disorders: evidence from an ecological momentary assessment study"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4234-770X","authenticated-orcid":false,"given":"Sven Niklas","family":"Sch\u00f6nig","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00g30e956","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e4t Hamburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6674-2440","authenticated-orcid":false,"given":"Tania Marie","family":"Lincoln","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00g30e956","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e4t Hamburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1961-9810","authenticated-orcid":false,"given":"Katarina","family":"Krkovic","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03bnmw459","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e4t Potsdam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"S0033291726104681_r22","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(23)00257-2"},{"key":"S0033291726104681_r38","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465801003010"},{"key":"S0033291726104681_r16","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.115.176438"},{"key":"S0033291726104681_r6","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbq041"},{"key":"S0033291726104681_r33","doi-asserted-by":"publisher","DOI":"10.1177\/2515245920978738"},{"key":"S0033291726104681_r32","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2017.12.002"},{"key":"S0033291726104681_r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2006.01.014"},{"key":"S0033291726104681_r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2024.115751"},{"key":"S0033291726104681_r18","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.186.5.427"},{"key":"S0033291726104681_r14","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291720002238"},{"key":"S0033291726104681_r39","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465812000690"},{"key":"S0033291726104681_r23","doi-asserted-by":"publisher","DOI":"10.1136\/bmjment-2023-300880"},{"key":"S0033291726104681_r8","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12421"},{"key":"S0033291726104681_r12","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2015.11.001"},{"key":"S0033291726104681_r15","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)00066-3"},{"key":"S0033291726104681_r11","first-page":"69","volume-title":"Social phobia: Diagnosis, assessment, and treatment","author":"Clark","year":"1995"},{"key":"S0033291726104681_r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2012.10.008"},{"key":"S0033291726104681_r46","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12265"},{"key":"S0033291726104681_r47","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2099"},{"key":"S0033291726104681_r48","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2016.10.015"},{"key":"S0033291726104681_r52","doi-asserted-by":"publisher","DOI":"10.1007\/s10869-022-09803-5"},{"key":"S0033291726104681_r17","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00158-9"},{"key":"S0033291726104681_r30","first-page":"218","article-title":"Tolerate or eliminate? 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