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It's not what you hear, it's the way you think about it: appraisals as determinants of affect and behaviour in voice hearers

Published online by Cambridge University Press:  25 November 2011

E. R. Peters*
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, London, UK
S. L. Williams
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, London, UK
M. A. Cooke
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, London, UK
E. Kuipers
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, London, UK
*
*Address for correspondence: Dr E. R. Peters, Department of Psychology, PO Box 77, Institute of Psychiatry, Henry Wellcome Building, De Crespigny Park, London SE5 8AF, UK. (Email: emmanuelle.peters@kcl.ac.uk)

Abstract

Background

Previous studies have suggested that beliefs about voices mediate the relationship between actual voice experience and behavioural and affective response.

Method

We investigated beliefs about voice power (omnipotence), voice intent (malevolence/benevolence) and emotional and behavioural response (resistance/engagement) using the Beliefs About Voices Questionnaire – Revised (BAVQ-R) in 46 voice hearers. Distress was assessed using a wide range of measures: voice-related distress, depression, anxiety, self-esteem and suicidal ideation. Voice topography was assessed using measures of voice severity, frequency and intensity. We predicted that beliefs about voices would show a stronger association with distress than voice topography.

Results

Omnipotence had the strongest associations with all measures of distress included in the study whereas malevolence was related to resistance, and benevolence to engagement. As predicted, voice severity, frequency and intensity were not related to distress once beliefs were accounted for.

Conclusions

These results concur with previous findings that beliefs about voice power are key determinants of distress in voice hearers, and should be targeted specifically in psychological interventions.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Beck, AT, Epstein, N, Brown, G, Steer, RA (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893897.CrossRefGoogle ScholarPubMed
Beck, AT, Kovacs, M, Weisman, A (1979 a). Assessment of suicide intention: the scale for suicide ideation. Journal of Consulting and Clinical Psychology 47, 343352.CrossRefGoogle ScholarPubMed
Beck, AT, Rush, AJ, Shaw, BF, Emery, G (1979 b). Cognitive Therapy of Depression. Guilford Press: New York.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1996). Manual for the Beck Depression Inventory – 2nd Edition. The Psychological Corporation: San Antonio, TX.Google Scholar
Benjamin, LS (1989). Is chronicity a function of the relationship between the person and the auditory hallucination? Schizophrenia Bulletin 15, 291310.CrossRefGoogle ScholarPubMed
Bentall, RP, Jackson, HF, Pilgrim, D (1988). Abandoning the concept of ‘schizophrenia’: some implications of validity arguments for psychological research into psychotic phenomena. British Journal of Clinical Psychology 27, 303324.CrossRefGoogle ScholarPubMed
Birchwood, M, Chadwick, P (1997). The omnipotence of voices: testing the validity of a cognitive model. Psychological Medicine 27, 13451353.CrossRefGoogle ScholarPubMed
Birchwood, M, Gilbert, P, Gilbert, J, Trower, P, Meaden, A, Hay, J, Murray, E, Miles, JNV (2004). Interpersonal and role-related schema influence the relationship with the dominant ‘voice’ in schizophrenia: a comparison of three models. Psychological Medicine 34, 15711580.CrossRefGoogle ScholarPubMed
Birchwood, M, Meaden, A, Trower, P, Gilbert, P, Plaistow, J (2000). The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychological Medicine 30, 337344.CrossRefGoogle ScholarPubMed
Brett-Jones, J, Garety, PA, Hemsley, DR (1987). Measuring delusional experiences: a method and its application. British Journal of Clinical Psychology 26, 257265.CrossRefGoogle ScholarPubMed
Chadwick, P, Birchwood, M (1994). The omnipotence of voices: a cognitive approach to auditory hallucinations. British Journal of Psychiatry 164, 190201.CrossRefGoogle ScholarPubMed
Chadwick, P, Birchwood, M (1995). The omnipotence of voices. II: The Beliefs About Voices Questionnaire (BAVQ). British Journal of Psychiatry 166, 773776.CrossRefGoogle ScholarPubMed
Chadwick, P, Lees, S, Birchwood, M (2000 a). The revised Beliefs About Voices Questionnaire (BAVQ-R). British Journal of Psychiatry 177, 229232.CrossRefGoogle Scholar
Chadwick, P, Sambrooke, S, Rasch, S, Davies, E (2000 b). Challenging the omnipotence of voices: group cognitive behavior therapy for voices. Behaviour Research and Therapy 38, 993–1003.CrossRefGoogle ScholarPubMed
Close, H, Garety, P (1998). Cognitive assessment of voices: further developments in understanding the emotional impact of voices. British Journal of Clinical Psychology 37, 173188.CrossRefGoogle ScholarPubMed
Csipke, E, Kinderman, P (2006). A longitudinal investigation of beliefs about voices. Behavioural and Cognitive Psychotherapy 34, 365369.CrossRefGoogle Scholar
Drury, V, Birchwood, M, Cochrane, R (2000). Cognitive therapy and recovery from acute psychosis: a controlled trial. 3. Five-year follow-up. British Journal of Psychiatry 177, 8–14.CrossRefGoogle ScholarPubMed
Hacker, D, Birchwood, M, Tudway, J, Meaden, A, Amphlett, C (2008). Acting on voices: omnipotence, sources of threat, and safety-seeking behaviours. British Journal of Clinical Psychology 47, 201213.CrossRefGoogle ScholarPubMed
Kay, S, Fizbein, A, Opler, L (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261275.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Oorschot, M, Collip, D, Lataster, J, Delespaul, P, van Os, J (2009). Experience sampling research in psychopathology: opening the black box of daily life. Psychological Medicine 39, 15331547.CrossRefGoogle ScholarPubMed
Peters, ER (2007). Assessment in psychosis. Journal of the Norwegian Psychological Association 44, 2–11.Google Scholar
Peters, ER, Landau, S, McCrone, P, Cooke, M, Fisher, P, Evans, R, Carswell, K, Dawson, K, Steel, C, Howard, A, Kuipers, E (2010). A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service. Acta Psychiatrica Scandinavica 122, 302318.CrossRefGoogle Scholar
Peters, ER, Lataster, T, Greenwood, K, Kuipers, E, Scott, J, Williams, S, Garety, PA, Myin-Germeys, I (2011). Appraisals, psychotic symptoms and affect in daily life. Psychological Medicine. Published online: 13 September 2011. doi:10.1017/S0033291711001802.CrossRefGoogle Scholar
Rosenberg, M (1965). Society and the Adolescent Self-Image. Princeton University Press: Princeton, NJ.CrossRefGoogle Scholar
Sayer, J, Ritter, S, Gournay, K (2000). Beliefs about voices and their effects on coping strategies. Journal of Advanced Nursing 31, 11991205.CrossRefGoogle ScholarPubMed
Trower, P, Birchwood, M, Meaden, A, Byrne, S, Nelson, A, Ross, K (2004). Cognitive therapy for command hallucinations: randomised controlled trial. British Journal of Psychiatry 184, 312320.CrossRefGoogle ScholarPubMed
van der Gaag, M, Hageman, MC, Birchwood, M (2003). Evidence for a cognitive model of auditory hallucinations. Journal of Nervous and Mental Disease 191, 542545.CrossRefGoogle ScholarPubMed