Distress, omnipotence, and responsibility beliefs in command hallucinations
Distress, omnipotence, and responsibility beliefs in command hallucinations
Objectives
Command hallucinations are considered to be one of the most distressing and disturbing symptoms of schizophrenia. Building on earlier studies, we compare key attributes in the symptomatic, affective, and cognitive profiles of people diagnosed with schizophrenia and hearing voices that do (n = 77) or do not (n = 74) give commands.
Methods
The study employed a cross-sectional design, in which we assessed voice severity, distress and control (PSYRATs), anxiety and depression (HADS), beliefs about voices (BAVQ-R), and responsibility beliefs (RIQ). Clinical and demographic variables were also collected.
Results
Command hallucinations were found to be more distressing and controlling, perceived as more omnipotent and malevolent, linked to higher anxiety and depression, and resisted more than hallucinations without commands. Commanding voices were also associated with higher conviction ratings for being personally responsible for preventing harm.
Conclusions
The findings suggest key differences in the affective and cognitive profiles of people who hear commanding voices, which have important implications for theory and psychological interventions. Practitioner pointsCommand hallucinations are associated with higher distress, malevolence, and omnipotence. Command hallucinations are associated with higher responsibility beliefs for preventing harm. Responsibility beliefs are associated with voice-related distress. Future psychological interventions for command hallucinations might benefit from focussing not only on omnipotence, but also on responsibility beliefs, as is done in psychological therapies for obsessive compulsive disorder.
Limitations
The cross-sectional design does not assess issues of causality. We did not measure the presence or severity of delusions.
303-309
Ellett, Lyn
96482ea6-04b6-4a50-a7ec-ae0a3abc20ca
Luzon, Olga
d7ddee14-d478-4fd4-b21c-5e7845d7f937
Birchwood, Max
f54d54f3-02f2-46fa-bf21-88f21be5895d
Abbas, Zarina
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Harris, Abi
216675f7-f516-4ea4-9e0a-8fac44f0be9f
Chadwick, Paul
13a767ec-4c8d-467b-85df-ca04a8d11a8e
September 2017
Ellett, Lyn
96482ea6-04b6-4a50-a7ec-ae0a3abc20ca
Luzon, Olga
d7ddee14-d478-4fd4-b21c-5e7845d7f937
Birchwood, Max
f54d54f3-02f2-46fa-bf21-88f21be5895d
Abbas, Zarina
e71f12b4-d8b2-414f-873f-c5063bc4fe5b
Harris, Abi
216675f7-f516-4ea4-9e0a-8fac44f0be9f
Chadwick, Paul
13a767ec-4c8d-467b-85df-ca04a8d11a8e
Ellett, Lyn, Luzon, Olga, Birchwood, Max, Abbas, Zarina, Harris, Abi and Chadwick, Paul
(2017)
Distress, omnipotence, and responsibility beliefs in command hallucinations.
British Journal of Clinical Psychology, .
(doi:10.1111/bjc.12139).
Abstract
Objectives
Command hallucinations are considered to be one of the most distressing and disturbing symptoms of schizophrenia. Building on earlier studies, we compare key attributes in the symptomatic, affective, and cognitive profiles of people diagnosed with schizophrenia and hearing voices that do (n = 77) or do not (n = 74) give commands.
Methods
The study employed a cross-sectional design, in which we assessed voice severity, distress and control (PSYRATs), anxiety and depression (HADS), beliefs about voices (BAVQ-R), and responsibility beliefs (RIQ). Clinical and demographic variables were also collected.
Results
Command hallucinations were found to be more distressing and controlling, perceived as more omnipotent and malevolent, linked to higher anxiety and depression, and resisted more than hallucinations without commands. Commanding voices were also associated with higher conviction ratings for being personally responsible for preventing harm.
Conclusions
The findings suggest key differences in the affective and cognitive profiles of people who hear commanding voices, which have important implications for theory and psychological interventions. Practitioner pointsCommand hallucinations are associated with higher distress, malevolence, and omnipotence. Command hallucinations are associated with higher responsibility beliefs for preventing harm. Responsibility beliefs are associated with voice-related distress. Future psychological interventions for command hallucinations might benefit from focussing not only on omnipotence, but also on responsibility beliefs, as is done in psychological therapies for obsessive compulsive disorder.
Limitations
The cross-sectional design does not assess issues of causality. We did not measure the presence or severity of delusions.
Text
Distress_omnipotence_and_responsibility_ELLETT_Firstonline11May2017_GREEN_AAM
- Accepted Manuscript
More information
Published date: September 2017
Identifiers
Local EPrints ID: 453764
URI: http://eprints.soton.ac.uk/id/eprint/453764
ISSN: 0144-6657
PURE UUID: 8fe469f2-2069-4159-a33b-1304ef76e24d
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Date deposited: 24 Jan 2022 17:40
Last modified: 17 Mar 2024 04:10
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Contributors
Author:
Olga Luzon
Author:
Max Birchwood
Author:
Zarina Abbas
Author:
Abi Harris
Author:
Paul Chadwick
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