Dissociation and mindfulness in patients with auditory verbal hallucinations.

The very few studies relating mindfulness and dissociation have found a negative association between them (depersonalization and absorption). However, all of these studies have been done in nonclinical populations, and there are no data on the relationship between these variables in psychiatric patients with auditory hallucinations. This study was designed to study the relationship between mindfulness and the two dissociative variables, absorption and depersonalization, as well as their predictive power for the severity of auditory hallucinations and the distress they cause in a clinical population. A total of 55 psychiatric patients with hallucinations were given the following tests: the Mindful Attention Awareness Scale (K. Brown & R. Ryan, 2003), the Tellegen Absorption Scale (A. Tellegen & G. Atkinson, 1974), the Cambridge Depersonalization Scale (M. Sierra & G. E. Berrios, 2000), the Psychotic Symptom Rating Scales (G. Haddock, J. McCarron, N. Tarrier, & E. B. Faragher, 1999), and the Positive and Negative Syndrome Scale (S. R. Kay, L. A. Opler, & J.-P. Lindenmayer, 1988). A significant negative correlation was found between mindfulness and the dissociative variables and between mindfulness and the distress caused by the hallucinations. A positive correlation was found between absorption and distress caused by hallucinations and between depersonalization and the severity of hallucinations. Finally, the variable with the most predictive power for severity of the voices was depersonalization, and the variable with the most predictive power for distress caused by the voices was mindfulness. Interventions addressing training in mindfulness techniques could diminish the distress associated with hearing voices.

Cognitive-behavioural therapy and recovery of a delusional dysmorphophobia case.

BACKGROUND: We present the application of cognitive-behavioural therapy in a clinical case diagnosed with delusional dysmorphophobia. METHOD: The psychometric scales used for evaluation were the Positive and Negative Syndrome Scale for Schizophrenia, Beck Anxiety and Depression inventories, the Rosenberg Self-Esteem Scale along with the degree of conviction in the delusional belief and in alternative explanations, and social functioning measured by patient reporting. The therapy included cognitive and behavioural techniques: evidence analysis, search for alternative explanations, logical and functional analysis, reality testing, progressive relaxation techniques, in vivo and imaginal exposure therapy. Evaluations were performed before and after the treatment and then at follow-up after 12 and 24 months. RESULTS: Progressively, the delusional conviction disappeared. There were significant improvements at an emotional level and the patient recovered social and work  functioning. CONCLUSIONS: The need to use psychological treatments for people with delusional disorder as first choice treatment must be considered.

Auditory Verbal Hallucinations: can Beliefs about Voices Mediate the Relationship Patients establish with them and Negative Affect?

This study was designed to find out whether a person's relationship with his voices and the negative affect he suffers from are mediated by beliefs about the voices. Research done to date shows contradictory results (Sorrell, Hayward, & Meddings, 2010, Vaughan & Fowler, 2004). A cross-sectional study was done to study the associations among variables, and a multiple mediation model (Preacher & Hayes, 2008) in which the beliefs about voices were the mediating variables was tested. Sixty subjects who heard voices participated. The VAY (Hayward, Denney, Vaughan, & Fowler, 2008), BAVQ (Chadwick & Birchwood, 1995), BAI (Beck & Steer, 1993) and BDI-II (Beck, Steer & Brown, 1996) were given. We found a significant positive correlation between perception of voices as dominant and intrusive and maintaining a position of distance from them on one hand, and negative affect [anxiety (r = .57, p < .001; r = .40, p < .001; r = .34, p < .01 respectively) and depression (r = .58, p < .001; r = .37, p < .01; r = .38, p < .001 respectively)] on the other. We also found that beliefs of malevolence and omnipotence mediated between relating style and negative affect (anxiety and depression). The theoretical implications of the results and clinical implications of the mediating relationships found are discussed.

Cognitive-behavioural therapy and recovery of a delusional dysmorphophobia case / Terapia cognitivo-conductual y recuperación en un caso de dismorfofobia delirante

BACKGROUND: We present the application of cognitive-behavioural therapy in a clinical case diagnosed with delusional dysmorphophobia. METHOD: The psychometric scales used for evaluation were the Positive and Negative Syndrome Scale for Schizophrenia, Beck Anxiety and Depression inventories, the Rosenberg Self-Esteem Scale along with the degree of conviction in the delusional belief and in alternative explanations, and social functioning measured by patient reporting. The therapy included cognitive and behavioural techniques: evidence analysis, search for alternative explanations, logical and functional analysis, reality testing, progressive relaxation techniques, in vivo and imaginal exposure therapy. Evaluations were performed before and after the treatment and then at follow-up after 12 and 24 months. RESULTS: Progressively, the delusional conviction disappeared. There were significant improvements at an emotional level and the patient recovered social and work functioning. CONCLUSIONS: The need to use psychological treatments for people with delusional disorder as first choice treatment must be considered

OBJETIVO: presentamos la aplicación de terapia cognitivo-conductual a un caso diagnosticado de dismorfofobia delirante. MÉTODO: las medidas de evaluación fueron la Escala de Síndromes Positivo-Negativo (PANNS), grado de convicción en creencia delirante y explicación alternativa, inventarios ansiedad/depresión de Beck, escala autoestima Rosenberg y funcionamiento social (informe paciente). La terapia incluyó técnicas cognitivas-conductuales: análisis de evidencias, explicaciones alternativas, análisis lógico-funcional, pruebas de realidad, relajación, exposición en imágenes/en vivo. Hubo medidas antes-después del tratamiento y en seguimientos a los 12-24 meses. RESULTADOS: progresivamente la convicción delirante desapareció. Hubo significativas mejorías emocionales y recuperación del funcionamiento socio-laboral. CONCLUSIONES: en los trastornos delirantes consideramos preciso ofrecer, como primera elección, tratamientos psicológicos

Auditory verbal hallucinations: can beliefs about voices mediate the relationship patients establish with them and negative affect?

This study was designed to find out whether a person’s relationship with his voices and the negative affect he suffers from are mediated by beliefs about the voices. Research done to date shows contradictory results (Sorrell, Hayward, & Meddings, 2010, Vaughan & Fowler, 2004). A cross-sectional study was done to study the associations among variables, and a multiple mediation model (Preacher & Hayes, 2008) in which the beliefs about voices were the mediating variables was tested. Sixty subjects who heard voices participated. The VAY (Hayward, Denney, Vaughan, & Fowler, 2008), BAVQ (Chadwick & Birchwood, 1995), BAI (Beck & Steer, 1993) and BDI-II (Beck, Steer & Brown, 1996) were given. We found a significant positive correlation between perception of voices as dominant and intrusive and maintaining a position of distance from them on one hand, and negative affect [anxiety (r = .57, p < .001; r = .40, p < .001; r = .34, p < .01 respectively) and depression (r = .58, p < .001; r = .37, p < .01; r = .38, p < .001 respectively)] on the other. We also found that beliefs of malevolence and omnipotence mediated between relating style and negative affect (anxiety and depression). The theoretical implications of the results and clinical implications of the mediating relationships found are discussed (AU)

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