The Structure of Behavior as Unity of Psychology According to Mariano Yela.

BACKGROUND: As Mariano Yela is one of the most eminent Spanish psychologists, the centenary of his birth is a good occasion to revisit his work. Despite being best known for his contributions to psychometrics, Yela has also made important contributions to theoretical psychology, with particular interest in the question of its unity-diversity. METHOD: Some of his most important theoretical works, presented in various contexts, were reviewed. RESULTS: One conception of psychology and one concern are emphasized throughout his work. The conception of psychology is based on behavior as meaningful action. The concern is to see any possible unity in the diversity of psychology. CONCLUSIONS: The structure of behavior defined by subject, situation and action emerge as the basis on which the unity of psychology could be established. If anything, unity of diversity. Some implications are discussed.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

[Evidence-Based Psychological Treatments for Adults: A Selective Review]

Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.

Ecstasy (MDMA): A rebellion coherent with the system.

Aim: This study attempts to demonstrate the relevance of the socio-cultural model of drugs in explaining the impressive development of ecstasy in the last 45 years. Method: First the study describes the use of ecstasy by groups which have left their imprint on the substance: university students, gays, yuppies and the "New Age" movement. Then the link between ecstasy and techno music led to the socially integrated "club" phenomenon, and the "rave", which began as a rupturing, nonconformist phenomenon. Findings: According to this argument, in spite of its clearly counterculture beginnings, the "rave" movement and its most characteristic drug, ecstasy, have gradually become integrated into mainstream culture, somehow reinforcing the functioning of capitalist postmodernity. Our study explains ecstasy's history in reference to the cultural contradictions of capitalism and the functions that it currently fulfils for young people. Based on this analysis, the implications of the cultural perspective are discussed as a paradigm of research in drug use, stressing notions of subculture, myths and rituals. It also proposes a harmonious articulation of academic and common knowledge as the most appropriate method for their study. Conclusion: A cultural approach to drug use could assist in unblocking a field so in need of conceptual and empirical revision.

Effects of Behavioral Activation on the Quality of Life and Emotional State of Lung Cancer and Breast Cancer Patients During Chemotherapy Treatment.

Research suggests that the progressive abandonment of activities in cancer patients are related to depression and worse quality of life. Behavioral activation (BA) encourages subjects to activate their sources of reinforcement and modify the avoidance responses. This study assesses the effectiveness of BA in improving quality of life and preventing emotional disorders during chemotherapy treatment. One sample of lung cancer patients and another of breast cancer patients were randomized into a BA experimental group (E.G.lung/4sess.n = 50; E.G.breast/6sess.n = 33) and a control group (C.G.lung/4sess.n = 40; C.G.breast/6sess.n = 35), respectively. In each session and in follow-ups (3/6/9 months), all participants completed different assessment scales. The results converge to show the effectiveness of BA, encouraging cancer patients to maintain rewarding activities which can activate their sources of day-to-day reinforcement and modify their experience avoidance patterns. BA appears to be a practical intervention which may improve social and role functioning and the emotional state of cancer patients during chemotherapy treatment.

Activation vs. Experiential Avoidance as a Transdiagnostic Condition of Emotional Distress: An Empirical Study.

Background: From a contextual transdiagnostic approach, this study focuses on the importance of the processes of Experiential Avoidance and Activation in explaining and treating psychological problems. There exists widespread empirical evidence to suggest that the response pattern known as Experiential Avoidance, a general unwillingness to remain in contact with particular private experiences through the use of maladaptive avoidance strategies, acts as a functional dimension in various psychological problems. Activation, that is, maintaining contact with experiences/conditions of life and consequently with associated sources of reward, is a condition present in most therapeutic processes. Although a great deal of research has analyzed the relationship of the value of reward with the etiology and maintenance of psychological problems, Activation, as a transdiagnostic factor, has been studied less. The aim of this paper is to carry out an empirical study of the relationship between Activation, EA and emotional state and analyze the capacity of these two conditions to discriminate the intensity and symptomatology type in subjects with emotional distress. Methods: The Hospital Anxiety and Depression Scale (HADS), Environmental Reward Observation Scale (EROS) and Behavioral Activation for Depression Scale (BADS) were completed by 240 health center users. Results: Of the participants, 55% showed clinically relevant emotional distress. All cases of depression showed clinical anxiety. To discriminate between subjects without (n = 109) and with emotional distress (n = 131), analyses of the ROC curves and logistic regression analysis identified the BADS-Avoidance/Rumination followed by the EROS. To discriminate between subjects with anxiety but without depression (n = 61) and with anxiety and depression (n = 70), the most efficient scales were EROS followed by BADS-Social Impairment. Conclusion: It was shown that people with no emotional complaints maintained greater contact with life experiences and with environmental sources of reward than those with emotional distress. Response patterns showing Experiential Avoidance and a reduction in Activation responses were associated with clinical distress. A reduction in Activation was the condition which distinguished those people with the greatest distress and also the greatest comorbidity of symptoms of depression and anxiety. These data support the transdiagnostic nature of Activation and suggest greater attention should be paid to this concept.

Treating anxiety and depression of cancer survivors: Behavioral activation versus acceptance and commitment therapy.

BACKGROUND: Behavioral activation (BA) and acceptance and commitment therapy (ACT) are considered particularly useful treatments when dealing with emotional problems of cancer survivors. The efficacy of these two treatments, applied on a group basis, were evaluated and compared. METHOD: An analysis was carried out of pre-post treatment changes in the emotional state and patterns of activation/avoidance of 52 cancer patients, with anxiety and/or depression, randomly assigned to three groups (BA/ACT/waiting list control). RESULTS: Both therapies were superior to no treatment in all the variables evaluated. Significant differences were found between the two treatments in favor of ACT in social impairment and avoidance/rumination. CONCLUSIONS: BA and ACT, applied on a group basis, are efficacious in the treatment of those emotional difficulties most prevalent in cancer survivors. Results suggest that activation and avoidance are the mechanisms responsible for the changes.

Psychology as a Science of Subject and Comportment, beyond the Mind and Behavior.

The turn of qualitative inquiry suggests a more open, plural conception of psychology than just the science of the mind and behavior as it is most commonly defined. Historical, ontological and epistemological binding of this conception of psychology to the positivist method of natural science may have exhausted its possibilities, and after having contributed to its prestige as a science, has now become an obstacle. It is proposed that psychology be reconceived as a science of subject and comportment in the framework of a contextual hermeneutic, social, human behavioral science. Thus, without rejecting quantitative inquiry, psychology recovers territory left aside like introspection and pre-reflective self-awareness, and reconnects with traditions marginalized from the main stream. From this perspective psychology might also recover its credibility as a human science in view of current skepticism.

Emotional state and psychological flexibility in breast cancer survivors.

PURPOSE: This study analyses the premise that less time spent carrying out valuable activities and inflexible avoidance of thoughts, feelings and memories related to the oncological process may play an important role in the emotional problems of cancer survivors. METHODS: Emotional state was evaluated, as was quality of life and psychological flexibility in a sample of 122 breast cancer survivors (Mage = 52.40; SDage = 7.26). The analysis was carried out using a cross-sectional predictive study. RESULTS: Approximately half of those in the sample suffered from clinically significant emotional distress. The predictor variables selected explained a high percentage of the variability in emotional problems and quality of life (51.10-77.10%). CONCLUSION: Avoidance explained a high percentage of the variance in anxiety, depression and general distress. A lower degree of participation in valuable activities contributed, more specifically, to explaining variability in depression. The quantity and availability of environmental reinforcement was closely related to quality of life. A decisive contribution towards promoting emotional well-being and quality of life can be made by nursing action aimed at diminishing those avoidance strategies related to the oncological experience which may distance patients from daily activities which are gratifying and congruent with their values.

The Four Causes of ADHD: Aristotle in the Classroom.

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most well-established and at the same time controversial disorders to the extreme of being placed in doubt. In the first of two parts, the established position is critically reviewed, beginning with showing fallacious reasoning on which the diagnosis is based, lacking clinical proof. Similarly, a certain rhetoric and metaphysics in genetic and neurobiological research is highlighted, where, for example, a meager accumulation of data is offered as robust conclusions, and correlates and correlations as causes and bases. However, that may be, the controversy is silenced in a dialog of the deaf between "defenders" and "critics." with no way out in sight in empirical and scientific terms. A new meta-scientific position is necessary to analyze the science of ADHD itself and its social uses. In this respect, the second part introduces Aristotle's four causes, material, formal, efficient, final, as an instrument of enquiry. According to this analysis, ADHD is not the pretended clinical entity as presented, but a practical entity providing a variety of functions. The implications would be rather different from the usual.

The mediating role of metacognitive variables in the relationship between Thought-Action Fusion and obsessive-compulsive symptomatology / El papel mediador de las variables metacognitivas en la relación entre la fusión pensamiento-acción y la sintomatología obsesivo-compulsiva

Diverse studies support the central role of Thought-Action Fusion (TAF) and other metacognitive variables in the understanding of obsessive-compulsive disorder (OCD) symptomatology. However,amore detailed study of the involvement of the sevariables is needed. This article seeks to assess the possible mediating role of the factors of the Metacognitions Questionnaire (MCQ) in the relationship between TAF and OCD symptoms both in clinical and non-clinical samples.A cross-sectional design was used in which120 participants, divided into three groups (two clinical and one non-clinical), completed the questionnaires assessing the constructsof interest. The mediational findings generally supported the proposed mediation model. Specifically, the mediational analyses focused on negative beliefs and the need to control (metacognitive factors of the MCQ) showed that MCQ Negative beliefs mediated the effects of TAF-Total and TAF factors (except for the TAF-Moral) on OCD symptomatology in the OCD group. The MCQ Need to control was non-significantasa mediator of the relationships between TAF and OCD. However, it was observed that this mediation approached significance, with considerable effect sizes. In the clinical-control group, the analyses showed that MCQ Negative beliefs mediated the effects of TAF-Like lihood-One self on OCD symptoms. In the remaining group, neither MCQ Negative beliefs nor MCQ Need to control were found to be significant mediators. It is generally concluded that certain beliefs, such as TAF, can evolve toward more complex metacognitive beliefs, which ultimate ly lead to the development of OCD symptoms.

Diversos estudios han señalado el papel de la fusión pensamiento-acción (TAF) y otras creencias metacognitivas en la comprensión de la sintomatología obsesivo-compulsiva. No obstante, es preciso un estudio más pormenorizado que esclarezca la contribución de estas variables. El objetivo del presente estudio es evaluar el posible papel mediador de los factores del Cuestionario de Metacogniciones (MCQ)en la relación entre la TAF y la sintomatología obsesivo-compulsiva, tanto en muestras clínicas como no clínicas. Con un diseño transversal, 120 participantes divididos entres grupos (dos clínicos y uno no clínico) respondieron a los cuestionarios que evaluaban los constructos de interés. Los resultados apoyaron de manera general el modelo mediacional propuesto. Concretamente, los análisis se centraron en la necesidad de control y las creencias negativas (factores metacognitivos del MCQ) y mostraron los siguientes resultados. En el grupo de sintomatología obsesivo-compulsiva, las creencias negativas mediaron los efectos deTAF-totaly los factores de TAF en la sintomatología obsesivo-compulsiva, a excepción de TAF-moral. El factor necesidad de control no llegó a ser un mediador significativo; no obstante, esta mediación estaba próxima a la significatividad y se contemplaron tamaños del efecto considerables. Respecto al grupo de control clínico, los análisis mostraron que las creencias negativas mediaban los efectos de TAF-probabilidad-uno mismo en la sintomatología obsesivo-compulsiva. En el grupo restante, ni las creencias negativas ni la necesidad de control resultaron ser mediadores significativos. Se concluye, de manera general, que creencias como la TAF pueden evolucionar hacia creencias metacognitivas más complejas que conllevan, en último término, el desarrollo de la sintomatología obsesivo-compulsiva.

Rethinking Schizophrenia in the Context of the Person and Their Circumstances: Seven Reasons.

We know a great deal about schizophrenia, but the current state of the art is one of uncertainty. Researchers are confused, and patients feel misunderstood. This situation has been identified as due largely to the fact that the dominant neurobiological perspective leaves out the person. The aim of the present article is to review and integrate a series of clinical, phenomenological, historical, cultural, epidemiological, developmental, epigenetic, and therapeutic phenomena in support of a suggestion that schizophrenia is above all a disorder of the person rather than of the brain. Specifically, we review seven phenomena, beginning with the conception of schizophrenia as a particular disorder of the self. We continue by looking at its recent origin, as a modern phenomenon, its juvenile onset, related to the formation of the self, the better prognosis in developing countries compared to developed countries, and the high incidence of the disorder among migrants. In the context of these phenomena of a marked socio-cultural nature, we consider the so-called "genetic myth," according to which schizophrenia would have a genetic origin. On reviewing the current genetic emphasis in the light of epigenetics, it emerges that the environment and behavior recover their prominent role in the vicissitudes of development. The seventh reason, which closes the circle of the argument, concerns the role of interpersonal "chemistry" in recovery of the sense of self.

Relationship between self-focused attention and mindfulness in people with and without hallucination proneness.

The purpose of this work was to study the relationship between self-focused attention and mindfulness in participants prone to hallucinations and others who were not. A sample of 318 healthy participants, students at the universities of Sevilla and Almería, was given the Launay-Slade Hallucinations Scale-revised (LSHS-R, Bentall & Slade, 1985). Based on this sample, two groups were formed: participants with high (n = 55) and low proneness (n = 28) to hallucinations. Participants with a score higher than a standard deviation from the mean in the LSHS-R were included in the high proneness group, participants with a score lower than a standard deviation from the mean in the LSHR-R were included in the second one. All participants were also given the Self-Absorption Scale (SAS, McKenzie & Hoyle, 2008) and the Southampton Mindfulness Questionnaire (SMQ, Chadwick et al., 2008). The results showed that participants with high hallucination proneness had significantly higher levels of public (t(80) = 6.81, p < .001) and private (t(77) = 7.39, p < .001) self-focused attention and lower levels of mindfulness (t(81) = -4.56, p < .001) than participants in the group with low hallucination proneness. A correlational analysis showed a negative association between self-focused attention (private and public) and mindfulness (r = -0.23, p < .001; r = -0.38, p < .001 respectively). Finally, mindfulness was found to partly mediate between self-focused attention and hallucination proneness. The importance of self-focused attention and mindfulness in understanding the etiology of hallucinations discussed and suggest some approaches to their treatment.

Person-based contextual therapy applied to a complex case of schizophrenia.

BACKGROUND: Psychological therapies are becoming more and more important in schizophrenia, and not as mere adjuncts to medication. The psychotherapy of schizophrenia is taking on a new lease of life in the wake of person-based phenomenological and psychological developments. METHOD: The case in question was a complex one, with variegated symptomatology that had persisted over many years. Approaching the case from the perspective of person-based cognitive therapy allowed us to understand the psychotic symptoms in the biographical context and to apply a therapy focused on the patient's recovery of her sense of self and of life. RESULTS: At the end of the therapy and throughout the 12-month follow-up, the psychotic experiences had practically disappeared, or ceased to be disturbing, and the patient had become re-integrated in social life. CONCLUSIONS: Psychotic symptoms take on meaning in the biographical context. Adopting this perspective can aid the psychopathological explanation of the disorder and provide significant therapeutic help, more focused on recovery. Psychological therapy has shown itself to be viable in complex cases treated within the public-sector healthcare context.

The role of magical thinking in hallucinations. Comparisons of clinical and non-clinical groups.

BACKGROUND: Magical thinking consists of accepting the possibility that events that, according to the causal concepts of a culture, cannot have any causal relationship, but might somehow nevertheless have one. Magical thinking has been related to both obsessive-compulsive disorder and schizophrenia. AIMS: The purpose of this study was to investigate the role of magical thinking in hallucinations of patients diagnosed with schizophrenia. METHODS: Four groups were recruited for this purpose from a clinical population (hallucinating schizophrenic patients, patients diagnosed with psychoses who had never hallucinated, obsessive-compulsive disorder patients and a clinical control group) and a non-clinical control group, who were given the Magical Ideation Scale. RESULTS: The results show that magical ideation differentiates the group of schizophrenic patients with auditory hallucinations from the rest of the groups that participated in the design. Items related to "mind reading", to the presence of auditory illusions in response to sound stimuli, and to the sense of sometimes being accompanied by an evil presence are the most closely related to the presence of auditory hallucinations. CONCLUSIONS: Magical thinking, understood as beliefs in non-consensual modes of causation, is closely linked to auditory hallucinations in patients diagnosed with schizophrenia.

Relationship between childhood trauma, mindfulness, and dissociation in subjects with and without hallucination proneness.

The purpose of this study was to examine the relationship between childhood traumas, mindfulness, and dissociation (more specifically, absorption and depersonalization) in healthy subjects with and without hallucination proneness. A sample of 318 subjects was given the Launay-Slade Hallucination Scale-Revised (R. P. Bentall & P. Slade, 1985). From this sample, 2 groups were formed: one with high and the other with low hallucination proneness. Furthermore, all participants were given the Tellegen Absorption Scale (A. Tellegen & G. Atkinson, 1974), the Cambridge Depersonalization Scale (M. Sierra & G. E. Berrios, 2000), the Southampton Mindfulness Questionnaire (P. D. J. Chadwick et al., 2008), and the Trauma Questionnaire (J. R. E. Davidson, D. Hughes, & D. G. Blazer, 1990). The results showed that in the group with high hallucination proneness, there were significantly more subjects with traumatic experiences than in the group with low predisposition, although no significant difference in the mean number of traumatic experiences undergone in childhood was found between the 2 groups, although there was a trend toward significance. A correlation analysis showed a significant negative association between mindfulness on the one hand and absorption and depersonalization on the other. A positive relationship was also found between childhood traumas and absorption and depersonalization. Finally, multiple mediation analysis showed that the absorption and depersonalization variables acted as mediators between childhood traumas and hallucination proneness. We discuss the importance of the relationship between the variables studied and hallucination proneness and suggest some approaches for their treatment.

Epigenetics and its implications for Psychology.

BACKGROUND: Epigenetics is changing the widely accepted linear conception of genome function by explaining how environmental and psychological factors regulate the activity of our genome without involving changes in the DNA sequence. Research has identified epigenetic mechanisms mediating between environmental and psychological factors that contribute to normal and abnormal behavioral development. METHOD: the emerging field of epigenetics as related to psychology is reviewed. RESULTS: the relationship between genes and behavior is reconsidered in terms of epigenetic mechanisms acting after birth and not only prenatally, as traditionally held. Behavioral epigenetics shows that our behavior could have long-term effects on the regulation of the genome function. In addition, epigenetic mechanisms would be related to psychopathology, as in the case of schizophrenia. In the latter case, it would be especially relevant to consider epigenetic factors such as life adversities (trauma, disorganized attachment, etc.) as related to its clinical manifestations, rather than genetic factors. Moreover, epigenetics implies overcoming classical dualist dichotomies such as nature-nurture, genotype-phenotype or pathogenesis-pathoplasty. CONCLUSIONS: In general, it can be stated that behavior and environment will finally take on a leading role in human development through epigenetic mechanisms.

Relationship of absorption, depersonalisation, and self-focused attention in subjects with and without hallucination proneness.

INTRODUCTION: The purpose of this work was to study the relationship of absorption, depersonalisation, and self-focused attention in subjects prone to hallucination. METHODS: A sample of 218 healthy subjects was given the LSHS-R Hallucination Scale (Bentall & Slade, 1985). Three groups, subjects with high, medium, and low hallucination proneness, were formed from this sample. The Tellegen Absorption Scale (TAS; Tellegen & Atkinson, 1974), Cambridge Depersonalisation Scale (CDS; Sierra & Berrios, 2000), and Self-Absorption Scale (SAS; McKenzie & Hoyle, 2008) were also given to all the participants. The Metacognitions Questionnaire (MCQ-30; Wells & Cartwright-Hatton, 2004) was used as a covariant to control for the effects of emotional vulnerability on the dependent variables studied. RESULTS: The results showed that subjects highly prone to hallucinations had significantly higher absorption, depersonalisation, and self-focused attention than the subjects in the other two groups. A hierarchical regression analysis showed that absorption and depersonalisation predict hallucination proneness. CONCLUSIONS: The importance of the absorption, depersonalisation, and self-focused attention variables for understanding the aetiology of hallucinations is discussed in the Conclusions, where some approaches to its treatment are also suggested.

Dissociative experiences as mediators between childhood trauma and auditory hallucinations.

The purpose of this work was to study the relationship between reported traumatic experiences in childhood and positive psychotic symptoms. We hypothesized that dissociative experiences were potential mediators between childhood trauma and hallucinations, but not delusions. The sample comprised 71 patients diagnosed with psychoses. They were assessed with the Dissociative Experiences Scale (DES-II; Carlson & Putnam, 1993), a questionnaire on trauma (TQ; Davidson, Hughes, & Blazer, 1990), and the Positive and Negative Syndrome Scale (PANSS; Kay, Opler, & Lindenmayer, 1988) delusions and hallucinations items. The results showed that childhood trauma was positively associated with the dissociation scale scores (r = .40) and also the hallucination (r = .36) and delusions scale scores (r = .32). Furthermore, it was demonstrated that the dissociation variable was a potential mediator between childhood trauma and hallucinations, but not between childhood trauma and delusions. Of the 3 DES-II factors, only depersonalization showed a mediating relationship between childhood trauma and hallucinations. The main conclusion is that the impact of childhood trauma on hallucinations may not simply be direct, but mediated by dissociative experiences, especially depersonalization. Clinical implications are also briefly discussed.

Relationship of metacognition, absorption, and depersonalization in patients with auditory hallucinations.

OBJECTIVES: The purpose of this work was to study the relationship of metacognition, absorption, and depersonalization in hallucinating patients. DESIGN: A within-subjects correlational design was employed. METHODS: We formed four groups from a clinical population (schizophrenic patients with hallucinations, schizophrenic patients with no hallucinations but with delusions, schizophrenic patients recovered from positive symptoms, and patients with a non-psychotic psychiatric disorder) and a non-clinical control group. All participants were given the Metacognitions Questionnaire (MCQ-30, Wells & Cartwright-Hatton, 2004), the Tellegen Absorption Scale (TAS, Tellegen & Atkinson, 1974) and the Cambridge Depersonalization Scale (CDS, Sierra & Berrios, 2000). RESULTS: Schizophrenic subjects with hallucinations scored significantly higher on the depersonalization scale than any other group, and significantly higher on the absorption scale than any group except for the clinical patient controls. Schizophrenic patients with hallucinations also had significantly more dysfunctional metacognitive beliefs than subjects with no psychiatric pathology. It was further found that the metacognition variable correlated positively with the absorption and depersonalization variables, and that these variables in turn correlated positively with each other. Finally, it should be stressed that the variables that best predict hallucination severity are depersonalization and the MCQ-30 subscale `Need to control thoughts'. CONCLUSIONS: We discuss the role of metacognitive and dissociative variables in understanding hallucinations and suggest some approaches to their treatment.