The relationship with the voices as a dialogical experience: The role of self-focused attention and dissociation.

OBJECTIVE: The purpose of this article was to study the relationship of self-focused attention and dissociation with the dialogical relationship persons diagnosed with psychosis have with their voices. METHOD: The DAIMON Scale was applied to 62 persons diagnosed with psychosis to measure the dialogical relationship with their voices, and the Cambridge depersonalization scale, the Tellegen absorption scale, and the self-focused attention scale. RESULTS: The results showed that the dialogical relationship with the voices was associated with high levels of self-focused attention (private and public), depersonalization, and absorption. It was also found that absorption mediated significantly between public self-focused attention and the dialogical relationship with the voices. CONCLUSIONS: The role of dissociation and self-focused attention in forming the dialogical relationship a person with psychosis has with the voices is discussed and approaches to treatment are suggested.

Childhood memories of threatening experiences and submissiveness and its relationship to hallucination proneness and ideas of reference: The mediating role of dissociation.

Recent studies have emphasized the importance of childhood memories of threatening experiences and submissiveness in a diversity of psychological disorders. The purpose of this work was to study their specific relationship with hallucination proneness and ideas of reference in healthy subjects. The ELES scale for measuring memory of adverse childhood experiences, the DES-II scale for measuring dissociation, the LSHS-R scale for measuring hallucination proneness, and the REF for ideas of reference were applied to a sample of 472 subjects. A positive association was found between childhood memories of adverse experiences and hallucination proneness and ideas of reference, on one hand, and dissociation on the other. A mediation analysis showed that dissociation was a mediator between the memory of adverse childhood experiences and hallucination proneness on one hand, and ideas of reference on the other. When the role of mediator of the types of dissociative experiences was studied, it was found that absorption and depersonalization mediated between adverse experiences and hallucination proneness. However, this mediating effect was not found between adverse experiences and ideas of reference. The relationship between these last two variables was direct. The results suggest that childhood memories of adverse experiences are a relevant factor in understanding hallucination proneness and ideas of reference. Similarly, dissociation is a specific mediator between adverse childhood experiences and hallucination proneness.

Relationship between inner dialog and ideas of reference and the mediating role of dissociation.

Recent lines of research have begun to concentrate on internal dialogue and its relationship to a diversity of psychopathological phenomena present in psychotic disorders. This study was intended as a preliminary exploration of the relationship of internal dialogue, dissociation and ideas of reference. To do this, a sample of 318 students filled in an internal dialogue scale (the VISQ, McCarthy-Jones & Fernyhough), one for dissociation (DES-II, Carlson & Putnam) and another for ideas of reference (REF, Lenzenweger, Bennett & Lilenfeld). The results confirm the hypothesis posed in the sense that internal dialogue was positively associated with dissociation and with ideas of reference. A partial mediation effect of dissociation was also found between inner speech and ideas of reference. Lines of future research this study opens and its possible integration in a model on ideas of reference are discussed.

[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.

Behavior Problems Inventory (BPI): Psychometric characteristics of an instrument for routine assessment of persons with psychoses and related disorders.

This study explores the psychometric characteristics of the Behavior Problems Inventory (BPI), an instrument for routine clinical assessment of behavior problems in outpatients with psychosis based on information provided by key family informants. Six hundred and twenty-one patients diagnosed with psychosis and bipolar affective disorder (ICD-10 F20-F31) attended at Community Mental Health Units were evaluated in routine reviews using the BPI and the Social Functioning Scale (SFS). Twenty-five subjects were simultaneously administered the Social Behavior Schedule (SBS) and 28 were again administered the BPI eight weeks later. The instrument shows adequate psychometric characteristics with high internal consistency and robust temporal reliability, as well as satisfactory concurrent and construct validity. Factor analysis identified three factors: Underactivity/Social Withdrawal, Active Problems and Lack of Impulse Control, with adequate saturation of the items on each of the factors. The BPI is easy to apply, reliable and valid, takes up little of valuable clinical time, allowing routine assessment in public service contexts for persons diagnosed with psychosis and bipolar affective disorder for whom key family informants are available.

Predictors in use of mental health resources: The role of behaviour problems in patients with severe mental illness.

BACKGROUND: In recent years, more variables are being included in the use of mental health resource prediction models. Some studies have shown that how well the patient can function is important for this prediction. However, the relevance of a variable as important as behaviour problems has scarcely been explored. AIM: This study attempted to evaluate the effect of behaviour problems in patients with severe mental illness on the use of mental health resources. METHOD: A total of 185 patients at a Community Mental Health Unit were evaluated using the Behaviour Problem Inventory. Later, a bivariate logistic regression was done to identify what behaviour problems could be specific predictors of use of mental health resources. RESULTS: The results showed that the general index of behaviour problems predicts both use of hospitalization resources and outpatient attention. Underactivity/social withdrawal is the best predictor of all the different areas. CONCLUSION: These results confirm the role of behaviour problems as predictors of the use of mental health resources in individuals with a severe mental illness.

Relationship between behavioural problems and use of mental health services in patients with severe mental illness and the mediating role of the perceived burden of care.

Mental health models proposed for predicting more use of mental health resources by patients with severe mental illness are including a wider variety of predictor variables, but there are still many more remaining to be explored for a complete model. The purpose of this study was to enquire into the relationship between two variables, behaviour problems and burden of care, and the use of mental health resources in patients with severe mental illness. Our hypothesis was that perceived burden of care mediates between behaviour problems of patients with serious mental illness and the use of mental health resources. The Behaviour Problem Inventory, which was filled out by the main caregiver, was used to evaluate 179 patients cared for in a community mental health unit. They also answered a questionnaire on perceived family burden. A structural equation analysis was done to test our hypothesis. The results showed that both the behaviour problems and perceived burden of care are good predictors of the use of mental health resources, where perceived burden of care mediates between behaviour problems and use of resources. These variables seem to be relevant for inclusion in complete models for predicting use of mental health resources.

The relationship of depersonalization and absorption to hallucinations in psychotic and non-clinical participants.

The purpose of this study was to examine the relationship between dissociative variables and hallucinations, or predisposition to hallucinations, respectively, in patients with psychoses and non-clinical participants, controlling for any possible effect of emotional variables and age. Three groups were formed for this purpose: patients diagnosed with schizophrenia with auditory hallucinations at the time of study, healthy participants prone to hallucinations, and healthy participants not prone to hallucinations. The final sample was 318 participants with a mean age of 21.41 years (SD: 5.78) and a male-to-female ratio of 67:251. All participants were given the Tellegen Absorption Scale, the Cambridge Depersonalization Scale and the Metacognitions Questionnaire. The results showed that patients with psychosis had higher levels of depersonalization than participants prone and not prone to hallucinations. Prone participants showed higher levels of absorption than patients with psychosis and healthy participants with no proneness to hallucinations. Finally, a multinomial logistic regression analysis showed that depersonalization increased the probability of belonging to the group of patients with psychosis and auditory hallucinations, and absorption in the group prone to hallucinations. The conclusions discuss the importance of dissociative variables in understanding the etiology of hallucinations and consider the possibility that different psychological processes may occur in healthy participants prone to hallucinations and in hallucinations in persons with psychoses.

Social functioning as a predictor of the use of mental health resources in patients with severe mental disorder.

Previous studies have tried to determine the factors causing greater use of health resources by patients with mental disorders. These studies have essentially focused on socio-economic variables. Nevertheless, many other variables, such as social functioning, have not yet been explored. This study aims to assess the effect of social functioning on mental health service use in a sample of patients with severe mental disorder (schizophrenia, other psychotic disorders or bipolar affective disorder) in an area of Spain. The Social Functioning Scale (SFS) was administered to 172 family members of patients with a severe mental disorder who were receiving care at a community mental health unit. Analysis of bivariate logistic regression identified specific areas as predictors of the use of mental health resources over a 12-month follow-up period. The overall social functioning score predicted need for hospital admissions. In addition, interpersonal behaviour had a major role in the number of outpatient visits, while social isolation significantly predicted the need for hospitalization. These results point out the necessity for including psychosocial variables, such as social functioning in current mental health resource use models.