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Scholte-Stalenhoef AN, Boyette LL, Begemann M, Schirmbeck F, Hasson-Ohayon I, Cahn W, de Haan L, Pijnenborg GHM. Response to psychotic experiences: Impact of personality traits on perceived levels of distress. Schizophr Res 2024; 267:282-290. [PMID: 38583258 DOI: 10.1016/j.schres.2024.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND This study examined the influence of personality traits on (subclinical) positive symptom distress in patients with a psychotic disorder, their unaffected siblings and healthy controls. METHODS Data were obtained from the Genetic Risk and Outcome of Psychosis study (GROUP), a Dutch longitudinal multicenter cohort study. Data from 140 patients, 216 unaffected siblings and 102 healthy controls was available for baseline levels of Five Factor Model personality traits and frequency and distress due to psychotic experiences three years later, assessed with the Community Assessment of Psychic Experience questionnaire. Main effects of all five personality traits on symptom distress were investigated as well as moderating effects of Neuroticism, Extraversion and Openness on positive symptom frequency and positive symptom distress. Age, gender, symptom frequency and IQ were controlled for. RESULTS In both patients and siblings, the observed main effects of Neuroticism and Openness on (subclinical) positive symptom distress three years later either lost significance or had a very small effect size when controlling for covariates, mainly due to the correction for the effect of positive symptoms on personality traits at baseline. In both groups, levels of Openness at baseline moderated the association between positive symptom frequency and positive symptom distress three years later, in the direction that higher levels of Openness were associated with weaker associations between positive symptom frequency and - distress, even when covariates were controlled for. DISCUSSION The level of Openness to Experiences influences the perceived distress from (subclinical) positive symptoms in both patients and siblings.
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Affiliation(s)
- Anne Neeltje Scholte-Stalenhoef
- Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, Groningen, the Netherlands.
| | - Lindy-Lou Boyette
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Marieke Begemann
- Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, Groningen, the Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | | | - Wiepke Cahn
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands; Altrecht Science, Altrecht Mental Health Institute, Utrecht, Utrecht, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands; Arkin, Institute for Mental Health, Amsterdam, the Netherlands
| | - Gerdina Hendrika Maria Pijnenborg
- Department of Clinical and Neurodevelopmental Neuropsychology, the Netherlands; Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands
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Næss JØ, Hirnstein M, Kusztrits I, Larøi F. An online survey on clinical and healthy individuals with auditory verbal hallucinations: Abuse did not lead to more negative voice content. Schizophr Res 2024; 265:39-45. [PMID: 36435717 DOI: 10.1016/j.schres.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/21/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
Despite the clinical and theoretical importance of the negative content in auditory verbal hallucinations (AVHs), little research has been conducted on the topic. A handful of studies suggest that trauma or adverse life events contribute to negative content. The findings are somewhat inconsistent, however, possibly due to methodological limitations. Moreover, only trauma occurring in childhood has been investigated so far. In the present study, we studied the effect of abuse, experienced in either child- or adulthood, and clinical status on negative content of AVHs in four groups of participants that were assessed as part of a large, previously published online survey: Individuals with a psychotic disorder and AVHs (total n = 33), who had experienced abuse (n = 21) or not (n = 12) as well as a group of healthy individuals with AVHs (total n = 53), who had experienced abuse (n = 31) or not (n = 22). We hypothesized that having experienced abuse was associated with a higher degree of negative content. The clinical group collectively reported significantly higher degrees of negative AVHs content compared to the healthy group, but there was no effect of abuse on the degree of negative AVHs content. The presence of AVHs was more common amongst individuals who reported a history of abuse compared to individuals with no history of abuse, both in clinical and healthy participants with AVHs. This implies that at group level, being subjected to traumatic events increases an individual's vulnerability to experiencing AVHs. However, it does not necessarily account for negative content in AVHs.
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Affiliation(s)
- Julie Øverbø Næss
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Marco Hirnstein
- Department of Biological and Medical Psychology, University of Bergen, Norway; NORMENT - Norwegian Centre of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
| | - Isabella Kusztrits
- Department of Biological and Medical Psychology, University of Bergen, Norway; NORMENT - Norwegian Centre of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Frank Larøi
- Department of Psychology, University of Oslo, Oslo, Norway; Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium.
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Kummar AS, Correia H, Tan J, Fujiyama H. An 8-week compassion and mindfulness-based exposure therapy program improves posttraumatic stress symptoms. Clin Psychol Psychother 2023. [PMID: 37947043 DOI: 10.1002/cpp.2929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 10/09/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023]
Abstract
The persistence of posttraumatic stress symptoms (PTSS) can be debilitating. However, many people experiencing such symptoms may not qualify for or may not seek treatment. Potentially contributing to ongoing residual symptoms of PTSS is emotion dysregulation. Meanwhile, the research area of mindfulness and compassion has grown to imply emotion regulation as one of its underlying mechanisms; yet, its influence on emotion regulation in PTSS cohort is unknown. Here, we explored the potential effectiveness of an 8-week Compassion-oriented and Mindfulness-based Exposure Therapy (CoMET) for individuals with PTSS using a waitlist control design. A total of 28 individuals (27 females, age range = 18-39 years) participated in the study (17 CoMET; 11 waitlist control). Following CoMET, participants reported significant decreases in PTSS severity (from clinical to non-clinical levels), emotion dysregulation and experiential avoidance, as well as significant increases in mindfulness, self-compassion and quality of life. Electroencephalogram-based brain network connectivity analysis revealed an increase in alpha-band connectivity following CoMET in a network that includes the amygdala, suggesting that CoMET successfully induced changes in functional connectivity between brain regions that play a crucial role in emotion regulation. In sum, the current study demonstrated promising intervention outcomes of CoMET in effectively alleviating the symptoms of PTSS via enhanced emotion regulation.
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Affiliation(s)
- Auretta Sonia Kummar
- School of Psychology, College of Health & Education, Murdoch University, Perth, Western Australia, Australia
| | - Helen Correia
- School of Psychology, College of Health & Education, Murdoch University, Perth, Western Australia, Australia
- Psychological Sciences, Australian College of Applied Professions, Perth, Western Australia, Australia
| | - Jane Tan
- School of Psychology, College of Health & Education, Murdoch University, Perth, Western Australia, Australia
| | - Hakuei Fujiyama
- School of Psychology, College of Health & Education, Murdoch University, Perth, Western Australia, Australia
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, Western Australia, Australia
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Corentin C, Fitzgerald C, Goodwin J. Benefits of Hearing Voices Groups & Other Self-Help Groups for Voice Hearers: A Systematic Review. Issues Ment Health Nurs 2023; 44:228-244. [PMID: 37075309 DOI: 10.1080/01612840.2023.2189953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
People who hear voices that others do not often rely on mainstream mental health services. Several alternatives to treatment have grown in popularity including "Hearing Voices Groups" and other self-help groups for voice hearers. The aim of this systematic review is to evaluate the current evidence relating to the use of Hearing Voices Groups (HVGs) and other self-help groups for voice hearers, and identify the benefits felt by those attending such groups. The following databases were searched for relevant academic articles: CINAHL; APA PsycArticles; APA PsycInfo; Social Sciences; SocINDEX; UK & Ireland Reference Centre and Medline, with 13 papers identified for inclusion. Participants reported several benefits of attending a HVG/self-help group, which reduced isolation, improved social and coping skills, and gave them a better understanding of the meaning and context of their voices. The groups also provide hope for the future and act as a catalyst for recovery. These study findings suggest that voice hearers find some benefits from attending HVGs/self-help groups. Evidence indicates that voice hearers can live meaningful lives and continue to hear voices once context and meaning to their voices become clear. HVGs/self-help groups provide a vital service to voice hearers, which they felt was not available within mainstream mental health services. If mental health providers gained a better understanding of the HVN, they may be able to integrate the values and ethos of the HVN into groups for voice hearers within mainstream mental health services or signpost voice hearers to these groups.
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Maisey S, Correia H, Paulik G. The role of self-compassion on the relationship between trauma and hearing voices. Clin Psychol Psychother 2021; 29:698-705. [PMID: 34476866 DOI: 10.1002/cpp.2663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/16/2021] [Accepted: 08/18/2021] [Indexed: 11/11/2022]
Abstract
Traumatic life events are associated with increased risk of hearing voices and posttraumatic stress (PTS) symptoms have been implicated in this relationship. Studies indicate that increased self-compassion is associated with reduced PTS symptoms and voice-distress. The present study sought to examine whether self-compassion moderated the relationship between PTS symptoms and voice-distress. Self-report and clinician-administered questionnaires were used to measure self-compassion, PTS symptom severity, voice-frequency, and voice-distress in 62 trauma-affected voice-hearers who presented to a community voice-hearing clinic. Correlation analyses revealed that PTS symptom severity was positively correlated with voice-distress, but not voice-frequency, and that self-compassion was negatively correlated with voice-distress and PTS symptom severity. While self-compassion did not moderate the relationship between PTS symptom severity and voice-distress, it was associated with a significant reduction in voice-distress, at all levels of PTS symptom severity. Preliminary findings suggest self-compassion may play an important role in reducing voice-distress and thus warrant further consideration of self-compassion as a target in treatment for help-seeking voice-hearers.
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Affiliation(s)
- Sarah Maisey
- School of Psychology and of Exercise Science, Murdoch University, Murdoch, Western Australia, Australia
| | - Helen Correia
- School of Psychology and of Exercise Science, Murdoch University, Murdoch, Western Australia, Australia
| | - Georgie Paulik
- School of Psychology and of Exercise Science, Murdoch University, Murdoch, Western Australia, Australia.,Perth Voices Clinic, Murdoch, Western Australia, Australia.,School of Psychological Science, University of Western Australia, Crawley, Western Australia, Australia
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Tsang A, Bucci S, Branitsky A, Kaptan S, Rafiq S, Wong S, Berry K, Varese F. The relationship between appraisals of voices (auditory verbal hallucinations) and distress in voice-hearers with schizophrenia-spectrum diagnoses: A meta-analytic review. Schizophr Res 2021; 230:38-47. [PMID: 33667857 DOI: 10.1016/j.schres.2021.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/05/2021] [Accepted: 02/14/2021] [Indexed: 02/01/2023]
Abstract
Cognitive-behavioural models of auditory verbal hallucinations (voices) predict that the interpretation of voices determines the levels of distress experienced by voice-hearers. Examining the contribution of these voice appraisals is central to the delivery of effective psychological interventions for the management of distressing psychotic symptoms. This meta-analysis synthesised evidence from studies that tested the relationship between a range of appraisals and several distress measures (voice-related and emotional distress) in individuals with schizophrenia-spectrum diagnoses. A database search (PsycINFO, PubMed and Web of Science) was conducted for articles published up to August 2020. Twenty-eight eligible studies, comprising of 1497 clinical participants examined the association between eight voice appraisals and distress. Moderate to large summary effects (r ranging between 0.30 and 0.50) were observed in several analyses focusing on 'maladaptive' appraisals and beliefs about voices (malevolence, power, metaphysical beliefs, beliefs about loss of control, voice intrusiveness), with voice dominance having a large summary effect, r = 0.58, 95% CI [0.43, 0.69]. Positive appraisals and beliefs had small negative summary effects on distress. The magnitude of the observed effects was similar across subgroup analyses considering measures of voice-related distress, anxiety and depression. The findings of this evidence synthesis broadly corroborate cognitive-behavioural models of distressing voices, but suggested that factors other than voice appraisals may also predict the distress and impairment caused by hallucinatory experiences in people with schizophrenia-spectrum disorders. Nonetheless, our findings confirm that voice appraisals are an important and meaningful target for treatment in help-seeking voice hearers with psychosis.
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Affiliation(s)
- Anthony Tsang
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester. 2(nd) Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester. 2(nd) Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK; Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Alison Branitsky
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Safa Kaptan
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester. 2(nd) Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK
| | - Sonya Rafiq
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester. 2(nd) Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK
| | - Samantha Wong
- Salford Royal NHS Foundation Trust Unit, Manchester Academic Health Science Centre, Salford, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester. 2(nd) Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK; Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester. 2(nd) Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK; Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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