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Langlois T, Sanchez-Rodriguez R, Bourcier A, Lamy P, Very E, Callahan S, Lecomte T. "Accept voices©" group intervention for the management of auditory verbal hallucinations-results at 6 and 12 months. Psychiatry Res 2022; 317:114860. [PMID: 36179593 DOI: 10.1016/j.psychres.2022.114860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 01/04/2023]
Abstract
"The Accept Voices© is a useful intervention for the management and acceptance of auditory verbal hallucinations in people with schizophrenia. This study aims at determining if the clinical effects remained at six- and 12-month follow-ups. Results show that participants (N = 22) maintained a decrease in auditory hallucinations, at the six and 12 months follow ups for severity and acceptance of Voices, anxiety and depression. Accept Voices© shows promise as a potential treatment for people with schizophrenia struggling with Voices.
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Affiliation(s)
- T Langlois
- Centre d'Études et de Recherches en Psychopathologie et Psychopathologie de la Santé, Université de Toulouse, UT2J, France.
| | - R Sanchez-Rodriguez
- Centre d'Études et de Recherches en Psychopathologie et Psychopathologie de la Santé, Université de Toulouse, UT2J, France
| | | | - P Lamy
- Centre médical la Villanelle, Cornebarrieu, France
| | - E Very
- Centre médical la Villanelle, Cornebarrieu, France
| | - S Callahan
- Centre d'Études et de Recherches en Psychopathologie et Psychopathologie de la Santé, Université de Toulouse, UT2J, France
| | - T Lecomte
- Université de Montréal, Montréal, Canada
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Zanello A, Dugré JR. Preliminary Evidence for Heterogeneity of Beliefs About Auditory Verbal Hallucinations Intent. J Nerv Ment Dis 2021; 209:872-878. [PMID: 34846355 DOI: 10.1097/nmd.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Perceptions of patient's auditory verbal hallucinations (AVHs), commonly termed voices, have important impacts on their everyday lives. Despite research emphasizing the consequences of malevolent voices, preliminary results suggest that beliefs about voices may not be mutually exclusive. As such, we aimed to characterize the heterogeneity of beliefs about AVHs and describe their clinical correlates. We recruited 78 patients referred to a Voices group therapy for refractory and distressing voices. Based on the Revised Beliefs About Voices Questionnaire, clustering analysis yielded four subgroups of patients with distinct pattern of beliefs about AVHs. These subgroups differed significantly in terms of affective disturbances, engagement, and resistance to their voices. Furthermore, no significant changes in beliefs about voices were observed after 6 weeks. Results of the current study suggest that the heterogeneity regarding the beliefs about AVHs should be targeted in treatment to reduce their associated negative outcomes.
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Affiliation(s)
- Adriano Zanello
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
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Fung HW, Leung YHS, Mak WH, Ross CA, Ling HWH. The Need for Acknowledging the Psychosocial Aspects of Voice-Hearing Experiences: Review of Online Information and Implications for Public Mental Health Education. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2021. [DOI: 10.1080/15398285.2020.1852375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hong Wang Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yin Hang Sharo Leung
- Department of Counselling Psychology and Human Resource Development, National Chi Nan University, Nantou County, Taiwan
| | - Wing Hung Mak
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Colin A. Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
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Langlois T, Sanchez-Rodriguez R, Bourcier A, Lamy P, Callahan S, Lecomte T. Impact of the group intervention "Accept Voices©" for the management of auditory hallucinations. Psychiatry Res 2020; 291:113159. [PMID: 32540685 DOI: 10.1016/j.psychres.2020.113159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022]
Abstract
AIM OF THE STUDY The objective of this study was to evaluate the potential impact of a third wave CBT group intervention for the management of auditory hallucinations in patients with schizophrenia. METHOD 38 patients with schizophrenia presenting with auditory hallucinations, followed in mental health services, participated in six sessions of a group based on acceptance and engagement therapy (ACT). The study followed a repeated single case experimental design (type A-B-A) based on the principle of a control phase followed by an intervention phase and a follow-up phase of similar duration. The various measurements were administered during the control phase, at pre-/post-group and six weeks after the last group session. RESULTS The results show a significant decrease in auditory hallucinations, as measured by the PSYRATS scale, during the treatment and follow-up phase, compared to the control phase. In addition, the participants saw significant reductions in depressive and anxious symptomatology (assessed with CDSS and SEAS), and increases in coping and acceptance in regards to voices (assessed using a study scale and VAAS). The level of Malevolence beliefs about voices (measured with BAVQ-R) also decreased significantly. CONCLUSIONS A brief group intervention based acceptance show promise in the reduction of the intensity of auditory hallucinations, depression and anxiety in patients with schizophrenia, while improving their acceptance.
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Affiliation(s)
- T Langlois
- Centre d'Études et de Recherches en Psychopathologie et Psychopathologie de la Santé, Université de Toulouse, UT2J, France.
| | - R Sanchez-Rodriguez
- Centre d'Études et de Recherches en Psychopathologie et Psychopathologie de la Santé, Université de Toulouse, UT2J, France
| | | | - P Lamy
- Centre médical la Villanelle, Cornebarrieu, France
| | - S Callahan
- Centre d'Études et de Recherches en Psychopathologie et Psychopathologie de la Santé, Université de Toulouse, UT2J, France
| | - T Lecomte
- Université de Montréal, Montréal, Canada
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Laws KR, Darlington N, Kondel TK, McKenna PJ, Jauhar S. Cognitive Behavioural Therapy for schizophrenia - outcomes for functioning, distress and quality of life: a meta-analysis. BMC Psychol 2018; 6:32. [PMID: 30016999 PMCID: PMC6050679 DOI: 10.1186/s40359-018-0243-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 06/19/2018] [Indexed: 12/14/2022] Open
Abstract
Background The effect of cognitive behavioural therapy for psychosis (CBTp) on the core symptoms of schizophrenia has proven contentious, with current meta-analyses finding at most only small effects. However, it has been suggested that the effects of CBTp in areas other than psychotic symptoms are at least as important and potentially benefit from the intervention. Method We meta-analysed RCTs investigating the effectiveness of CBTp for functioning, distress and quality of life in individuals diagnosed with schizophrenia and related disorders. Data from 36 randomised controlled trials (RCTs) met our inclusion criteria- 27 assessing functioning (1579 participants); 8 for distress (465 participants); and 10 for quality of life (592 participants). Results The pooled effect size for functioning was small but significant for the end-of-trial (0.25: 95% CI: 0.14 to 0.33); however, this became non-significant at follow-up (0.10 [95%CI -0.07 to 0.26]). Although a small benefit of CBT was evident for reducing distress (0.37: 95%CI 0.05 to 0.69), this became nonsignificant when adjusted for possible publication bias (0.18: 95%CI -0.12 to 0.48). Finally, CBTp showed no benefit for improving quality of life (0.04: 95% CI: -0.12 to 0.19). Conclusions CBTp has a small therapeutic effect on functioning at end-of-trial, although this benefit is not evident at follow-up. Although CBTp produced a small benefit on distress, this was subject to possible publication bias and became nonsignificant when adjusted. We found no evidence that CBTp increases quality of life post-intervention. Electronic supplementary material The online version of this article (10.1186/s40359-018-0243-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Keith R Laws
- School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK.
| | - Nicole Darlington
- School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK
| | | | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona and CIBERSAM, Barcelona, Spain
| | - Sameer Jauhar
- Centre of Affective Disorders, Institute of Psychiatry, London, UK
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Zanello A, Badan Bâ M, Sentissi O. Are there clinical differences between inner, outer or dual spatial locations of auditory verbal hallucinations? Psychiatry Res 2018; 264:124-130. [PMID: 29631244 DOI: 10.1016/j.psychres.2018.03.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 02/11/2018] [Accepted: 03/18/2018] [Indexed: 11/28/2022]
Abstract
The aim of the present exploratory study was to examine the clinical differences of Auditory Verbal Hallucinations (AVHs) according to their spatial localization. Sixty-six outpatients were divided into three separate groups: inner, external and dual AVHs. The three groups were compared on sociodemographic variables (age, gender, education, marital status, living situation, employment, social disability), on clinical psychiatric characteristics (diagnosis, medication, comorbidities, illness onset, illness duration and hospitalizations) and on the measure yielded by the clinical assessments (Brief Psychiatric Rating Scale-Expanded, version 4.0; Maastricht Voices Interview for Adults; Belief About Voices Questionnaire Revised, the Clinical Global Impression, the Global Assessment Functioning Self-Esteem Rating Short Form, the World Health Organisation Quality of Life-Bref). Gender, living situation, social quality of life and some items regarding beliefs about AVHs raised significant difference, however most of the other comparisons failed to reach significance. Taken together, our findings suggest that all AVHs subtypes have equal clinical significance in patients presenting a chronic mental illness. However, the power of the study limits the generalization of the findings. Clinical implications of the findings are proposed.
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Affiliation(s)
- Adriano Zanello
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Belle-Idée, ch. Petit Bel-Air 2, 1226 Thônex, Geneva, Switzerland.
| | - Maryse Badan Bâ
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Belle-Idée, ch. Petit Bel-Air 2, 1226 Thônex, Geneva, Switzerland
| | - Othman Sentissi
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Belle-Idée, ch. Petit Bel-Air 2, 1226 Thônex, Geneva, Switzerland
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Maura J, Weisman de Mamani A. Culturally Adapted Psychosocial Interventions for Schizophrenia: A Review. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2017.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kennedy L, Xyrichis A. Cognitive Behavioral Therapy Compared with Non-specialized Therapy for Alleviating the Effect of Auditory Hallucinations in People with Reoccurring Schizophrenia: A Systematic Review and Meta-analysis. Community Ment Health J 2017; 53:127-133. [PMID: 27295054 DOI: 10.1007/s10597-016-0030-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 06/02/2016] [Indexed: 11/24/2022]
Abstract
Cognitive behavioral therapy (CBT) is recommended as a psychological intervention for those diagnosed with schizophrenia. The prevalence of auditory hallucinations is high among this group, many of whom are cared for by community mental health teams that may not have easy access to qualified CBT practitioners. This systematic review examined the evidence for the superiority of CBT compared to non-specialized therapy in alleviating auditory hallucinations in community patients with schizophrenia. Two RCTs met the inclusion criteria totaling 105 participants. The Positive and Negative Syndrome Scale (PANSS)-Positive Scale was the outcome measure examined. A meta-analysis revealed a pooled mean difference of -0.86 [95 % CI -2.38, 0.65] in favor of CBT, although this did not reach statistical significance. This systematic review concluded there is no clinically significant difference in the reduction of positive symptoms of schizophrenia when treated by CBT compared to a non-specialized therapy for adults experiencing auditory hallucinations.
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Affiliation(s)
- Laura Kennedy
- King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
| | - Andreas Xyrichis
- King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK.
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Pontillo M, De Crescenzo F, Vicari S, Pucciarini ML, Averna R, Santonastaso O, Armando M. Cognitive behavioural therapy for auditory hallucinations in schizophrenia: A review. World J Psychiatry 2016; 6:372-380. [PMID: 27679778 PMCID: PMC5031939 DOI: 10.5498/wjp.v6.i3.372] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/22/2016] [Accepted: 08/08/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy (CBT) in reduction of command hallucinations.
METHODS PubMed/MEDLINE, Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, ClinicalTrial.gov searches were performed using the keywords “hallucinations”, “behavioural therapy” and “ cognitive therapy” in order to identify relevant articles published during the years of 2011 to 2016. No language limits were used. Studies conducted within control group, reviews, editorials, were excluded. Data on efficacy, acceptability and tolerability were extracted by three authors independently. Disagreements were resolved in a consensus meeting or by another reviewer.
RESULTS A total of eight articles were eligible for inclusion. Two are randomized clinical trials (RCTs) and six are observational studies. The two RCTs included showed a greater efficacy of CBT compared to standard care on auditory hallucinations (AHs). Nevertheless, they considered different CBT models, particularly Treatment of Resistant Command Hallucinations and Cognitive Therapy for Command Hallucinations. As regards non RCT-studies, all papers included showed reduction on frequency and severity of AHs and distress related to them. However, the lack of content details within non-RCTs studies decreased their comparability. In terms of predictive variables, our findings show that negative symptoms at baseline appeared to be the strongest predictor of the treatment efficacy. Indeed, negative symptoms showed a significant negative correlation on outcome.
CONCLUSION Although more conclusive studies are still needed, we found some preliminary evidence for the efficacy of CBT in the treatment of command hallucinations.
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Zanello A, Badan Bâ M. [Validation of the French version of the "Beliefs About Voices Questionnaire-Revised" (BAVQ-R)]. Encephale 2016; 42:320-4. [PMID: 27126143 DOI: 10.1016/j.encep.2016.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 03/09/2015] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The BAVQ-R explores the beliefs and reactions that "voice hearers" have about their voices. Recently, the BAVQ-R was translated into French, but little is known regarding its validity and reliability. Thus, the aim of this study was to examine further the psychometric characteristics of the BAVQ-R French version. METHOD Seventy-six adult outpatients participated in the study. In addition to the BAVQ-R, patients were administered a psychiatric symptoms severity interview, and self-esteem and quality of life questionnaires. Then, the BAVQ-R was again completed six weeks later after the seven sessions of brief group cognitive behavioral therapy: the Voices Group. RESULTS The BAVQ-R was well accepted and was completed in less than 10minutes. All items presented floor and ceiling effects. For 15 items, item-total correlations were inferior to 0.30. Internal consistency was 0.83 for the global score, 0.83 for the malevolence, 0.81 for the benevolence, 0.64 for the omnipotence, 0.82 for the resistance and 0.77 for the engagement. The temporal stability was superior to 0.70, except for the omnipotence (0.65). Regarding, the construct validity, on the one hand malevolence, omnipotence and resistance were correlated (0.56≤r≤0.64; P<0.001) and on the other hand benevolence and engagement (r=0.62; P<0.001). Regarding convergent validity significant correlations were found between malevolence, omnipotence resistance and severity of anxio-depressive symptoms, negative self-esteem (0.40≤r≤0.52; P<0.001). The BAVQ-R allows discriminating neither between psychotic and non-psychotic patients (Mann-Whitney, all P>0.05) nor between groups established on the basis of the voice sources (Kruskal-Wallis, all P>0.05). Moreover, the BAVQ-R does not seem to be sensitive to change: no difference was observed after Voices Group intervention (Mann-Whitney, all P>0.05). Sociodemographic variables are not related to BAVQ-R. DISCUSSION The French version of the BAVQ-R has sufficiently adequate psychometric characteristics to be used in a clinical setting. However, floor and ceiling effects suggest a lack of sensitivity of the items. Psychometric characteristics of the BAVQ-R could be improved by selecting items and extending the Likert scale to score them.
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Affiliation(s)
- A Zanello
- HUG, département de santé mentale et de psychiatrie, CAPPI Pâquis, rue de Lausanne, 67, 1202 Genève, Suisse.
| | - M Badan Bâ
- HUG, département de santé mentale et de psychiatrie, CAPPI Pâquis, rue de Lausanne, 67, 1202 Genève, Suisse
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Smailes D, Alderson-Day B, Fernyhough C, McCarthy-Jones S, Dodgson G. Tailoring Cognitive Behavioral Therapy to Subtypes of Voice-Hearing. Front Psychol 2015; 6:1933. [PMID: 26733919 PMCID: PMC4685120 DOI: 10.3389/fpsyg.2015.01933] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 12/01/2015] [Indexed: 01/20/2023] Open
Abstract
Cognitive behavioral therapy (CBT) for voice-hearing (i.e., auditory verbal hallucinations; AVH) has, at best, small to moderate effects. One possible reason for this limited efficacy is that current CBT approaches tend to conceptualize voice-hearing as a homogenous experience in terms of the cognitive processes involved in AVH. However, the highly heterogeneous nature of voice-hearing suggests that many different cognitive processes may be involved in the etiology of AVH. These heterogeneous voice-hearing experiences do, however, appear to cluster into a set of subtypes, opening up the possibility of tailoring treatment to the subtype of AVH that a voice-hearer reports. In this paper, we (a) outline our rationale for tailoring CBT to subtypes of voice-hearing, (b) describe CBT for three putative subtypes of AVH (inner speech-based AVH, memory-based AVH, and hypervigilance AVH), and (c) discuss potential limitations and problems with such an approach. We conclude by arguing that tailoring CBT to subtypes of voice-hearing could prove to be a valuable therapeutic development, which may be especially effective when used in early intervention in psychosis services.
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Affiliation(s)
- David Smailes
- Department of Psychology, Durham UniversityDurham, UK; Department of Psychology, Leeds Trinity UniversityLeeds, UK
| | | | | | - Simon McCarthy-Jones
- Department of Psychology, Durham UniversityDurham, UK; Department of Psychiatry, Trinity College DublinDublin, Ireland
| | - Guy Dodgson
- Early Intervention in Psychosis, Northumberland, Tyne and Wear NHS Foundation Trust Ashington, UK
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