bipolar disorder; distress; emotional valence; impact on functioning; major depression; schizoaffective disorder; schizophrenia; Anxiety; Anxiety Disorders; Hallucinations/psychology; Humans; Depression; Voice; Developmental and Educational Psychology; Clinical Psychology; Arts and Humanities (miscellaneous); Psychiatry and Mental Health
Abstract :
[en] OBJECTIVES: Auditory verbal hallucinations (AVHs) occur as a symptom in various mental disorders, and show different phenomenological aspects, depending on their underlying psychopathology. Anxiety and depression, which are known to be involved in the development of AVHs, are suggested to amplify a vicious cycle in which negative interpretations of daily experiences feed into the formation of negative core schemas about the self and others. However, the way in which these variables interrelate is still unknown. Therefore, our aim was to determine the specific roles of anxiety and depression in the relationship between core schemas and emotional aspects of AVHs for three groups (non-clinical voice hearers, affective voice hearers and non-affective voice hearers).
METHODS: Positive and negative core schemas of the self and others were tested as predictors of emotional distress due to AVHs, examining anxiety and depression separately as potential mediators.
RESULTS: Results showed full mediating effects of depression in non-affective voice hearers in the relationship between negative core schemas and AVH distress, but not in affective voice hearers. Anxiety was not a mediator in any of the groups.
CONCLUSIONS: These findings suggest different emotional mechanisms depending on the underlying psychopathology.
Disciplines :
Neurosciences & behavior
Author, co-author :
Kusztrits, Isabella ; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway ; NORMENT Norwegian Centre for Mental Disorders Research, University of Bergen & Haukeland University Hospital, Bergen, Norway
Toh, Wei Lin ; Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
Thomas, Neil ; Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
Laroi, Frank ; Université de Liège - ULiège > Psychologie et Neuroscience Cognitives (PsyNCog) ; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway ; NORMENT Norwegian Centre for Mental Disorders Research, University of Bergen & Haukeland University Hospital, Bergen, Norway
Meyers, Denny; Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
Hirnstein, Marco ; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway ; NORMENT Norwegian Centre for Mental Disorders Research, University of Bergen & Haukeland University Hospital, Bergen, Norway
Rossell, Susan ; Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia ; Psychiatry, St Vincent's Hospital, Melbourne, Victoria, Australia
Language :
English
Title :
From core schemas about the self and others to voice phenomenology: Anxiety and depression affect voice hearers differently.
This work was supported by a research grant from the Bergen Research Foundation (BFS2016REK03) to MH, the Australian National Health and Medical Research Council (NHMRC; senior fellowship to S.L.R (GNT1154651) and a project grant to S.L.R and N.T. (GNT1060664)) as well as a Barbara Dicker Brain Sciences Foundation to S.L.R., N.T. and W.L.T.
Andrew, E. M., Gray, N. S., & Snowden, R. J. (2008). The relationship between trauma and beliefs about hearing voices: A study of psychiatric and non-psychiatric voice hearers. Psychological Medicine, 38(10), 1409–1417. https://doi.org/10.1017/S003329170700253X
Appiah-Kusi, E., Fisher, H., Petros, N., Wilson, R., Mondelli, V., Garety, P., Mcguire, P., & Bhattacharyya, S. (2017). Do cognitive schema mediate the association between childhood trauma and being at ultra-high risk for psychosis? Journal of Psychiatric Research, 88, 89–96. https://doi.org/10.1016/j.jpsychires.2017.01.003
Association, G. A. o. t. W. M. (2014). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. The Journal of the American College of Dentists, 81(3), 14.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173. https://doi.org/10.1037/0022-3514.51.6.1173
Barrowclough, C., Tarrier, N., Humphreys, L., Ward, J., Gregg, L., & Andrews, B. (2003). Self-esteem in schizophrenia: Relationships between self-evaluation, family attitudes, and symptomatology. Journal of Abnormal Psychology, 112(1), 92. https://doi.org/10.1037/0021-843X.112.1.92
Baumeister, D., Sedgwick, O., Howes, O., & Peters, E. (2017). Auditory verbal hallucinations and continuum models of psychosis: A systematic review of the healthy voice-hearer literature. Clinical Psychology Review, 51, 125–141. https://doi.org/10.1016/j.cpr.2016.10.010
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893. https://doi.org/10.1037/0022-006X.56.6.893
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, 78(2), 490–498.
Bentall, R., & Slade, P. D. (1985). Reliability of a scale measuring disposition towards hallucination: A brief report. Personality and Individual Differences, 6(4), 527–529. https://doi.org/10.1016/0191-8869(85)90151-5
Cole, E. R., Strauss, C., Fife-Schaw, C., & McCarthy-Jones, S. (2017). Echoes of others: A path analytic examination of an interpersonal–cognitive model of voice-related distress. Psychology and Psychotherapy: Theory, Research and Practice, 90(4), 617–632. https://doi.org/10.1111/papt.12129
Eshkohl, R., Bernstein, D. P., & Young, J. (2010). Schema therapy. Distinctive features. Routledge.
Fowler, D., Freeman, D., Smith, B., Kuipers, E., Bebbington, P., Bashforth, H., Coker, S., Hodgekins, J., Gracie, A., Dunn, G., & Garety, P. (2006). The Brief Core Schema Scales (BCSS): Psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples. Psychological Medicine, 36(6), 749–759. https://doi.org/10.1017/S0033291706007355
Garety, P. A., Kuipers, E., Fowler, D., Freeman, D., & Bebbington, P. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31(2), 189–195. https://doi.org/10.1017/S0033291701003312
Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76(4), 408–420. https://doi.org/10.1080/03637750903310360
Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford publications.
Hayward, M., Jones, A.-M., Strawson, W. H., Quadt, L., Larsson, D. E. O., Silva, M., Davies, G., Fielding-Smith, S., Hazell, C. M., Critchley, H. D., & Garfinkel, S. N. (2021). A cross-sectional study of auditory verbal hallucinations experienced by people with a diagnosis of borderline personality disorder. Clinical Psychology and Psychotherapy, 1–11. https://doi.org/10.1002/cpp.2655
Jaya, E. S., Ascone, L., & Lincoln, T. M. (2018). A longitudinal mediation analysis of the effect of negative-self-schemas on positive symptoms via negative affect. Psychological Medicine, 48(8), 1299–1307. https://doi.org/10.1017/S003329171700277X
Lawrence, C., Jones, J., & Cooper, M. (2010). Hearing voices in a non-psychiatric population. Behavioural and Cognitive Psychotherapy, 38(3), 363–373. https://doi.org/10.1017/S1352465810000172
Lee, S., & Lee, D. K. (2018). What is the proper way to apply the multiple comparison test? Korean Journal of Anesthesiology, 71(5), 353. https://doi.org/10.4097/kja.d.18.00242
Linscott, R. J., & van Os, J. (2013). An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: On the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine, 43(6), 1133–1149. https://doi.org/10.1017/S0033291712001626
Oliver, J. E., O’Connor, J. A., Jose, P. E., McLachlan, K., & Peters, E. (2012). The impact of negative schemas, mood and psychological flexibility on delusional ideation–mediating and moderating effects. Psychosis, 4(1), 6–18. https://doi.org/10.1080/17522439.2011.637117
Oorschot, M., Lataster, T., Thewissen, V., Bentall, R., Delespaul, P., & Myin-Germeys, I. (2012). Temporal dynamics of visual and auditory hallucinations in psychosis. Schizophrenia Research, 140(1–3), 77–82. https://doi.org/10.1016/j.schres.2012.06.010
Paulik, G. (2012). The role of social schema in the experience of auditory hallucinations: A systematic review and a proposal for the inclusion of social schema in a cognitive behavioural model of voice hearing. Clinical Psychology and Psychotherapy, 19(6), 459–472. https://doi.org/10.1002/cpp.768
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/BRM.40.3.879
Rosen, C., McCarthy-Jones, S., Jones, N., Chase, K. A., & Sharma, R. P. (2018). Negative voice-content as a full mediator of a relation between childhood adversity and distress ensuing from hearing voices. Schizophrenia Research, 199, 361–366. https://doi.org/10.1016/j.schres.2018.03.030
Rossell, S. L., Schutte, M. J. L., Toh, W. L., Thomas, N., Strauss, C., Linszen, M. M. J., van Dellen, E., Heringa, S. M., Teunisse, R., Slotema, C. W., & Sommer, I. E. C. (2019). The questionnaire for psychotic experiences: An examination of the validity and reliability. Schizophrenia Bulletin, 45(Supplement_1), S78–S87. https://doi.org/10.1093/schbul/sby148
Schoemann, A., Boulton, A., & Short, S. (2020). Monte Carlo power analysis for indirect effects. Retrieved from https://schoemanna.shinyapps.io/mc_power_med/
Scott, M., Rossell, S. L., Meyer, D., Toh, W. L., & Thomas, N. (2020). Childhood trauma, attachment and negative schemas in relation to negative auditory verbal hallucination (AVH) content. Psychiatry Research, 290, 112997. https://doi.org/10.1016/j.psychres.2020.112997
Scott, M., Rossell, S. L., Toh, W. L., & Thomas, N. (2020a). The relationship between anxiety, depression, and subtypes of negative auditory verbal hallucination (AVH) content in affective and non-affective psychosis. Psychiatry Research, 294, 113500. https://doi.org/10.1016/j.psychres.2020.113500
Scott, M., Rossell, S. L., Toh, W. L., & Thomas, N. (2020b). Understanding the role of self in auditory verbal hallucinations using a self-discrepancy paradigm. Psychology and Psychotherapy: Theory, Research and Practice, 94(S2), 268–285. https://doi.org/10.1111/papt.12276
Sheehan, D., Lecrubier, Y., Sheehan, K. H., Janavs, J., Weiller, E., Keskiner, A., Schinka, J., Knapp, E., Sheehan, M., & Dunbar, G. (1997). The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. European Psychiatry, 12(5), 232–241. https://doi.org/10.1016/S0924-9338(97)83297-X
Smith, B., Fowler, D. G., Freeman, D., Bebbington, P., Bashforth, H., Garety, P., Dunn, G., & Kuipers, E. (2006). Emotion and psychosis: Links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations. Schizophrenia Research, 86(1–3), 181–188. https://doi.org/10.1016/j.schres.2006.06.018
Thomas, N., Farhall, J., & Shawyer, F. (2015). Beliefs about voices and schemas about self and others in psychosis. Behavioural and Cognitive Psychotherapy, 43(2), 209–223. https://doi.org/10.1017/S1352465813000817
Toh, W. L., Thomas, N., Hollander, Y., & Rossell, S. L. (2020). On the phenomenology of auditory verbal hallucinations in affective and non-affective psychosis. Psychiatry Research, 290, 113147. https://doi.org/10.1016/j.psychres.2020.113147
Toh, W. L., Thomas, N., Robertson, M., & Rossell, S. L. (2020). Characteristics of non-clinical hallucinations: A mixed-methods analysis of auditory, visual, tactile and olfactory hallucinations in a primary voice-hearing cohort. Psychiatry Research, 289, 112987. https://doi.org/10.1016/j.psychres.2020.112987
Waters, F., & Fernyhough, C. (2017). Hallucinations: A systematic review of points of similarity and difference across diagnostic classes. Schizophrenia Bulletin, 43(1), 32–43. https://doi.org/10.1093/schbul/sbw132
Wechsler, D. (2001). Wechsler test of adult reading: WTAR. Psychological Corporation.
Williams, J., Bucci, S., Berry, K., & Varese, F. (2018). Psychological mediators of the association between childhood adversities and psychosis: A systematic review. Clinical Psychology Review, 65, 175–196. https://doi.org/10.1016/j.cpr.2018.05.009
Young, J. E. (1999). Cognitive therapy for personality disorders: A schema-focused approach. Professional Resource Press/Professional Resource Exchange.
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2006). Schema therapy: A practitioner's guide. Guilford Press.
Yzerbyt, V., Muller, D., Batailler, C., & Judd, C. M. (2018). New recommendations for testing indirect effects in mediational models: The need to report and test component paths. Journal of Personality and Social Psychology, 115(6), 929–943. https://doi.org/10.1037/pspa0000132
