Showing papers by "Max Birchwood published in 1997"
TL;DR: The study found support for the cognitive model and therapeutic approach, which centre around the possibility that voice beliefs develop as part of an adaptive process to the experience of voices, and are underpinned by core beliefs about the individuals self-worth and interpersonal schemata.
Abstract: BACKGROUND: A preliminary report by the authors suggested that the range of affect generated by voices (anger, fear, elation) was linked not to the form, content or topography of voice activity, but to the beliefs patients held about them, in particular their supposed power and authority. We argued that this conformed to a cognitive model; that is, voice beliefs represent an attempt to understand the experience of voices, and cannot be understood by reference to the form/content of voices alone. This study puts this cognitive model to empirical test. METHODS: Sixty-two voice hearers conforming to ICD-10 schizophrenia or schizoaffective diagnoses were interviewed and completed standardized measures of voice activity; beliefs about voices and supporting evidence, coping behaviour; affect and depression. RESULTS: Beliefs about the power and meaning of voices showed a close relationship with coping behaviour and affect (malevolent voices were associated with fear and anger and were resisted; benevolent voices were associated with positive effect and were engaged) and accounted for the high rate of depression in the sample (53%). Measures of voice form and topography did not show any link with behaviour or affect and in only one-quarter of cases did neutral observers rate voice beliefs as 'following directly' from voice content. CONCLUSION: The study found support for our cognitive model and therapeutic approach. Factors governing the genesis of these key beliefs remain unknown. A number of hypotheses are discussed, which centre around the possibility that voice beliefs develop as part of an adaptive process to the experience of voices, and are underpinned by core beliefs about the individuals self-worth and interpersonal schemata. Language: en
310 citations
TL;DR: Vigorous intervention early in the course of illness, early recognition and treatment of relapse and the promotion of psychological adjustment to psychotic illness are proposed as key elements of this third paradigm of "early intervention".
Abstract: The last few decades have seen a paradigm shift in the way we think about serious mental illness, and particularly schizophrenia. Until quite recently, schizophrenia was considered as an illness with an almost inevitably poor prognosis, with little hope of doing more than managing the symptoms with medication. However, research over the last two decades has shown that this bleak outlook is by no means justified, and that early and appropriate intervention can change the course of illnesses like schizophrenia.
199 citations
TL;DR: A belief that the voice is benevolent was associated with compliance with both innocuous and severe commands, and participants who believed they retained subjective control over their voices were less likely to comply with all types of command.
Abstract: This study explores factors influencing compliance with command hallucinations. The most widely acknowledged factor is the content of the command. Three categories of command content were found to be discrete in terms of compliance: ‘innocuous’ commands, ‘severe’ commands and commands to self-harm. This study takes a cognitive approach and highlights the importance of the beliefs individuals hold about their voices. Beliefs appear to be important in determining whether or not individuals comply with commands and the affect generated.
A belief that the voice is benevolent was associated with compliance with both innocuous and severe commands. In addition, participants who believed they retained subjective control over their voices were less likely to comply with all types of command. Furthermore, qualitative evidence suggested that several other beliefs may influence compliance with command hallucinations such as beliefs about the effects of transgression, beliefs about the power and authority of the commander, beliefs about the social acceptability of the action (which may be closely correlated or synonymous with severity) and its effectiveness in achieving a valued goal. Further research is necessary to investigate the importance of these beliefs and their interrelationships more fully.
90 citations
TL;DR: In this article, the authors used the Beck Depression Inventory, Beliefs About Voices Questionnaire, Cognitive Assessment Schedule and the Topographical Voices Scale to assess schizophrenic individuals with hearing auditory hallucinations.
Abstract: Twenty-one people diagnosed as schizophrenic by SCAN and hearing auditory hallucinations were assessed for depression and the nature of the voice content and beliefs about these using the Beck Depression Inventory, Beliefs About Voices Questionnaire, the Cognitive Assessment Schedule and the Topographical Voices Scale. Examples of content were rated as either derogatory or nonderogatory by the author and a blind rater, with a kappa of 0.6. Depression was linked to both derogatory voice content ( p =0.0004) and malevolent beliefs and/or resistance coping strategies ( p =0.0176) as well as voice intrusiveness and loudness. There was a positive relationship between SCAN depressive and positive symptoms ( p =0.013). A cognitive-behavioural model is proposed and it is recommended that schizophrenic hallucinators with derogatory content and/or malevolent beliefs are screened for depression and suicidal ideation.
57 citations