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Journal ArticleDOI

Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS).

01 Jul 1999-Psychological Medicine (Cambridge University Press)-Vol. 29, Iss: 4, pp 879-889
TL;DR: It is concluded that the PSYRATS are useful assessment instruments and can complement existing measures and have excellent inter-rater reliability.
Abstract: BACKGROUND: Scales to measure the severity of different dimensions of auditory hallucinations and delusions are few. Biochemical and psychological treatments target dimensions of symptoms and valid and reliable measures are necessary to measure these. METHOD: The inter-rater reliability and validity of the Psychotic Symptom Rating Scales (PSYRATS: auditory hallucination subscale and delusions subscale), which measure several dimensions of auditory hallucinations and delusions were examined in this study. RESULTS: The two scales were found to have excellent inter-rater reliability. Their validity as compared with the KGV scale (Krawiecka et al. 1977) was explored. CONCLUSIONS: It is concluded that the PSYRATS are useful assessment instruments and can complement existing measures.
Citations
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Journal ArticleDOI
TL;DR: The SMQ has a single factor structure, was internally reliable, significantly correlated with the MAAS, showed expected associations with affect, and distinguished among meditators, non-meditators and people with psychosis.
Abstract: Objective. To assess the reliability and validity of the Southampton mindfulness questionnaire (SMQ), a 16-item measure of mindful awareness of distressing thoughts and images. Methods. A total of 256 people participated, comprising a non-clinical community sample of 134 (83 meditators and 51 non-meditators) and a clinical sample of 122 people with a current distressing psychosis. To assess concurrent validity, non-clinical participants and half clinical participants (total 197 participants) completed the mindful attention awareness scale (MAAS). Predicted links were assessed with affect, and 59 patients completed a validated measure to assess link between mindfulness and intensity of 'delusional' experience. Results. The scale has a single factor structure, was internally reliable, significantly correlated with the MAAS, showed expected associations with affect, and distinguished among meditators, non-meditators and people with psychosis. Conclusions. The data support use of the SMQ in clinical practice and research to assess mindful responding to distressing thoughts and images.

438 citations

Journal ArticleDOI
TL;DR: Mood, self-esteem and negative evaluative beliefs should be considered when conceptualising psychosis and designing interventions, and evidence for the role of emotion in schizophrenia spectrum-disorders is provided.

418 citations


Cites background from "Scales to measure dimensions of hal..."

  • ...Four scores are obtained: negative self (6 items), positive self (6 items), negative others (6 items) and positive others (6 items)....

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  • ...Psychotic Symptom Rating Scales (Haddock et al., 1999)....

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Journal ArticleDOI
TL;DR: There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction, and anxiety, but not depression, made an independent contribution to delusional conviction.
Abstract: The aim of the study was to elucidate the factors contributing to the severity and persistence of delusional conviction. One hundred participants with current delusions, recruited for a treatment trial of psychological therapy (PRP trial), were assessed at baseline on measures of reasoning, emotions, and dimensions of delusional experience. Reasoning biases (belief inflexibility, jumping to conclusions, and extreme responding) were found to be present in one half of the sample. The hypothesis was confirmed that reasoning biases would be related to delusional conviction. There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction. Emotional states were not associated with the reasoning processes investigated. Anxiety, but not depression, made an independent contribution to delusional conviction.

412 citations


Cites background from "Scales to measure dimensions of hal..."

  • ...The PSYRATS (Haddock et al., 1999) is a 17-item multidimensional measure of delusions and hallucinations on which each item is measured on a 5-point scale ranging from 0 (not endorsing item) to 4 (fully endorsing item)....

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Journal ArticleDOI
TL;DR: CBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.
Abstract: Background Cognitive—behavioural therapy (CBT) improves persistent psychotic symptoms. Aims To test the effectiveness of added CBT in accelerating remission from acute psychotic symptoms in early schizophrenia. Method A 5-week CBT programme plus routine care was compared with supportive counselling plus routine care and routine care alone in a multi-centre trial randomising 315 people with DSM—IV schizophrenia and related disorders in their first (83%) or second acute admission. Outcome assessments were blinded. Results Linear regression over 70 days showed predicted trends towards faster improvement in the CBT group. Uncorrected univariate comparisons showed significant benefits at 4 but not 6 weeks for CBT v . routine care alone on Positive and Negative Syndrome Scale total and positive sub-scale scores and delusion score and benefits v . supportive counselling for auditory hallucinations score. Conclusions CBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.

372 citations

Journal ArticleDOI
TL;DR: The development of a reliable and valid tool to assess ideas of persecution and social reference in a simple self-report format is presented, guided by a current definition of persecutory ideation and incorporating assessment of conviction, preoccupation and distress.
Abstract: BackgroundParanoia is increasingly being studied in clinical and non-clinical populations. However there is no multi-dimensional measure of persecutory ideas developed for use across the general population-psychopathology continuum. This paper reports the development of such a questionnaire: the ‘Green et al. Paranoid Thought Scales’. The aim was to devise a tool to assess ideas of persecution and social reference in a simple self-report format, guided by a current definition of persecutory ideation, and incorporating assessment of conviction, preoccupation and distress.MethodA total of 353 individuals without a history of mental illness, and 50 individuals with current persecutory delusions completed a pool of paranoid items and additional measures to assess validity. Items were devised from a recent definition of persecutory delusions, current assessments of paranoia, the authors' clinical experience, and incorporated dimensions of conviction, preoccupation and distress. Test–retest reliability in the non-clinical group was assessed at 2 weeks follow-up, and clinical change in the deluded group at 6 months follow-up.ResultsTwo 16-item scales were extracted, assessing ideas of social reference and persecution. Good internal consistency and validity was established for both scales and their dimensions. The scales were sensitive to clinical change. A hierarchical relationship between social reference and persecution was found. The data provide further evidence for a continuum of paranoid ideas between deluded and healthy individuals.ConclusionsA reliable and valid tool for assessing paranoid thoughts is presented. It will provide an effective way for researchers to ensure consistency in research and for clinicians to assess change with treatment.

327 citations


Cites background or methods from "Scales to measure dimensions of hal..."

  • ...The clinical group’s persecutory beliefs were also assessed on PSYRATS (Haddock et al. 1999)....

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  • ...Psychotic Symptom Rating Scales (Delusions Subscale) (PSYRATS; Haddock et al. 1999)....

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  • ...1999) and Psychotic Symptom Rating Scales (PSYRATS; Haddock et al. 1999)....

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  • ...It is predicted that the GPTS will have associations with the PS (Fenigstein & Vanable, 1992) and dimensional aspects of the Peters et al. Delusions Inventory (PDI ; Peters et al. 1999) and Psychotic Symptom Rating Scales (PSYRATS; Haddock et al. 1999)....

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References
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Journal ArticleDOI
TL;DR: This paper reviews the most frequently used and misused reliability measures appearing in the mental health literature and suggests some suitable reliability measures to be used.
Abstract: This paper reviews the most frequently used and misused reliability measures appearing in the mental health literature. We illustrate the various types of data sets on which reliability is assessed (i.e., two raters, more than two raters, and varying numbers of raters with dichotomous, polychotomous, and quantitative data). Reliability statistics appropriate for each data format are presented, and their pros and cons illustrated. Inadequancies of some methods are highlighted. The meaning of different levels of reliability obtained with various statistics is discussed. This critique is intended for the reading professional and the investigator who has an occasional need for reliability assessment. Statistical expertise is not required and theoretical material is referenced for the interested reader. Necessary formulas for computations are presented in the appendices. A summary table of some suitable reliability measures is presented.

1,318 citations

Journal ArticleDOI
TL;DR: It is proposed that two distinct syndromes can be discerned from the phenomenological profiles, and the positive syndrome represents productive features superadded to the mental status and the negative syndrome represents absence of normal functions.
Abstract: Over 75 years ago, Bleuler (1911) confronted psychiatry with the question of ‘schizophrenia’ or ‘schizophrenias'. Today we recognise the heterogeneity of the condition, but we are still groping at efforts to clarify the different subtypes or subprocesses. Over the decades there have been various attempts to subclassify schizophrenia and tease apart the syndromes, none of which has been entirely successful. More recently, as a result of the work by Crow (1980) in England and Strauss et al (1974) in the USA, it has been proposed that two distinct syndromes can be discerned from the phenomenological profiles. The positive syndrome consists of productive features superadded to the mental status, such as delusions, hallucinations, and disorganised thinking. The negative syndrome represents absence of normal functions, such as deficits in the cognitive, affective, and social realms.

966 citations

Journal ArticleDOI
TL;DR: It is shown that highly disparate relationships with voices-fear, reassurance, engagement and resistance-reflect vital differences in beliefs about the voices, and how these core beliefs about voices may become a new target for treatment.
Abstract: We offer provisional support for a new cognitive approach to understanding and treating drug-resistant auditory hallucinations in people with a diagnosis of schizophrenia. Study 1 emphasises the relevance of the cognitive model by detailing the behavioural, cognitive and affective responses to persistent voices in 26 patients, demonstrating that highly disparate relationships with voices-fear, reassurance, engagement and resistance-reflect vital differences in beliefs about the voices. All patients viewed their voices as omnipotent and omniscient. However, beliefs about the voice's identity and meaning led to voices being construed as either 'benevolent' or 'malevolent'. Patients provided cogent reasons (evidence) for these beliefs which were not always linked to voice content; indeed in 31% of cases beliefs were incongruous with content, as would be anticipated by a cognitive model. Without fail, voices believed to be malevolent provoked fear and were resisted and those perceived as benevolent were courted. However, in the case of imperative voices, the primary influence on whether commands were obeyed was the severity of the command. Study 2 illustrates how these core beliefs about voices may become a new target for treatment. We describe the application of an adapted version of cognitive therapy (CT) to the treatment of four patients' drug-resistant voices. Where patients were on medication, this was held constant while beliefs about the voices' omnipotence, identity, and purpose were systematically disputed and tested. Large and stable reductions in conviction in these beliefs were reported, and these were associated with reduced distress, increased adaptive behaviour, and unexpectedly, a fall in voice activity. These changes were corroborated by the responsible psychiatrists. Collectively, the cases attest to the promise of CT as a treatment for auditory hallucinations.

777 citations

Journal ArticleDOI
TL;DR: Simple 5‐point scales are described together with the method used to study their reliability, the results of which are shown.
Abstract: Simple 5-point scales are described together with the method used to study their reliability, the results of which are shown. The scales are short, easy to administer and sensitive to change, therefore particularly applicable where there is the need for screening chronic psychotic populations. Some uses for the scales are suggested.

673 citations

01 Jan 1989
TL;DR: The development and principles of congitive-behavioural treatments, Keith Hawton et al cognitive-behavioral assessment, Joan Kirk anxiety states, David M.Clark phobic disorders, Gillian Butler obsessional disorders, Paul M.Salkovskis eating disorders, Christopher Fairburn and Peter Cooper chronic psychiatric handicaps, John Hall marital problems, Karen B.Schmaling et al sexual dysfunctions as mentioned in this paper.
Abstract: The development and principles of congitive-behavioural treatments, Keith Hawton et al cognitive-behavioural assessment, Joan Kirk anxiety states, David M.Clark phobic disorders, Gillian Butler obsessional disorders, Paul M.Salkovskis and Joan Kirk depression, Melanie Fennell somatic problems, Paul M.Salkovskis eating disorders, Christopher Fairburn and Peter Cooper chronic psychiatric handicaps, John Hall marital problems, Karen B.Schmaling et al sexual dysfunctions, Keith Hawton problem-solving, Keith Hawton and Joan Kirk.

481 citations