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      The Beliefs about Voices Questionnaire – Revised: A factor structure from 450 participants

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          Abstract

          Hallucinated voices are common across psychiatric and non-clinical groups. The predominant cognitive theory about the impact of voices posits that beliefs about voice power (‘Omnipotence’) and voice intent (‘Malevolence’/‘Benevolence’) play a key role in determining emotional and behavioral reactions. The revised Beliefs about Voices Questionnaire (BAVQ-R) was designed to assess these constructs, together with two styles of responding (Engagement and Resistance). The BAVQ-R is widely used in clinical and research settings, yet it has not received validation of its constructs and factor structure. This study examined the factor structure of the BAVQ-R by combining datasets from five study centers, comprising 450 participants (belief constructs) and 269 participants (response styles), and using confirmatory and exploratory factor analysis. Findings failed to support a three factor belief model, instead showing a two-factor structure (‘Persecutory beliefs’ combining Omnipotence and Malevolence constructs, and a Benevolent construct). Emotional and behavioral items did not separate. Overall, results showed that (i) a two-factor model of beliefs (Persecutory and Benevolent beliefs) provides a better fit to the data than a three-factor model, and (ii) emotional and behavioral modes of responding items should not be separated. Theoretical implications of this finding are discussed in relation to the research and therapy.

          Highlights

          • The BAVQ-R was designed to measure beliefs about voices and reactions to voices.

          • Despite widespread use, the factor structure of the BAVQ-R has not been established.

          • A two-factor model of beliefs (Persecutory and Benevolent) provided the best fit.

          • A two-factor model of reactions (Engagement and Resistance) provided the best fit.

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          Most cited references35

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          Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications.

          To review the research addressing the relationship of childhood trauma to psychosis and schizophrenia, and to discuss the theoretical and clinical implications. Relevant studies and previous review papers were identified via computer literature searches. Symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to childhood abuse and neglect as many other mental health problems. Recent large-scale general population studies indicate the relationship is a causal one, with a dose-effect. Several psychological and biological mechanisms by which childhood trauma increases risk for psychosis merit attention. Integration of these different levels of analysis may stimulate a more genuinely integrated bio-psycho-social model of psychosis than currently prevails. Clinical implications include the need for staff training in asking about abuse and the need to offer appropriate psychosocial treatments to patients who have been abused or neglected as children. Prevention issues are also identified.
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            The current state of cognitive therapy: a 40-year retrospective.

            The basic framework of the cognitive theory of psychopathology and cognitive therapy of specific psychiatric disorders was developed more than 40 years ago. Since that time, there has been continuing progress in the development of cognitive theory and therapy and in the empirical testing of both. A substantial body of research supports the cognitive model of depression and, to a somewhat lesser extent, the various anxiety disorders. Cognitive therapy (CT), often labeled as the generic term cognitive behavior therapy, has been shown to be effective in reducing symptoms and relapse rates, with or without medication, in a wide variety of psychiatric disorders. Suggestions for future research and applications are presented.
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              The same or different? A phenomenological comparison of auditory verbal hallucinations in healthy and psychotic individuals.

              Whereas auditory verbal hallucinations (AVHs) are most characteristic of schizophrenia, their presence has frequently been described in a continuum, ranging from severely psychotic patients to schizotypal personality disorder patients to otherwise healthy participants. It remains unclear whether AVHs at the outer borders of this spectrum are indeed the same phenomenon. Furthermore, specific characteristics of AVHs may be important indicators of a psychotic disorder. To investigate differences and similarities in AVHs in psychotic and nonpsychotic individuals, the phenomenology of AVHs in 118 psychotic outpatients was compared to that in 111 otherwise healthy individuals, both experiencing AVHs at least once a month. The study was performed between September 2007 and March 2010 at the University Medical Center, Utrecht, the Netherlands. Characteristics of AVHs were quantified using the Psychotic Symptoms Rating Scales Auditory Hallucinations subscale. The perceived location of voices (inside/outside the head), the number of voices, loudness, and personification did not differentiate between psychotic and healthy individuals. The most prominent differences between AVHs in healthy and psychotic individuals were the emotional valence of the content, the frequency of AVHs, and the control subjects had over their AVHs (all P values < .001). Age at onset of AVHs was at a significantly younger age in the healthy individuals (P < .001). In our sample, the negative emotional valence of the content of AVHs could accurately predict the presence of a psychotic disorder in 88% of the participants. We cannot ascertain whether AVHs at the outer borders of the spectrum should be considered the same phenomenon, as there are both similarities and differences. The much younger age at onset of AVHs in the healthy subjects compared to that in psychotic patients may suggest a different pathophysiology. The high predictive value of the emotional content of voices implies that inquiring after the emotional content of AVHs may be a crucial step in the diagnosis of psychotic disorders in individuals hearing voices. © Copyright 2011 Physicians Postgraduate Press, Inc.
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                Author and article information

                Contributors
                Journal
                Psychiatry Res
                Psychiatry Res
                Psychiatry Research
                Elsevier/North-Holland Biomedical Press
                0165-1781
                1872-7123
                1 January 2018
                January 2018
                : 259
                : 95-103
                Affiliations
                [a ]School of Psychology, University of Sussex, Brighton BN1 9QH, UK
                [b ]Sussex Partnership NHS Foundation Trust, Hove, UK
                [c ]Department of Biological and Medical Psychology, University of Bergen, Norway
                [d ]Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
                [e ]NORMENT Center of Excellence, University of Oslo, Norway
                [f ]Clinical Research Centre, North Metro Health Service, Graylands Hospital, Perth, Australia
                [g ]School of Psychiatry and Clinical Neurosciences, University of Western Australia, Australia
                [h ]Nidaros District Psychiatric Center, Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
                [i ]Department of Clinical Medicine (K1), University of Bergen, Norway
                [j ]Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
                [k ]Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
                [l ]Department of Clinical Psychology, University of Bergen, Norway
                [m ]Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
                [n ]Voices Clinic, Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Melbourne, Australia
                Author notes
                [* ]Corresponding author at: School of Psychology, University of Sussex, Brighton BN1 9QH, UK.School of Psychology, University of SussexBrightonBN1 9QHUK c.y.strauss@ 123456sussex.ac.uk
                Article
                S0165-1781(17)30329-3
                10.1016/j.psychres.2017.09.089
                5764292
                29035759
                a6f48943-f5d1-41b8-976a-f0955f8b055e
                © 2017 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 24 February 2017
                : 31 August 2017
                : 30 September 2017
                Categories
                Article

                Clinical Psychology & Psychiatry
                hallucinations,hearing voices,bavq,beliefs about voices,omnipotence,malevolence

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