South West London and St George's NHS Trust, London, UK.
School of Psychology, University of Sussex, Brighton, UK.
Psychol Psychother. 2017 Dec;90(4):617-632. doi: 10.1111/papt.12129. Epub 2017 May 12.
Cognitive models propose that levels of distress associated with auditory verbal hallucinations ('voices') are influenced by the hearers' beliefs about their voices (perceived malevolence and omnipotence), their negative beliefs about themselves and others and their attachment style. This study aims to test a comprehensive model of the relationship between these variables in order to identify distal and proximal interpersonal and cognitive factors contributing to voice-related distress. This interpersonal-cognitive model of voices proposes that attachment anxiety/avoidance drive negative beliefs about self and others, which in turn lead to persecutory (malevolent/omnipotent) beliefs about voices, which in turn increase levels of voice-related distress.
DESIGN/METHODS: Path analysis was used to test the interpersonal-cognitive model in a sample of 180 people currently hearing voices (57% self-reported schizophrenia-spectrum diagnoses; 90% some form of self-reported mental health diagnosis).
Path analysis provided support for a model in which there were direct pathways from attachment anxiety and avoidance to negative beliefs about self and others; direct pathways from negative beliefs about self and others to persecutory beliefs about voices; and a direct path from persecutory beliefs about voices, and negative beliefs about self, to voice distress.
Findings add support to the suggestion that voice-related distress occurs in the context of an insecure attachment style and negative core beliefs about self/others. A therapeutic focus on beliefs about voices, attachment style and core beliefs about self/others may be important to minimize voice-related distress. Further tests of this model that can establish causal relationships between variables are now needed.
Distress associated with auditory verbal hallucinations ('voices') is highly variable. This study tests a comprehensive interpersonal-cognitive model of voice distress using path analysis with 180 participants. The model tested in the current paper shows that attachment style predicts negative beliefs about self and others, which in turn predicts negative beliefs about voices, which in turn predicts voice-related distress. Findings support the suggestion that voice-related distress occurs in the context of an insecure attachment style and negative core beliefs about self and others. In addition to focusing on beliefs about voices, a therapeutic focus on attachment style and core beliefs about self and others may be important in order to minimize voice-related distress.
认知模型提出，与听觉言语幻觉（“声音”）相关的困扰程度受到听众对声音的信念（感知的恶意和全能）、他们对自己和他人的消极信念以及他们的依恋风格的影响。本研究旨在测试这些变量之间关系的综合模型，以确定导致与声音相关的困扰的远程和近端人际认知因素。这个声音的人际认知模型提出，依恋焦虑/回避会导致对自我和他人的消极信念，进而导致对声音的迫害性（恶意/全能）信念，进而增加与声音相关的困扰程度。
设计/方法：路径分析用于测试 180 名当前听到声音的个体样本中的人际认知模型（57%自我报告为精神分裂症谱系诊断；90%自我报告某种形式的心理健康诊断）。
路径分析支持了这样一种模型，即依恋焦虑和回避直接导致对自我和他人的消极信念；直接从自我和他人的消极信念到对声音的迫害性信念；以及从对声音的迫害性信念和对自我的消极信念到声音困扰的直接路径。
研究结果进一步支持了这样一种观点，即与声音相关的困扰发生在不安全的依恋风格和对自我/他人的消极核心信念的背景下。对声音、依恋风格和自我/他人核心信念的信念的治疗重点可能对于最大限度地减少与声音相关的困扰很重要。现在需要进一步测试这个模型，以确定变量之间的因果关系。
与听觉言语幻觉（“声音”）相关的困扰程度差异很大。本研究使用路径分析测试了 180 名参与者的声音困扰综合人际认知模型。当前论文中测试的模型表明，依恋风格预测自我和他人的消极信念，进而预测对声音的消极信念，进而预测与声音相关的困扰。研究结果支持这样一种观点，即与声音相关的困扰发生在不安全的依恋风格和对自我和他人的消极核心信念的背景下。除了关注声音的信念之外，关注依恋风格和自我与他人的核心信念也可能很重要，以尽量减少与声音相关的困扰。
