Junginger J
Department of Psychology, State University of New York at Binghamton 13902, USA.
Psychiatr Serv. 1995 Sep;46(9):911-4. doi: 10.1176/ps.46.9.911.
Recent studies have supported the belief that command hallucinations can induce dangerous behavior. This study tried to replicate previous findings that compliance with the command was associated with delusions related to hallucinations and the ability to identify the hallucinated voice. This study also assessed the association between compliance and the dangerousness of the command, chronicity of illness, a diagnosis of schizophrenia, and past compliance with hallucinated commands.
The most recent command hallucination reported by 93 psychiatric inpatients was rated for level of dangerousness and level of compliance with the command.
Subjects who experienced less dangerous commands or who could identify the hallucinated voice reported higher levels of compliance, although reported compliance with more dangerous commands was not uncommon. Commands experienced in the hospital were less dangerous than those experienced elsewhere and tended to be specific to the hospital environment. Subjects were less likely to comply with commands experienced in the hospital.
Based on their self-reports, psychiatric patients who experience command hallucinations are at risk for dangerous behavior. Ability to identify the hallucinated voice is a fairly reliable predictor of reported compliance. Level of dangerousness resulting from compliance with command hallucinations may be a function of the patient's environment.
近期研究支持了命令性幻听可诱发危险行为这一观点。本研究试图重复先前的发现，即对命令的服从与幻觉相关的妄想以及识别幻听声音的能力有关。本研究还评估了服从与命令的危险性、疾病的慢性程度、精神分裂症的诊断以及既往对幻听命令的服从之间的关联。
对93名精神科住院患者报告的最近一次命令性幻听进行危险性水平和对命令的服从水平评定。
经历危险性较低命令的受试者或能够识别幻听声音的受试者报告的服从水平较高，尽管报告对更危险命令的服从情况也并不罕见。在医院经历的命令比在其他地方经历的命令危险性更低，且往往与医院环境相关。受试者不太可能服从在医院经历的命令。
根据他们的自我报告，经历命令性幻听的精神科患者存在危险行为风险。识别幻听声音的能力是报告的服从情况的一个相当可靠的预测指标。服从命令性幻听导致的危险性水平可能是患者环境的一个函数。
