Br J Clin Psychol. 2016 Jan 11. doi: 10.1111/bjc.12102. [Epub ahead of print]

Experiential avoidance and appraisals of voices as predictors of voice-related distress.

Varese F1,2, Morrison AP2,3, Beck R3, Heffernan S4, Law H3, Bentall RP5.

• 1Division of Health Research, Lancaster University, UK.
• 2School of Psychological Sciences, University of Manchester, UK.
• 3Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
• 4Mersey Care NHS Trust, Liverpool, UK.
• 5Institute of Psychology Health and Society, University of Liverpool, UK.

Abstract

OBJECTIVES:

Research has suggested that the extent to which voices (i.e., auditory verbal hallucinations) are experienced as distressing might be influenced by negative beliefs about voices as well as maladaptive metacognitive styles involving the negative appraisal and maladaptive control of mental experiences. This cross-sectional study examined the contribution of both specific appraisals of voices and a metacognitive factor (i.e., experiential avoidance) to voice-related distress.

METHODS:

Self-report measurers of voice characteristics (voice frequency, duration as well as amount and intensity of voice-related distress), experiential avoidance, and appraisals of voices were collected in a sample of 101 voice-hearers.

RESULTS:

Experiential avoidance and negative beliefs about voices were associated with higher levels of voice-related distress, but not to measures of voice frequency and duration. Experiential avoidance and negative 'metaphysical' beliefs about voices were significant predictors of voice-related distress even after accounting for the effect of frequency and duration of voices, and explained similar proportions of unique variance in distress.

CONCLUSIONS:

These findings suggest that the appraisals of voices and experiential avoidance are predictive of voice-related distress and that cognitive-behavioural interventions targeting both voice-specific appraisals and general maladaptive metacognitive processes could prove useful treatment approaches for clients with distressing voices.

PRACTITIONER POINTS:

Experiential avoidance (EA) and negative appraisals predict voice-related distress caused by voices, but not their frequency and duration. Interventions for voices should consider targeting EA and negative appraisals (e.g., cognitive-behavioural therapy, Acceptance and Commitment Therapy) to ameliorate distress.

© 2016 The British Psychological Society.

KEYWORDS:

cognitive-behavioural therapy; experiential avoidance; hallucinations; psychosis; voices

PMID:

26752336