Experiencing malevolent voices is associated with attentional dysfunction in psychotic patients

Inattention in people with schizophrenia is common. However, there has been little research on the association between inattention and auditory hallucinations. The aim of the study was to investigate how inattention is affected by beliefs about voices as benevolent and malevolent and perceived control of voices. A total of 31 patients who experienced auditory hallucinations and who met the criteria for schizophrenia or other psychosis completed the attention subscale of the Scale for the Assessment of Negative Symptoms (SANS) and the Connors’ Continuous Performance Test II (CCPT‐II). The revised Beliefs About Voices Questionnaire (BAVQ‐R) was used to assess malevolent and benevolent beliefs about voices, and severity of auditory hallucinations (the Psychotic Symptom Rating Scales; PSYRATS) was used to assess perceived control of voices and frequency of voices. Levels of depression (the Beck Depression Inventory; BDI), anxiety (the Beck Anxiety Inventory; BAI), severity of overall psychiatric symptoms (the Brief Psychiatric Rating Scale; BPRS), and severity of negative symptoms (SANS) were assessed to control for their potential confounding effects. The relations between the variables were explored with correlations and multiple hierarchical regression analyses. The results indicated that more malevolent, but not more benevolent, beliefs about voices predicted lower levels of attention, independently of general psychiatric symptoms and various other psychotic symptoms such as frequency of and perceived control of voices. These findings suggest an important relationship between malevolent beliefs about voices and levels of inattention. The possible impact of changing beliefs about voices to improve attentional functioning is discussed.     

Changing a culture: a brief program analysis of a social learning program on a maximum-security forensic unit

This report presents outcome data collected for a three-year period from a maximum-security forensic psychiatric program. Admission and discharge variables, restraint/seclusion, and client abuse/neglect data are presented from a one-year period that preceded the advent of the Behavior Management Treatment Program's (BMTP's) Social Learning Diagnostic Program to two years after implementing the Social Learning Diagnostic Program. Significant overall progress and improvement was observed in all variables analyzed after instituting a social learning program paradigm. This report provides a brief summary of the BMTP's Social Learning Diagnostic Program along with a discussion of the role played by Dangerousness Management Plans in the treatment of patients within the social learning milieu. Additionally the patient population served, and the rationale for implementation of a program based in social learning theory, are discussed.