Abstract: Auditory hallucinations among the most invalidating
and distressing experiences reported by patients diagnosed with
schizophrenia, leading to feelings of powerlessness and helplessness
towards their illness. In more severe cases, these auditory
hallucinations can take the form of commanding voices, which are
often related to high suicidality rates in these patients. Several
authors propose that the meanings attributed to the hallucinatory
experience, rather than characteristics like form and content, can be
determinant in patients’ reactions to hallucinatory activity,
particularly in the case of voice-hearing experiences. In this study, 48
patients diagnosed with paranoid schizophrenia presenting auditory
hallucinations were studied. Multiple regression analyses were
computed to study the influence of several developmental aspects,
such as family and social dynamics, bullying, depression, and sociocognitive
variables on the auditory hallucinations, on patients’
attributions and relationships with their voices, and on the resulting
invalidation of hallucinatory experience. Overall, results showed how
relationships with voices can mirror several aspects of interpersonal
relationship with others, and how self-schemas, depression and actual
social relationships help shaping the voice-hearing experience. Early
experiences of victimization and submission help predict the
attributions of omnipotence of the voices, and increased hostility
from parents seems to increase the malevolence of the voices,
suggesting that socio-cognitive factors can significantly contribute to
the etiology and maintenance of auditory hallucinations. The
understanding of the characteristics of auditory hallucinations and the
relationships patients established with their voices can allow the
development of more promising therapeutic interventions that can be
more effective in decreasing invalidation caused by this devastating
mental illness.
Abstract: The aim of the current study was to develop and
validate a Response to Stressful Situations Scale (RSSS) for the
Portuguese population. This scale assesses the degree of stress
experienced in scenarios that can constitute positive, negative and
more neutral stressors, and also describes the physiological,
emotional and behavioral reactions to those events according to their
intensity. These scenarios include typical stressor scenarios relevant
to patients with schizophrenia, which are currently absent from most
scales, assessing specific risks that these stressors may bring on
subjects, which may prove useful in non-clinical and clinical
populations (i.e. Patients with mood or anxiety disorders,
schizophrenia). Results from Principal Components Analysis and
Confirmatory Factor Analysis of two adult samples from general
population allowed to confirm a three-factor model with good fit
indices: χ2 (144)= 370.211, p = 0.000; GFI = 0.928; CFI = 0.927; TLI =
0.914, RMSEA = 0.055, P(rmsea ≤0.005) = .096; PCFI = .781.
Further data analysis of the scale revealed that RSSS is an adequate
assessment tool of stress response in adults to be used in further
research and clinical settings, with good psychometric characteristics,
adequate divergent and convergent validity, good temporal stability
and high internal consistency.