Background Negative affect (NA) has been suggested to be both an antecedent and a consequence of auditory verbal hallucinations (AVH). Furthermore, negative appraisals of voices have been theorized to contribute to the maintenance of AVH. Using the experience sampling method (ESM), this study examined the bi-directional relationship between NA and AVH, and the moderating effect of negative beliefs about voices. Methods Forty-seven patients diagnosed with schizophrenia spectrum disorders with frequent AVH completed a clinical interview, followed by ESM for 10 times a day over 6 days on an electronic device. Time-lagged analyses were conducted using multilevel regression modeling. Beliefs about voices were assessed at baseline. Results A total of 1654 data points were obtained. NA predicted an increase in AVH in the subsequent moment, and AVH predicted an increase in NA in the subsequent moment. Baseline beliefs about voices as malevolent and omnipotent significantly strengthened the association between NA and AVH within the same moment. In addition, the belief of omnipotence was associated with more hallucinatory experiences in the moment following NA. However, beliefs about voices were not associated directly with momentary levels of NA or AVH. Conclusions Experiences of NA and AVH drove each other, forming a feedback loop that maintained the voices. The associations between NA and AVH, either within the same moment or across moments, were exacerbated by negative beliefs about voices. Our results suggest that affect-improving interventions may stop the feedback loop and reduce AVH frequency.

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Background. Affective disturbances in schizophrenia and bipolar disorder may represent a transdiagnostic etiological process as well as a target of intervention. Hypotheses on similarities and differences in various parameters of affective dynamics (intensity, successive/acute changes, variability, and reactivity to stress) between the two disorders were tested. Methods. Experience sampling method was used to assess dynamics of positive and negative affect, 10 times a day over 6 consecutive days. Patients with schizophrenia (n = 46) and patients with bipolar disorder (n = 46) were compared against age-matched healthy controls (n = 46). Results. Compared to controls, the schizophrenia group had significantly more intense momentary negative affect, a lower likelihood of acute changes in positive affect, and reduced within-person variability of positive affect. The bipolar disorder group was not significantly different from either the schizophrenia group or the healthy control group on any affect indexes. Within the schizophrenia group, level of depression was associated with weaker reactivity to stress for negative affect. Within the bipolar disorder group, level of depression was associated with lower positive affect. Conclusions. Patients with schizophrenia endured a more stable and negative affective state than healthy individuals, and were less likely to be uplifted in response to happenings in daily life. There is little evidence that these affective constructs characterize the psychopathology of bipolar disorder; such investigation may have been limited by the heterogeneity within group. Our findings supported the clinical importance of assessing multiple facets of affective dynamics beyond the mean levels of intensity.

Background and aims.-Obsessive-Compulsive Disorder (OCD) is characterized by obsessions (unwanted thoughts and/or images that cause significant distress) and compulsions (stereotyped behaviors and/or mental acts performed to reduce the distress). While obsessions are related to cognitive inflexibility, compulsions mirror dysfunctional response/behavior inhibition. The Portuguese validated version of the Maudsley Obsessional-Compulsive Inventory (MOCI) assesses three independent but related factors: Doubting/Rumination (more cognitive); Checking and Cleaning (more behavioral). Aim.-To study (a) the correlations between the MOCI dimensions and psychological distress; (b) the mediator role each MOCI dimension on the relationship between the other MOCI dimensions and psychological distress. Methods.-247 university students (78.9% girls, mean aged 20.5 ± 1.64 years) answered the Portuguese versions of the MOCI and the Depression, Anxiety and Stress Scale. Correlation/mediation were performed using process for SPSS. Results.-All the MOCI dimensions presented significant positive correlations with Anxiety and Depression (r > .16, p < .05). Doubting/Rumination and Checking also correlated with Stress (r > .22, p < .01). Doubting/Rumination fully mediated the relationship between Checking and Anxiety/Stress/Depression; and between Cleaning and Anxiety/Depression. Neither Checking or Cleaning were mediators in the relationship between Doubting/Rumination and psychological distress. Conclusions.-Our results of OC symptoms in a non-clinical sample suggest that compulsions may boost obsessions, and this relation generates psychological distress. Our data supports the Compulsive-Obsessive Disorder hypothesis which postulates that obsessions in OCD may be a post hoc rationalization of otherwise inexplicable compulsive urges. The "compulsive urges" would be a consequence of a deficit in goal-directed learning, causing these individuals to over-rely on their habit system, resulting in inappropriate persistence of habits (compulsions).