Although harmful command hallucinations have been linked to violent behavior, few studies have examined factors mediating this relationship. The principal aim of this study was to examine a range of factors potentially associated with acting on harmful command hallucinations using a multivariate approach. The sample comprised 75 participants drawn from community and forensic services. Measures assessing characteristics of the command hallucination and the hallucinator, including forensic risk factors, were administered. Using ordinal logistic regression, we found compliance to be associated with increasing age, viewing the command hallucination as positive, congruent delusions, and reporting low maternal control in childhood. Antipsychotic medication was protective while, contrary to expectations, traditional predictors of violence reduced the odds of compliance with command hallucinations viewed as threatening. The findings suggest that compliance with harmful commands is driven by a complex interaction between beliefs related to the command hallucination and personal characteristics, with risk of compliance increasing with age.

Objective: This study evaluated a brief psychological intervention aimed at improving distress tolerance and decreasing future admissions for individuals presenting to a mental health service in the context of crisis or self-harm. Methods: Eighty-five participants completed The Crisis Intervention Package at the point of contact with the mental health service. The outcome of the intervention was evaluated through pre- and post-scores on the Distress Tolerance Scale and future hospital admissions. Results: Participants showed a significant improvement in Distress Tolerance Scale scores ( P < 0.001) indicating an increase in ability to tolerate distressing emotions. Additionally, there was a significant decrease in hospital admissions 6 months pre-test to 6 months post-test. Conclusions: The results demonstrate the potential effectiveness of structured, brief interventions aimed at increasing distress tolerance and self-management skills for individuals presenting to a mental health service in crisis.

No abstract

No abstract