The effects of a voice hearing simulation on implicit fear of voices

Abstract

The current study investigated potential changes in implicit negativity of hearing voices in a non-voice hearing student population (N=28) subjected to a hearing voices simulation using the Implicit Relational Assessment Procedure (IRAP). On the Baseline IRAP, participants were required to pair voices-as-positive and voices-as-negative statements on alternating trial blocks. Participants were subsequently exposed to a simulation procedure and a Post-Simulation IRAP. At baseline and post-simulation, hearing voices was implicitly evaluated as both positive and fearful, however positivity toward voices reduced and negativity increased after the simulation. Interestingly, implicit changes also appeared to be influenced by high delusional ideation. Keywords: hearing voices simulation, IRAP, implicit measures IMPLICIT NEGATIVITY TOWARD HEARING VOICES 3Given the breadth of the label of psychosis, and even schizophrenia, researchers have begun to investigate key features that may be specific to these patterns of suffering, specifically hearing voices. This impetus is likely due to two related facts: 1. It is now established that voices are a very commonly reported symptom, not only in diagnoses of psychosis and other psychiatric diagnoses (see Sartorius et al., 1986; Slotema et al., 2012), but also in non-clinical contexts (e.g., Beavan, Read, & Cartwright, 2011); and 2. Social movements, such as the Hearing Voices Movement (aim to normalize and promote the acceptance of unusual experiences) have grown rapidly and are now powerful advocates for social change (Bentall, 2004;Corstens, Longden, McCarthy-Jones, Waddingham, & Thomas, 2014).Given the prevalence of voice hearing in clinical and non-clinical contexts, and the growing desire for a social change in attitudes toward mental health difficulties, an increasing number of studies have examined attitudes toward voice hearing. Indeed, a vast literature exists demonstrating the presence of negative professional attitudes toward psychological suffering (Schulze, 2007), thus many studies on voice hearing contain interventions that attempt to target these negative attitudes in mental health professionals, often with the aim of targeting stigma, empathy, etc. regarding voices. Many of these studies have included simulations of distressing (or critical) voices within these interventions, due to the prevalence of these types of voices, as reported by voice hearers (Larøi et al., 2012). Overall, these interventions have been associated with positive outcomes and voice simulations have been shown to reduce stigma, but improve empathy, behavioral intentions, and positive attitudes toward voice hearers (Bunn & Terpstra, 2009;Chaffin & Adams, 2013;Dearing & Steadman, 2009;Deegan, 1996;Hojat et al., 2001;Kalyanaraman, Penn, Ivory, & Judge, 2010;Kidd, Tusaie, Morgan, Preebe, & Garrett, 2015;Sideras, Mckenzie, Noone, Dieckmann, & Allen, 2015;Ward, 2015;Wieland, Levine, & Smith, 2015;Wilson et al., 2009 (Ando, Clement, Barley, & Thornicroft, 2011). Furthermore, the simulation pr...

Do Response Options in the Implicit Relational Assessment Procedure (IRAP) Matter? A Comparison of Contextual Relations versus Relational Coherent Indicators

“…The IRAP task requires participants to alternate between affirming stereotypes (e.g., thin-positive-similar/fat-positive-opposite) and anti-stereotypes (e.g., thin-negative-similar/ fat-negative-opposite) when trials illustrating relations of this type are presented on a computer-screen. Early IRAP research used C rel s, (e.g., same-opposite); however, recent IRAP researchers have tended to use RCIs (e.g., True/False; Right/Wrong; Yes/No; see Hussey et al 2015;McEnteggart et al 2016;Hussey and Barnes-Holmes 2012), thus it is important to examine whether C rel s/RCIs are interchangeable with no effect on the research, or if there is a potential impact on IRAP findings depending on which type of response options are used.…”