Visual hallucinations in psychiatric conditions: Appraisals and their relationship to distress

Gauntlett‐Gilbert, Jeremy; Kuipers, Elizabeth

doi:10.1348/014466504x19451

Cited by 27 publications

(24 citation statements)

References 18 publications

(21 reference statements)

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“…Whether this is helpful with other visual experiences is unclear, although studies show that the appraisals and beliefs should be a core target for treatment. 70,108 …”

Section: Treatment Approachesmentioning

confidence: 99%

Visual Hallucinations in the Psychosis Spectrum and Comparative Information From Neurodegenerative Disorders and Eye Disease

Waters

Collerton

ffytche

et al. 2014

Schizophrenia Bulletin

272

263

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Much of the research on visual hallucinations (VHs) has been conducted in the context of eye disease and neurodegenerative conditions, but little is known about these phenomena in psychiatric and nonclinical populations. The purpose of this article is to bring together current knowledge regarding VHs in the psychosis phenotype and contrast this data with the literature drawn from neurodegenerative disorders and eye disease. The evidence challenges the traditional views that VHs are atypical or uncommon in psychosis. The weighted mean for VHs is 27% in schizophrenia, 15% in affective psychosis, and 7.3% in the general community. VHs are linked to a more severe psychopathological profile and less favorable outcome in psychosis and neurodegenerative conditions. VHs typically co-occur with auditory hallucinations, suggesting a common etiological cause. VHs in psychosis are also remarkably complex, negative in content, and are interpreted to have personal relevance. The cognitive mechanisms of VHs in psychosis have rarely been investigated, but existing studies point to source-monitoring deficits and distortions in top-down mechanisms, although evidence for visual processing deficits, which feature strongly in the organic literature, is lacking. Brain imaging studies point to the activation of visual cortex during hallucinations on a background of structural and connectivity changes within wider brain networks. The relationship between VHs in psychosis, eye disease, and neurodegeneration remains unclear, although the pattern of similarities and differences described in this review suggests that comparative studies may have potentially important clinical and theoretical implications.

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“…Whether this is helpful with other visual experiences is unclear, although studies show that the appraisals and beliefs should be a core target for treatment. 70,108 …”

Section: Treatment Approachesmentioning

confidence: 99%

Visual Hallucinations in the Psychosis Spectrum and Comparative Information From Neurodegenerative Disorders and Eye Disease

Waters

Collerton

ffytche

et al. 2014

Schizophrenia Bulletin

272

263

View full text Add to dashboard Cite

show abstract

“…The work so far indicates that the appraisal of the VH is important in understanding distress. Gauntlett-Gilbert and Kuipers (2005) found that an individual's appraisal did not simply follow on from the content, frequency or duration of the VH and that if the individual's appraisal of this experience was negative then this directly predicted distress.Collerton and Dudley (2004) argued that the appraisal of the visual experience was central to understanding the distress associated with VH. Specifically, it was proposed that people would appraise the visual experience as a threat to their physical or psychological wellbeing, and that they would use Safety Seeking Behaviours (SSBs) to help manage this distress much like people with other emotional and psychotic symptoms do.…”

mentioning

confidence: 93%

Identifying Specific Interpretations and Use of Safety Behaviours in People with Distressing Visual Hallucinations: An Exploratory Study

Dudley

Wood

Spencer

et al. 2012

Behav. Cogn. Psychother.

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Background: Visual hallucinations (VH) are a common experience and can be distressing and disabling, particularly for people suffering from psychotic illness. However, not everyone with visual hallucinations reports the experience to be distressing. Models of VH propose that appraisals of VH as a threat to wellbeing and the use of safety seeking behaviours help maintain the distress. Aims: This study investigated whether people with distressing VH report threat appraisals and use safety behaviours. Method: The study utilized a single group descriptive design, in which 15 participants with psychosis and VH were asked questions in order to assess the content, distress, appraisals, and behaviours associated with visual hallucinations. Results: People who found visual hallucinations distressing (n = 13) held negative appraisals about those hallucinations and specifically saw them as a threat to their physical or psychological wellbeing. They also engaged in safety seeking behaviours that were logically related to the appraisal and served to maintain the distress. Conclusions: People with distressing VH regard them as a threat to their wellbeing and use safety seeking behaviours as a result of this perceived threat. These key processes are potential targets for treatments that will alleviate the distress associated with VH.Keywords: Psychosis, safety seeking behaviours, visual hallucinations. IntroductionVisual hallucinations (VH) are common in people with psychosis where they are associated with particular distress and disability (Mueser, Bellack and Brady, 1990). To date there has been scant research into VH. The work so far indicates that the appraisal of the VH is important in understanding distress. Gauntlett-Gilbert and Kuipers (2005) found that an individual's appraisal did not simply follow on from the content, frequency or duration of the VH and that if the individual's appraisal of this experience was negative then this directly predicted distress.Collerton and Dudley (2004) argued that the appraisal of the visual experience was central to understanding the distress associated with VH. Specifically, it was proposed that people would appraise the visual experience as a threat to their physical or psychological wellbeing, and that they would use Safety Seeking Behaviours (SSBs) to help manage this distress much like people with other emotional and psychotic symptoms do.The current research is intended to inform two key elements of the Collerton and Dudley (2004) model and by doing so provide a greater understanding of the psychological processes involved in the experience of distressing VH. First, the research was designed to study the specific appraisals of VH. Previous research into VH has indicated that appraisal is important but has not specified whether it is perceived as a threat to wellbeing. The second aim was to investigate the use of SSBs by people with VH. If people appraised their experiences as a threat to wellbeing then it would be expected that they would take steps to prevent the feared outcom...

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“…In fact, benevolent appraisals have been associated with voice engagement, omnipotent and fearful appraisals with distress, and malevolent appraisals with voice resistance, and each of these are independent of frequency, severity, and intensity of voices (Chadwick & Birchwood, 1994;Gauntlett-Gilbert & Kuipers, 2005;Jackson, Hayward, & Cooke, 2011;Mawson, Berry, Murray, & Hayward, 2011;O'Brien & Johns, 2013;Peters, Williams, Cooke, & Kuipers, 2012). On a broader level, various studies have suggested that mental health labels such as psychosis (as an indication of 'abnormality') can facilitate negative appraisals of voices, especially when the experiences are perceived as rare or unusual (Corrigan, 2004;Mak, Poon, Pun, & Cheung, 2007).…”

Section: Hearing Voices Researchmentioning

confidence: 99%

A Pilot Study of the Relations Within Which Hearing Voices Participates: Towards A Functional Distinction Between Voice Hearers and Controls

et al. 2016

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Visual hallucinations in psychiatric conditions: Appraisals and their relationship to distress

Cited by 27 publications

References 18 publications

Visual Hallucinations in the Psychosis Spectrum and Comparative Information From Neurodegenerative Disorders and Eye Disease

Visual Hallucinations in the Psychosis Spectrum and Comparative Information From Neurodegenerative Disorders and Eye Disease

Identifying Specific Interpretations and Use of Safety Behaviours in People with Distressing Visual Hallucinations: An Exploratory Study

A Pilot Study of the Relations Within Which Hearing Voices Participates: Towards A Functional Distinction Between Voice Hearers and Controls

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