Beliefs about voices and their effects on coping strategies

Cognitive behavioural techniques are increasingly used as adjuncts to medic ation in the treatment of auditory hallucinations for people with schizophr enia. There are now literally hundreds of nurses trained in the use of cogn itive behavioural interventions for psychosis. However, there is still disa greement about the nature of the cognitive processes that lead to deficits or biases in patients' processing of information about their psychotic expe riences. Using Chadwick & Birchwood's Beliefs About Voices Questionnaire (B AVQ), the investigator collected data regarding voices from a sample of men and women being treated for schizophrenia by secondary mental health servi ces. The investigator then carried out a cross-lagged panel analysis of the data. The investigator found, as predicted, positive relationships between a resistive coping style and an attribution of malevolence to voices, and between an engaging coping style and an attribution of benevolence to voice s. Coping and attributional styles were not necessarily stable over time. T here was a non-significant difference between women's and men's attribution s and coping styles, There was less fluctuation over time in the women's sc ores on the BAVQ, This research shows that one cannot assume that either co ping or attributional style becomes more stable over time. However, while t here are strong relationships between attributions and coping styles,and pa rticularly between malevolence and resistance and benevolence and engagemen t, these relationships are not necessarily mutually exclusive and some peop le in the study believe their voices to be both malevolent and benevolent. These findings suggest that clinicians need to make a very careful assessme nt of attribution and coping with regard to hallucinations and that systema tic reassessment is very important. Further research is necessary in both t he phenomenology of attribution and coping, but also to relate these variab les to other aspects of schizophrenic illnesses.