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Empirical studies into aspects of belief content that are associated with distress in persecutory delusions have been inconsistent. Typically these studies have focused on the anticipation of threat consistent with the conceptualisation of persecutory delusions as a form of threat belief. Research in the voices literature has focused on the relationship the voice-hearer establishes with their voice. In doing so, it has been demonstrated that specific aspects of interpersonal belief content are associated with distress. The study had two main aims: (1) to explore how people with persecutory delusions perceived the self, others and persecutors across specific dimensions of interpersonal belief, and (2) whether the difference self other and persecutor on dimensions of interpersonal beliefs was associated with emotional and delusional distress. A cross-sectional investigation of 29 individuals currently experiencing persecutory delusions was conducted. A repertory grid methodology was used to explore aspects of belief content between self, other and persecutor, and differences were correlated with emotional and delusional distress measures. The results highlighted a role for malevolence as a key belief dimension in the way people with persecutory delusions view persecutors and others. With regard to distress, there was a key role for how others were viewed compared to the persecutor. When participants saw others and persecutors to be similar in terms of malevolence and omnipotence, this was associated with higher levels of depression and anxiety. The appraisals people with persecutory beliefs make concerning others on interpersonal beliefs appear important in distress. Therefore, interventions that focus on improving relationships with others may facilitate the alleviation of distress.

Beliefs about voices have been shown to be more important than voice content in determining an individual's emotional and behavioural responses to command hallucinations (CH). Inflated responsibility beliefs (IRB) and thought-aCtion fusion (TAF), originally implicated in QCD, have been found in psychosis. The current study examined whether IRB and TAF are relevant in CH, and whether there is a relationship between the two constructs in voice hearers. 18 people with CH, 17 with non-CH, and 23 non-clinical controls (NCC) completed measures of IRB, TAF, obsessive-compulsive symptoms, depression and anxiety. People with CH were also interviewed about their responsibility beliefs for compliance with voices, using the pie chart technique commonly used in anxiety disorder treatments. For the auditory hallucination (AH) group, a significant positive relationship was found between IRB and both TAF-Moral and TAF-Likelihood, however only TAF-Moral remained significant after controlling for potential confounds. In terms of differences in IRB, the AH group scored significantly higher than NCC. The CH group had significantly higher IRB than non-CH and NCC on both measures of IRB. The non-CH group scored Significantly higher than NCC on one measure of IRB only. In terms of TAF, the AH group scored significantly higher than NCC across all TAF subscales. The CH group had a significantly higher TAF bias than NCC on all TAF subscales, and scored Significantly higher than non-CH on T AF-Moral, but not TAF-Likelihood beliefs. The non-CH group had a significantly higher TAF bias than NCC for TAF- Likelihood domains, but not TAF-Moral. The results suggested IRB and TAF are relevant in command hallucinations, which are not simply accounted for by the presence of obsessive-compulsive symptoms. Further research into the role of IRB and TAF in compliance with commands is needed, as well as research into more targeted assessment and treatment approaches for command hallucinations. 3

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