This thesis uses a narrative approach to explore how hallucinations are understood by people with dementia, their carers and community mental health nurses. The study aims to make visible the multiple enactments of realities of hallucinations as they are practiced within a community mental health setting. While existing research shows a growing body of research about experiences of dementia, the experience of hallucinations has been unexplored. Research about hallucinations has predominantly focused on epidemiology or pharmaceutical interventions. The research was conducted in one area of Scotland, using three triadic case studies comprising a person with dementia living at home, their carer and community nurse. Data were collected through conversational interviews. In this study realities are conceptualised as enacted and multiple. The study was informed by an ethic of care approach which critiques the view of people as isolated individuals. People are understood to live in relationships within which they co-construct narratives. It provided an ethical framework to research relationships and data analysis. Data were analysed using voice centred relational analysis, which uses four separate ‘listenings’ for each interview. This method identifies the multiple voices speaking and allows a high degree of reflexivity. I-poems were produced for each of the interviews and some visual illustrations were used in different ways to illustrate the analysis and allow an alternative interpretive perspective on the data. The analysis reveals that people with dementia and their carers contextualise their understanding of hallucinations into their narrative identity. They strive for continuity but also experience them as potential threats. Ambiguity and uncertainty are characteristic of the experience of hallucinations of people with dementia and carers and I suggest that liminality is a useful concept to understand this. Community nurses have multiple, and fluid understandings of hallucinations; they negotiate these different hallucinations within a situated practice enactment. Their decision to act on hallucinations does not depend on whether they relate to consensus reality, but whether they cause distress. The findings of this study highlight the complexities and ambiguities of hallucinations within dementia and shows how they are managed in practice. The theoretical perspectives of enacted realities and ethic of care, alongside creative methods enhances understanding of the ephemeral nature of hallucinations. This study adds to literature challenging the exclusion of the people with dementia from research by demonstrating that they are able to talk about their experiences of hallucinations. The study contributes to the story of hallucinations in dementia by disrupting the fixed boundaries of the dominant discourse that views hallucinations as a clear cut break with reality.

No description available.

Thesis (Ph.D)--Murdoch University, 2004. / Thesis submitted to the Division of Health Sciences. Includes bibliographical references (p. [503]-531).

Thesis (Ph.D.) - University of Queensland, 2004. / Includes bibliography.

The process of making judgments and formulating convictions is a vital function performed by all human beings. Successful accomplishment of such tasks usually involves the integration of interoceptive cues (i.e. past experience, feeling states, etc.) with exteroceptive, or objective, information. Often, personal idiosyncracies determine the relative amount of flexibility with which convictions or opinions are held, regardless of contradictory information.

No description available.

Bakgrund: Schizofreni är en psykossjukdom med hög suicidrisk. Det vanligaste symtomenet vid schizofreni är hörselhallucinationer som kan upplevas både i positiv och negativ anda. Det råder stigmatisering kring sjukdomen där kunskapsbrist och rädsla för personen tros ligga till grund. Syfte: Att beskriva vuxna personers upplevelser av hörselhallucinationer vid schizofreni. Metod: Litteraturöversikten baserades på 12 vetenskapliga artiklar där nio av dem hade en kvalitativ ansats och tre med kvantitativ ansats. Dessa artiklar hämtades från databaserna CINAHL Complete, PubMed och PsycINFO. I databaserna användes följande sökord: hallucination, voice hearing, psychosis, patient, life, hearing voices, nursing, people who hear voices, auditory hallucinations, schizophrenia och experiences. Resultat: Resultatet delades upp i fyra teman: I Röstens natur och intention beskrevs röstens ton, känsla, intensitet och varaktighet. Relationen till rösten belyste personens identifiering och personifiering av rösten där den kunde ses som något kroppseget eller som en enskild individ. Meningsskapande och copingstrategier angav olika strategier personen använde i syfte att klara av och hantera rösterna. Påverkan på individen belyste hur personen påverkades av rösten genom förändrad självbild och självskada, isolering och kontrollförlust. Diskussion: Resultatet diskuterades utifrån begreppen livsvärld och meningsskapande där meningsskapandet kunde ses som en central del i personens förmåga att hantera situationen med hörselhallucinationerna. / Background: Schizophrenia is a mental disorder with a high suicidal risk. The most common symptoms experienced with schizophrenia are auditory hallucinations which can be experienced both in a positive and a negative way. The disorder is stigmatized most likely due to a lack of knowledge and a fear of the person. Aim: To describe adults experiences of auditory hallucinations induced by schizophrenia. Method: The literature review consisted of twelve scientific articles of which nine were conducted using a qualitative approach and three with a quantitative research methodology. The articles were found in the databases CINAHL Complete, PubMed and PsycINFO. The following words were used in the databases: hallucination, voice hearing, psychosis, patient, life, hearing voices, nursing, people who hear voices, auditory hallucinations, schizophrenia and experiences. Results: The results were divided into four themes: The nature of the voice described the characteristics of the voice i.e. tone, feeling, intensity and duration. The relation to the voice described how the affected persons identified the voice as a part of themselves. Finding meaning and coping strategies described the different strategies which were used to cope with the voices. The impact on the individual highlighted how the person was affected by the voices by an altered self, added self-harm behavior, isolation and loss of control. Discussions: The results were discussed with the concepts of life world and finding meaning. Finding meaning was found as one of the affected person’s most important coping strategies for dealing with the auditory hallucinations.

Thèse (M.Serv.Soc.)--Université Laval, 2009. / Bibliogr.: f. 83-88. Publié aussi en version électronique dans la Collection Mémoires et thèses électroniques.

This thesis is comprised of three papers. Paper 1 presents a systematic review on the evidence for the relationship between appraisals of auditory verbal hallucinations and voice-related distress in psychosis. A literature search was conducted using the following electronic databases: Web of Science, PsycINFO, Embase and Pubmed. Twenty-four studies were identified that satisfied inclusion criteria for the review. Several types of appraisals were found to be associated with distress in voice-hearers: malevolence, control, power, origin of voices and benevolence beliefs. Evidence for an association was particularly strong for malevolence and control appraisals, indicating that these may be important to target in interventions. Overall findings generally supported that modification of voice appraisals, particularly malevolence, power and control appraisals, in cognitive therapy is associated with a reduction in voice-related distress. Paper 2 presents an experimental study which explored whether people who are exposed to stressful material are more likely to report hearing voices when they are not present (i.e. false alarms). Factors that may predict or moderate voice-hearing were also explored. A non-clinical sample (N = 130) completed measures of trauma history, hallucination proneness, dissociation, affect and attachment styles, before being allocated to view pictures depicting stressful interpersonal scenarios or pictures with neutral interpersonal scenarios. Participants then completed a voice detection task. False alarms were recorded as a proxy measure of voice-hearing. Participants in the stressful group reported significantly higher levels of stress than in the neutral group. No differences were found in false alarms. Physical abuse history and depersonalisation significantly correlated with false alarms. This study indicates that people with physical abuse history and dissociative tendencies may be more vulnerable to hearing voices; clinically, these factors should therefore be assessed. However, findings of this study should be interpreted tentatively due to lack of diversity within the sample. Paper 3 is a critical reflection of the systematic review, the empirical paper and the research process as a whole. Strengths and limitations of the presented research are discussed as well as directions for future research.

Hallucinations are often considered a sign of psychotic illness, but are also common in other diagnostic groups and individuals without mental health problems. This thesis uses Perceptual Control Theory (PCT), a cybernetic model which explains behaviour and cognition in terms of control processes regulating ongoing perception according to internally represented goals, as a theoretical framework to understand hallucinations. First, a theoretical/conceptual paper (Paper 1) examines how PCT provides an integrated account of (i) the mechanisms responsible for the formation of hallucinations, (ii) their phenomenological heterogeneity, (iii) the interaction between these mechanisms and environmental factors that might contribute to the formation of hallucinations, and (iv) the processes leading to different affective reactions to hallucinatory experiences (e.g. distress). The main implications of this model are discussed in the context of pertinent theoretical and empirical literature, and relevant clinical and research implications are considered. Second, this thesis includes an empirical investigation (Paper 2) examining two PCT-informed hypotheses in a cross-section of 22 clinical and 18 non-clinical individuals with auditory verbal hallucinations (“hearing voices”), namely (i) that the content of voices will be thematically linked to the participants’ personal goals, and (ii) that affective reactions to voices will depend on the extent to which voices facilitate and/or interfere with important personal goals. The analysis revealed that 82.5% of participants reported voices that thematically matched at least one of their reported goals. As predicted, affective reactions to voices were strongly associated with measures of interference and facilitation of goals, even when controlling for important covariates (e.g. participants’ history of mental health difficulties; voices’ content, frequency and duration).Finally, a critical evaluation is provided (Paper 3), where the methodological strengths and limitations of the work presented in the present thesis are discussed with the aim to reflect on the research process, and inform future investigations into the topics considered in this thesis.