The Schedule for Affective Disorders and Schizophrenia-Change Version (SADS-C), the Social Adjustment Scale-Patient Version II (SAS-PATII) and the Command Hallucination Questionnaire (CAQ) were administered to 86 psychotic inpatients to investigate the relationship between command hallucinations, aggressive behavior, and compliance. Two SADS-C items ("severity of hallucinations" and "depersonalization") were useful as indicators of command hallucinations. Ninety-two percent had complied with their command at least once in the past month. Three SADS-C variables related to compliance with command hallucinations were identified: middle insomnia, the belief that the voice was acting in your best interest, and overt irritability. The patients' level of distortion of reality did not appear to influence compliance rates. Results also indicated that patients who experience command hallucinations were not significantly more or less dangerous than other psychotic inpatients.

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程展緯. / 論文 (藝术碩士)--香港中文大學, 1998. / 參考文獻 (leaves 22-23). / 附中英文摘要. / Cheng Zhanwei. / Lun wen (yi shu shuo shi)-- Xianggang Zhong wen da xue, 1998. / Can kao wen xian (leaves 22-23). / Fu Zhong Ying wen zhai yao. / Chapter (一） --- 前言´ؤ´ؤ從物理性的分析開始 --- p.1 / Chapter (二） --- 繪畫中幻象界與物象界的對立關 係 --- p.3 / Chapter (三） --- 游離的概念 --- p.8 / Chapter (四） --- 參照模型槪念看繪畫的游 離 --- p.9 / Chapter (五） --- 參照視錯覺雕塑看繪畫的游離 性 --- p.15 / Chapter (六） --- 總結 --- p.19 / Chapter (七） --- 註釋 --- p.20 / Chapter (八） --- 參考書目 --- p.22

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Introduction: Patients of schizophrenia experienced a cluster of symptoms known as psychosis, which were concurrent phenomena presented across multiple psychopathological dimensions, among which hallucination was one of the principal features. Auditory verbal hallucination (AVH) was the most common among other modalities (i.e. visual, olfactory, gustatory and tactile) of hallucinations and was said to occur when audible voices were heard without presence of corresponding stimuli. There were two main neurocognitive hypotheses on the underlying mechanism of the occurrence of AVH, namely the inner speech hypothesis and the top down processing hypothesis. Existing descriptive psychopathology studies were not guided by any theoretical frameworks. This study was the groundwork to examine experiences of AVH as described by patients with psychosis and other psychiatric conditions based on these two major hypotheses. Method: This study was a retrospective case series. Comprehensive searches of AVH cases were done on biomedicine and psychology databases, in which case reports, case studies and studies with detailed descriptions of phenomenology of AVH with various aetiologies, a total of twenty cases, were selected. Four in-depth qualitative interviews were also conducted with psychosis patients for in-depth understandings of their AVH phenomena experiences. Result: Three specific features from the two neurocognitive hypotheses were identified. (1) Form of address, (2) linguistic complexity, and (3) command hallucinations were likely interpreted by inner speech hypothesis; whereas (1) single theme and repetitive contents, (2) relations with past experience/knowledge/perceptual expectations, and (3) congruent moods were likely interpreted by top down processing bias hypothesis. Discussion: This study has categorized AVH phenomena from twenty literature cases and four in-depth qualitative interview cases by specific features of the two mainstream hypotheses; and commented on each of the specific features on their relevancies to the two mainstream hypotheses. Conceptualisation of underlying neurocognitive mechanisms could made taxonomy easier, and as a result benefit clinical staging, better prediction of prognosis and better communications with patients and their families. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

The Charles Bonnet syndrome is characterized by complex visual hallucinations in people without psychopathology or disturbance of normal consciousness. This thesis highlights the association of visual deficits with the syndrome, and proposes that it is analogous to the perception of phantom limbs; both conditions arise when normal sensory input to the brain is severely reduced. The five studies that comprise this thesis systematically gather information on the syndrome to answer three basic questions: how can the hallucinations be classified, what are the clinical implications for individuals who experience them, and what might cause the hallucinations. Study 1 examines 64 cases described in the literature. Demographic information on the hallucinators, properties of the hallucinations, initiating factors, as well as etiological mechanisms are reviewed. Study 2 examines the properties of the hallucinations in a sample of 60 subjects and reveals, by statistical analysis, a dimension of the hallucinatory experience that ranges from discrete, singular perceptual experiences to multiple changing experiences. Studies 3 and 4 examine the mental status of hallucinators score within the normal range on tests of anxiety, depression, and psychological symptomology and exhibit no evidence of gross cognitive impairment. A detailed analysis of results show that a small proportion of hallucinators score within the normal range on tests of anxiety, depression, and psychological symptomology and exhibit no evidence of gross cognitive impairment. A detailed analysis of results show that a small proportion of hallucinators endorse comparatively more symptom-oriented items than the remainder of hallucinators, as well as more items non-hallucinators (in Study 4). Finally, Study 5 examines the performance of two hallucinating groups as well as a group of visually impaired non-hallucinating on threshold estimation and signal detection tasks. The results of the combined studies indicate

Adaptation to vision impairment was studied by telephone interviews with 78 legally blind adults (mean age 79.5) who had received rehabilitation services from an agency in upstate New York. Data were collected on demographics, health, activity levels, social support, blindness data, adaptation to vision loss (AVL scale, Horwitz and Reinhardt, 2005), and symptoms of Charles Bonnet Syndrome (CBS). Using multiple regression and logistic regression, the most significant predictors of high AVL scores were found to be good interpersonal communication and a relative living close by, while predictors of CBS were self-reported health issues, especially diabetes, and fewer trips into the community. Very few respondents reported receiving any information on CBS from eye care providers. This suggests that doctors should consider discussing CBS with patients, and that both social workers and doctors need a better understanding of CBS, as symptoms could easily be mistaken for mental illness, causing inappropriate referrals.