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“There is a thought in me which is not mine.” This is, roughly, the complaint of patients suffering from thought insertion. This first-rank symptom of schizophrenia is particularly puzzling for it seems to challenge a very well entrenched principle to the effect that our conscious thoughts are necessarily subjective, that we necessarily have a sense of ownership for them (Cartesian principle). Despite their wide disagreement, classical accounts of the symptom save the Cartesian principle by interpreting thought insertion as a problem of the sense of agency for thought rather than as a problem of subjectivity. I argue that those accounts fail and that thought insertion really is a problem of subjectivity. We can nevertheless save the Cartesian principle if we realize that the presupposition, shared by classical accounts, to the effect that inserted thoughts are unequivocally conscious, is ill-grounded. Distinguishing between reflexive awareness and phenomenal consciousness, and relying on a careful comparison between thought insertion and other pathologies of agency, I propose a novel account of the symptom which is compatible with the Cartesian principle and which allows to take the patient's reports seriously. This account, I conclude, opens up novel perspectives on the comprehension of schizophrenia, and reveals a common confusion between two different dimensions of the mind. [ABSTRACT FROM AUTHOR]

The experience of psychosis involves changes in an individual's sense of self and their understanding of others and the world around them. Studying life narratives and narrative identity offers one way to better understand these changes. Narratives of persons with psychosis display alterations in their themes, structures, and processes. These narratives often portray the person as possessing relatively little sense of agency, without meaningful connections to others, and often describe events in a negative emotional tone. The structure of these narratives often lacks temporal cohesion, unfolding in a disjointed manner. The overall structure and content of narratives further appear to struggle to respond to experience, suggesting that individuals with psychosis may have difficulty incorporating new information into their narrative, leading to a lack of narrative evolution. This body of research illustrates how psychosis reflects the interruption of an unfolding life in which sense of self is compromised and cannot be understood as a collection of symptoms and skill deficits. There is a need for treatment to address disruptions in personal narratives among persons with psychosis to promote a sense of purpose, possibility and meaning. As our understanding of psychosis continues to evolve and we emphasize first-person life stories, the authors believe that stigma in providers will decrease and the importance of subjective recovery will be further revealed. [ABSTRACT FROM AUTHOR]

This article explores the widespread belief in Stuart England that the Devil could intrude thoughts into the human mind. Drawing on medical and religious literature, it argues that this idea was accepted throughout the seventeenth century, and remained largely unchallenged by naturalistic theories of mental illness. Indeed, contemporaries often combined demonic and physiological explanations for conditions such as "melancholy". The article argues that the concept of satanic thoughts survived because it was consistent with wider aspects of Protestant doctrine, and its effects were socially and politically unthreatening. Finally, it considers the relationship between the early modern belief in satanic incursions in the mind and modern understandings of mental health. [ABSTRACT FROM AUTHOR]

In thought insertion, subjects experience thoughts which they claim not to be their own. What they claim, it is typically said, is that the thought is not theirs in the sense that they are not the agent or author of the thought. But what does it mean to be the agent or author of a thought? The most intuitive idea is that for a thought to be one's own means for the thought to causally originate within the subject. I defend this analysis against rivaling accounts and discuss several challenges that have not been recognized so far. [ABSTRACT FROM PUBLISHER]

The purpose of this study is to offer a model in which auditory verbal hallucinations (AVHs) can be conceptualized as dialogical experiences. This model is of interest in that it integrates several different perspectives (phenomenological, cognitive, social, and evolutionary) and the findings of empirical research on the subject. Hallucinations are understood as the product of a state of consciousness in which the self is dissociated into different positions or perspectives. After reviewing the most relevant results of psychological research, dialogical self theory is proposed as the theoretical framework for understanding hallucinatory experiences. It is argued that the voices possess a series of characteristics, pragmatic properties, relationships with the voices similar to their social surroundings, and more dissociative experiences in people who experience voices than in those who do not, with which they may be considered a dialogical experience. Finally, a model attempting to integrate psychological research on AVHs within the framework of dialogical self theory is presented. [ABSTRACT FROM PUBLISHER]

Introduction.Observing another person’s action influences the execution of one’s own action via the mirror neuron system. However, the ability to control the effect of such action observation on one’s voluntary action has not been investigated. The aim of this study was to elucidate the influence of observing another’s action on own voluntary movement in patients with schizophrenia. Methods.Fifteen patients with schizophrenia and 15 healthy age-matched controls participated in this study. Subjects were asked to perform a gripping task at 50% of their maximal voluntary force (MVF), whereas simultaneously watching others performed the same task with a different grip force (0%, 50% and 100% MVF). Results.The healthy controls applied a constant grip force under each condition. In patients with schizophrenia, the grip force was significantly reduced during viewing the gripping of others at 50% MVF compared to during viewing other’s gripping at 0% and 100% MVF. The score of the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Positive Symptoms were correlated with the fluctuation in grip force among the action observation conditions. Conclusion.Patients with schizophrenia might have difficulty controlling the influence of action observation on self-generated performance. [ABSTRACT FROM AUTHOR]

For 25 years, the international Hearing Voices Movement and the UK Hearing Voices Network have campaigned to improve the lives of people who hear voices. In doing so, they have introduced a new term into the mental health lexicon: "the voice-hearer." This article offers a "thick description" of the figure of "the voice-hearer." A selection of prominent texts (life narratives, research papers, videos and blogs), the majority produced by people active in the Hearing Voices or consumer/survivor/ex-patient movements, were analysed from an interdisciplinary medical humanities perspective. "The voice-hearer" (i) asserts voice-hearing as a meaningful experience, (ii) challenges psychiatric authority and (iii) builds identity through sharing life narrative. While technically accurate, the definition of "the voice-hearer" as simply "a person who has experienced voice-hearing or auditory verbal hallucinations" fails to acknowledge that this is a complex, politically resonant and value-laden identity. The figure of "the voice-hearer" comes into being through a specific set of narrative practices as an "expert by experience" who challenges the authority and diagnostic categories of mainstream psychiatry, especially the category of "schizophrenia." [ABSTRACT FROM AUTHOR]

Introduction. It has been suggested that a bias to misattribute self-generated thoughts to a nonself source underlies the experience of auditory-verbal hallucinations (AVH). We tested this hypothesis with healthy participants prone or not prone to AVH. Method. Participants (N=133) were presented with 96 words for subsequent recognition (half positively, half negatively valenced). For self-generated trials, participants generated a sentence containing the word. For other-generated trials, participants heard a prerecorded sentence containing the word. At test, studied words were re-presented visually, intermixed with 96 matched lures. Participants indicated the study status (old or new) and source (self or other) for each item. Sensitivity and bias measures were derived for item and source memory using signal detection theory. The 20 participants scoring highest on questions relating to AVH from the revised Launay-Slade Hallucination Scale formed the high-AVH group and the 20 scoring lowest formed the low-AVH group. Results. ANOVAs revealed no significant differences between the two participant groups in sensitivity or bias of source memory, regardless of item valence. There was a trend for the sensitivity of item memory to be lower in the high-AVH group, compared with the low-AVH group. The bias of item memory was not significantly different between groups. Conclusions. Although we found no evidence that source-monitoring problems underlie the experience of AVHs in the general population, we recommend that signal detection measures be applied in future investigations of source monitoring in at-risk and clinical populations. [ABSTRACT FROM PUBLISHER]

Neuroimaging studies in schizophrenia help clarify the neural substrates underlying the pathogenesis of this neuropsychiatric disorder. Contemporary brain imaging in schizophrenia is predominated by magnetic resonance imaging (MRI)-based research approaches. This review focuses on the various imaging studies from India and their relevance to the understanding of brain abnormalities in schizophrenia. The existing studies are predominantly comprised of structural MRI reports involving region-of-interest and voxel-based morphometry approaches, magnetic resonance spectroscopy and single-photon emission computed tomography/positron emission tomography (SPECT/PET) studies. Most of these studies are significant in that they have evaluated antipsychotic-naïve schizophrenia patients - a relatively difficult population to obtain in contemporary research. Findings of these studies offer robust support to the existence of significant brain abnormalities at very early stages of the disorder. In addition, theoretically relevant relationships between these brain abnormalities and developmental aberrations suggest possible neurodevelopmental basis for these brain deficits. [ABSTRACT FROM AUTHOR]

Three broad areas related to changes in DSM-5 are addressed in this article, and their implications for mental health nursing (MHN) education are discussed. The first area is the changes in structure and in the classification and description of mental disorders; knowledge of these is necessary so that nurse educators can teach students about the new faces of pathology in DSM-5 and what these changes mean for their future practice. Second, nurse educators must prepare advanced practice nurses to deal with the realities of the issues, criticisms, and concerns surrounding use of the DSM, including the influence of market forces on diagnosis, the validity and reliability of diagnosis, and cultural bias in diagnosis. Finally, there are additional concerns in preparing primary care nurses (nurse practitioners [NPs]) for the changes to DSM-5. It is not only psychiatric mental health (PMH) advanced practice nurses who must be aware of DSM changes and issues. The majority of mental health care in the United States is given in primary care settings and NPs must be prepared to assess and diagnose psychiatric disorders. The challenge to PMH nursing education is twofold: upholding the clinical role of advanced practice nurses in delivering mental health care, and maintaining the humanism and emphasis on quality care that has long characterized PMH nursing practice. [ABSTRACT FROM AUTHOR]

Introduction. Hearing voices occurs in people without psychosis. Why hearing voices is such a key pathological feature of psychosis whilst remaining a manageable experience in nonpsychotic people is yet to be understood. We hypothesised that religious voice hearers would interpret voices in accordance with their beliefs and therefore experience less distress. Methods. Three voice hearing groups, which comprised: 20 mentally healthy Christians, 15 Christian patients with psychosis, and 14 nonreligious patients with psychosis. All completed (1) questionnaires with rating scales measuring the perceptual and emotional aspects of hallucinated voices, and (2) a semistructured interview to explore whether religious belief is used to make sense of the voice hearing experience. Results. The three groups had perceptually similar experiences when hearing the voices. Mentally healthy Christians appeared to assimilate the experience with their religious beliefs (schematic processing) resulting in positive interpretations. Christian patients tended not to assimilate the experience with their religious beliefs, frequently reporting nonreligious interpretations that were predominantly negative. Nearly all participants experienced voices as powerful, but mentally healthy Christians reported the power of voices positively. Conclusion. Religious belief appeared to have a profound, beneficial influence on the mentally healthy Christians' interpretation of hearing voices, but had little or no influence in the case of Christian patients. [ABSTRACT FROM AUTHOR]

This study aimed to investigate how childhood sexual abuse (CSA) affects self-construction and construction of other people in people who have experienced psychosis. A sample of 21 such people was divided into 2 groups, according to whether they had experienced CSA or not. They were compared on repertory grids that included the element 'self now' and elements that represented other people. The results provided little evidence to support the hypotheses that people who had experienced CSA had lower levels of self-elaboration, saw themselves less like other people, or had greater conflict in their self-concept. The results are discussed with regard to limitations in the study and use of measures of conflict and elaboration in clinical practice. [ABSTRACT FROM AUTHOR]

Aims: A trend has emerged in the last two decades which views hearing voices as a meaningful experience and attempts to facilitate both their exploration and the development of effective strategies of coping with them. This study explores the experience of hearing voices, aiming to highlight the complexity of the phenomenon and the meaning that the experience has for the person. Methods: Semi-structured interviews were conducted with 15 individuals who currently hear voices and are being treated by the Thessaloniki Psychiatric Hospital. The interview material was analysed by the abbreviated version of grounded theory. Results: The two out of six main categories presented in this paper concern: (a) “the function of voices”, which includes what the voices say and how the hearer deals with them; and (b) “understanding hearing voices”, which includes the explanations given by voice hearers regarding the source and origin of voices as well as the relation of voices to reality and to their thoughts. Conclusions: The study highlights that hearing voices is a complex experience which voice hearers deal with in a variety of ways, and that voice hearers develop sophisticated frameworks for making sense of that experience. [ABSTRACT FROM AUTHOR]

Evidence-based interventions designed to reduce the risk of re-offending, particularly violent re-offending, are commonly offered in correctional systems around the world. The interventions are often based upon the application of several principles of service delivery that have become widely known as the 'what works' approach to offender rehabilitation. The applicability of these principles to forensic psychiatric services has yet to be determined. The aims are to examine the possible application of the 'what works' approach and its implications for forensic mental health practice. The method used was a review of relevant research from both the general offender and forensic psychiatry literature. The principles underlying the 'what works' approach are likely to have utility in service delivery in forensic psychiatry, particularly when a treatment target is a reduction in risk of harm to others. The individualized models of patient care practiced in forensic psychiatry are also likely to have utility in improving treatment outcomes in correctional settings. The conclusion is that an increased interchange of ideas and interventions between the two areas of practice is likely to be of mutual benefit. This is an area that requires significant development. [ABSTRACT FROM AUTHOR]

This article reports a social worker's experience of setting up a hearing voices group in a mental health hospital. The article reviews some of the literature relating to hearing voices and sets this in the context of services in the UK. A brief description of the group is provided and the author suggests such a group is welcomed by participants because they find sharing their experiences of hearing voices helpful. [ABSTRACT FROM AUTHOR]

This paper deals with the emotive subject of psychiatric misdiagnosis in ethnic minority patients. It discusses the nature of psychiatric illness, the nature of psychiatric diagnoses, why making a diagnosis is thought to be important and current calls for the use of dimensional rather than categorical diagnoses. It details the literature concerning misdiagnosis in people of Caribbean origin living in the UK and uses a wide-based institutional model to generate hypotheses to explain why misdiagnosis may occur. It borrows from developments in epidemiological and psychiatric research and from the literature concerning misdiagnosis of African-American patients in the US, to produce conclusions as to how the misdiagnosis debate can be taken forward.This paper aims to promote the use of diagnoses that are treatment relevant. [ABSTRACT FROM AUTHOR]