Attributions for hallucinations in bipolar affective disorder

Area of Science:

• Psychiatry and Mental Health
• Neuroscience of Hallucinations
• Clinical Psychology

Background:

• Hallucinations are common in schizophrenia spectrum disorders, with extensive research on attribution.
• Attributions for hallucinations in bipolar disorder remain under-investigated.
• Understanding these attributions is crucial for effective treatment.

Purpose of the Study:

• To investigate the prevalence, modality, and mood-state correlations of hallucination attributions in bipolar disorder.
• To compare these attributions with those observed in schizophrenia spectrum disorders.
• To inform the development of tailored cognitive behavioral therapy (CBT) interventions.

Main Methods:

• A preliminary study involving 40 participants with bipolar disorder.
• Data collected from a larger randomized control trial for CBT in bipolar disorder.
• Utilized a specially designed instrument based on the Belief about Voices Questionnaire (BAVQ) to assess attributions both in and out of episode.

Main Results:

• Nearly half of the participants reported experiencing true hallucinations.
• Visual hallucinations were more common during mania, while auditory hallucinations occurred more frequently during depression.
• The majority attributed hallucinations to illness when out of episode; malevolent/omnipotent attributions were rare compared to schizophrenia spectrum findings.

Conclusions:

• Hallucination attributions in bipolar disorder appear distinct from those in schizophrenia spectrum disorders.
• The rarity of malevolent attributions suggests a different underlying attributional style.
• Cognitive behavioral therapy (CBT) for distress reduction may require specific tailoring for bipolar disorder patients.