What is the frequency and nature of visual hallucinations in non-clinical participants?

OBJECTIVES: There is a paucity of psychological treatments for visual hallucinations (VH). A key aspect in the psychological treatment of hallucination-related distress is normalisation to explain that these experiences are commonplace and can be non-distressing. In order to normalise VH, it is vital that more is known about VH in non-clinical populations. This study investigated the prevalence, content, context, appraisals, distress, and behavioural reactions to VH in a non-clinical sample. DESIGN: A cross-sectional study was conducted. METHODS: 466 students completed the Multi-Modality Unusual Sensory Experiences Questionnaire-VH subscale with additional contextual follow-up questions. RESULTS: Of the 466 participants, 395 (84.8%) reported anomalous visual experiences. 176 (37.77%) participants reported VH similar to the content seen in psychosis. Of the overall sample, 17.38% felt their experience met the VH definition. Participants mainly saw figures, when alone and in the evening. Participants endorsed normalising appraisals: 112 out of 176 (78.87%) believed their mind was playing tricks on them and 83 (58.45%) believed they were tired. However, many also believed the VH was a threat to their mental (66, 46.48%) or physical well-being (41, 28.87%). These negative appraisals were associated with distress. CONCLUSION: VH are seemingly common in non-clinical populations and are similar in a number of ways to those of people with psychosis. Awareness that VH occur on a continuum could normalise people's experiences and reduce their negative appraisals and related distress.

Technology Matters: Collaboratively augmenting longitudinal monitoring (C.A.L.M) in bipolar disorder - co-design, co-production and evaluation of the alpha prototype app.

Apps developed for bipolar disorder (BD) allow a sense of autonomy and self-regulation whilst monitoring for early warning signs indicative of a relapse. C.A.L.M BD was specifically co-designed and co-produced with young people (16-25 years) living with BD, their family members, clinicians, researchers in human-computer interaction and an app development company to address the current lack of such technology for this age range. The prototype app tracked mood, and provided young people with the instant ability to monitor mood trends and use lifeline functionality when in crisis. The evaluation of the app demonstrated that it successfully engaged participants and provided insight to an effective way of iteratively designing an app. The future development of this app could improve outcomes for young people living with BD, however, needs to be evaluated rigorously.

Understanding agoraphobic avoidance: the development of the Oxford Cognitions and Defences Questionnaire (O-CDQ).

BACKGROUND: Many patients with mental health disorders become increasingly isolated at home due to anxiety about going outside. A cognitive perspective on this difficulty is that threat cognitions lead to the safety-seeking behavioural response of agoraphobic avoidance. AIMS: We sought to develop a brief questionnaire, suitable for research and clinical practice, to assess a wide range of cognitions likely to lead to agoraphobic avoidance. We also included two additional subscales assessing two types of safety-seeking defensive responses: anxious avoidance and within-situation safety behaviours. METHOD: 198 patients with psychosis and agoraphobic avoidance and 1947 non-clinical individuals completed the item pool and measures of agoraphobic avoidance, generalised anxiety, social anxiety, depression and paranoia. Factor analyses were used to derive the Oxford Cognitions and Defences Questionnaire (O-CDQ). RESULTS: The O-CDQ consists of three subscales: threat cognitions (14 items), anxious avoidance (11 items), and within-situation safety behaviours (8 items). Separate confirmatory factor analyses demonstrated a good model fit for all subscales. The cognitions subscale was significantly associated with agoraphobic avoidance (r = .672, p < .001), social anxiety (r = .617, p < .001), generalized anxiety (r = .746, p < .001), depression (r = .619, p < .001) and paranoia (r = .655, p < .001). Additionally, both the O-CDQ avoidance (r = .867, p < .001) and within-situation safety behaviours (r = .757, p < .001) subscales were highly correlated with agoraphobic avoidance. The O-CDQ demonstrated excellent internal consistency (cognitions Cronbach's alpha = .93, avoidance Cronbach's alpha = .94, within-situation Cronbach's alpha = .93) and test-re-test reliability (cognitions ICC = 0.88, avoidance ICC = 0.92, within-situation ICC = 0.89). CONCLUSIONS: The O-CDQ, consisting of three separate scales, has excellent psychometric properties and may prove a helpful tool for understanding agoraphobic avoidance across mental health disorders.