The power and omnipotence of voices: subordination and entrapment by voices and significant others.
BACKGROUND
Cognitive therapy for psychotic symptoms often embraces self-evaluative beliefs (e.g. self-worth) but whether and how such beliefs are related to delusions remains uncertain. In previous research we demonstrated that distress arising from voices was linked to beliefs about voices and not voice content alone. In this study we examine whether the relationship with the voice is a paradigm of social relationships in general, using a new framework of social cognition, 'ranking' theory.


METHODS
In a sample of 59 voice hearers, measures of power and social rank difference between voice and voice hearer are taken in addition to parallel measures of power and rank in wider social relationships.


RESULTS
As predicted, subordination to voices was closely linked to subordination and marginalization in other social relationships. This was not the result of a mood-linked appraisal. Distress arising from voices was linked not to voice characteristics but social and interpersonal cognition.


CONCLUSIONS
This study suggests that the power imbalance between the individual and his persecutor(s) may have origins in an appraisal by the individual of his social rank and sense of group identification and belonging. The results also raise the possibility that the appraisal of voice frequency and volume are the result of the appraisal of voices' rank and power. Theoretical and novel treatment implications are discussed.
Birchwood
M
M
Early Intervention Service, Northern Birmingham Mental Health Trust and School of Psychology, University of Birmingham.
Meaden
A
A
Trower
P
P
Gilbert
P
P
Plaistow
J
J
D000328:Adult; D003702:Delusions / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D004291:Dominance-Subordination; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012649:Self Concept; D013067:Speech Perception