title: Experiential avoidance and appraisals of voices as predictors of voice-related distress.
abstract: OBJECTIVE
  Research has suggested that the extent to which voices (i.e., auditory verbal hallucinations) are experienced as distressing might be influenced by negative beliefs about voices as well as maladaptive metacognitive styles involving the negative appraisal and maladaptive control of mental experiences. This cross-sectional study examined the contribution of both specific appraisals of voices and a metacognitive factor (i.e., experiential avoidance) to voice-related distress.
  
  
  METHODS
  Self-report measurers of voice characteristics (voice frequency, duration as well as amount and intensity of voice-related distress), experiential avoidance, and appraisals of voices were collected in a sample of 101 voice-hearers.
  
  
  RESULTS
  Experiential avoidance and negative beliefs about voices were associated with higher levels of voice-related distress, but not to measures of voice frequency and duration. Experiential avoidance and negative 'metaphysical' beliefs about voices were significant predictors of voice-related distress even after accounting for the effect of frequency and duration of voices, and explained similar proportions of unique variance in distress.
  
  
  CONCLUSIONS
  These findings suggest that the appraisals of voices and experiential avoidance are predictive of voice-related distress and that cognitive-behavioural interventions targeting both voice-specific appraisals and general maladaptive metacognitive processes could prove useful treatment approaches for clients with distressing voices.
  
  
  CONCLUSIONS
  Experiential avoidance (EA) and negative appraisals predict voice-related distress caused by voices, but not their frequency and duration. Interventions for voices should consider targeting EA and negative appraisals (e.g., cognitive-behavioural therapy, Acceptance and Commitment Therapy) to ameliorate distress.
authors.affiliation: Division of Health Research, Lancaster University, UK.|School of Psychological Sciences, University of Manchester, UK.
authors.forename: Filippo
authors.initials: F
authors.lastname: Varese
authors.affiliation: School of Psychological Sciences, University of Manchester, UK.|Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Morrison
authors.affiliation: Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
authors.forename: Rosie
authors.initials: R
authors.lastname: Beck
authors.affiliation: Mersey Care NHS Trust, Liverpool, UK.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Heffernan
authors.affiliation: Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Law
authors.affiliation: Institute of Psychology Health and Society, University of Liverpool, UK.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Bentall
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001362:Avoidance Learning; D015928:Cognitive Behavioral Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006212:Hallucinations / Q000523:psychology*; D006801:Humans; D008297:Male; D000067489:Metacognition; D008875:Middle Aged; D011237:Predictive Value of Tests; D057566:Self Report; D013315:Stress, Psychological / Q000523:psychology*
keywords: cognitive-behavioural therapy; experiential avoidance; hallucinations; psychosis; voices