Mindfulness as a Mediator Between the Relational Style with Voices and Negative Affect
Recent studies have established associations between relating to voices and distress. However, the potential influence of mindfulness on this relationship has received little attention. This study was designed to explore the extent to which associations between relating to voices and distress are mediated by mindfulness. A cross-sectional study was conducted to explore the associations between these variables. A sample of 62 patients with psychotic disorder were given the Voices and You Scale (VAY) to measure the relational style with the voices, the Mindfulness and Awareness Scale (MAAS) to measure the capability of mindfulness, and the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) to measure anxiety and depression, respectively. The results showed a negative association between a dysfunctional style of relating to the voices and mindfulness. It was also found from simple mediation analysis that the mindfulness variable negatively mediated the dysfunctional relational style with voices and distress. Mindfulness is a variable that can mediate the effect of relating style upon voices and distress and should be a target of therapeutic intervention.
KeywordsRelational style with voices Mindfulness Auditory hallucinations Negative affect Psychosis
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory manual. San Antonio: Harcourt Brace and Company.Google Scholar
- Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio: Psychological Corporation.Google Scholar
- Birtchnell, J. (2002). Relating in psychotherapy: the application of a new theory. Hove: Brunner-Routledge.Google Scholar
- Chadwick, P. D. J., Barnbrook, E., & Newman-Taylor, K. (2007). Responding mindfully to distressing voices: links with meaning, affect and relationship with voice. Journal of the Norwegian Psychological Association, 44, 581–588.Google Scholar
- Chadwick, P., Strauss, C., Jones, A.M., Kingdon, D., Ellet, L., Dannahy, L., et al. (2016). Group mindfulness-based intervention for distressing voices: a pragmatic randomised controlled trial. Schizophrenia Research. http://dx.doi.org/10.1016/j.schres.2016.04.001.
- Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Press.Google Scholar
- Kabat-Zinn, J. (1994). Wherever you go there you are: mindfulness meditation in everyday life. New York: Hyperion.Google Scholar
- León-Palacios, M. G., Úbeda-Gómez, J., Escudero-Pérez, S., Barros-Albarán, M. D., López-Jiménez, A. M., & Perona-Garcelán, S. (2015). Auditory verbal hallucinations: can beliefs about voices mediate the relationship patients establish with them and negative affect? Spanish Journal of Psychology, 18(e76), 1–8.Google Scholar
- Perona-Garcelán, S., Cuevas-Yust, C., García-Montes, J. M., Pérez-Álvarez, M., Ductor-Recuerda, M. J., Salas-Azcona, R., et al. (2008). Relationship between self-focussed attention and dissociation in patients with and without auditory hallucinations. Journal of Nervous and Mental Disease, 196, 190–197.CrossRefPubMedGoogle Scholar
- Perona-Garcelán, S., García-Montes, J. M., Ductor-Recuerda, M. J., Vallina-Fernández, O., Cuevas-Yust, C., Pérez-Álvarez, M., et al. (2012). Relationship of metacognition, absorption and depersonalization in patients with auditory hallucinations. British Journal of Clinical Psychology, 51, 100–118.CrossRefPubMedGoogle Scholar
- Perona-Garcelán, S., Carrascoso-López, F., García-Montes, J. M., Ductor-Recuerda, M. J., López-Jiménez, A. M., Vallina-Fernández, O., et al. (2014a). Relationship between childhood trauma, mindfulness, and dissociation in subjects with and without hallucination proneness. Journal of Trauma & Dissociation, 15, 35–51.CrossRefGoogle Scholar
- Perona-Garcelán, S., García-Montes, J. M., López-Jiménez, A. M., Rodríguez-Testal, J. F., Ruiz-Veguilla, M., Ductor-Recuerda, M. J., et al. (2014b). Relationship between self-focused attention and mindfulness in people with and without hallucination proneness. Spanish Journal of Psychology, 17(e20), 1–8.Google Scholar
- Perona-Garcelán, S., Úbeda-Gómez, J., León-Palacios, M. G., Barros-Albarrán, M. D., Escudero-Pérez, S., López-Jiménez, A. M., et al. (2016a). An exploration of the reliability and validity of the Spanish version of the “Voice and You” (VAY): a scale for measuring the relationship with voices. Clinical Psychology and Psychotherapy, 23, 183–188.CrossRefPubMedGoogle Scholar
- Perona-Garcelán, S., Úbeda-Gómez, J., León-Palacios, M. G., Escudero-Pérez, S., Barros-Albarrán, M. D., López-Jiménez, A. M., et al. (2016b). Relationship between public and private self-focused attention and auditory verbal hallucinations as an interpersonal process. Psychosis, 8(2), 118–129.CrossRefGoogle Scholar
- Sanz, J., & Navarro, M. E. (2003). Psychometric properties of a Spanish version of the Beck Anxiety Inventory (BAI) in university students. Ansiedad y Estrés, 9, 59–84.Google Scholar
- Sanz, J., Perdigón, A. L., & Vázquez, C. (2003). The Spanish adaptation of Beck’s Depression Inventory-II (BDI-II): 2. Psychometric properties in the general population. Clínica y Salud, 14, 249–280.Google Scholar
- Soler, J., Tejedor, R., Feliu-Soler, A., Pascual, J. C., Cebolla, A., Soriano, J., et al. (2012). Psychometric proprieties of Spanish version of Mindful Attention Awareness Scale (MAAS). Actas Española de Psiquiatría, 40, 19–26.Google Scholar
- Strauss, C., Thomas, N., & Hayward, M. (2015). Can we respond mindfully to distressing voices? A systematic review of evidence for engagement, acceptability, effectiveness and mechanisms of change for mindfulness-based interventions for people distressed by hearing voices. Frontiers in Psychology, 6, 1154.CrossRefPubMedPubMedCentralGoogle Scholar
- Úbeda-Gómez, J., León-Palacios, M. G., Escudero-Pérez, S., Barros-Albarrán, M. D., López-Jiménez, A. M., & Perona-Garcelán, S. (2015). Relationship between self-focused attention, mindfulness and distress in individuals with auditory verbal hallucinations. Cognitive Neuropsychiatry, 20, 482–488.CrossRefPubMedGoogle Scholar
- Waters, F., Allen, P., Aleman, A., Fernyhough, C., Woodward, T. S., Badcok, J. C., & Larøi, F. (2012). Auditory hallucinations in schizophrenia and nonschizophrenia populations: a review and integrated model of cognitive mechanisms. Schizophrenia Bulletin, 38(4), 683–693.CrossRefPubMedPubMedCentralGoogle Scholar
- World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.Google Scholar