Marino Pérez-Álvarez

Changes in the self resulting from the use of mobile phones

The present work examines the potential consequences of the use of mobile telephones on people’s behaviour and identity. In doing so, we start from the premise that, even though this technology may have different effects in different cultural contexts, it promotes and foments certain patterns of behaviour and of understanding one’s own identity. It is suggested that this new identity goes hand in hand with a spatial-temporal recomposition of the context in which actions take place. On the opening up of an almost continuous virtual space, conflicts may arise between the different roles played by an individual which were previously differentiated as a function of space. Similarly, increased flexibility in arrangements leads to the appearance of a new concept of time, which we might call the ‘present extensive’. We also discuss the possible superstitions the use of this new technology may bring with it. As a result of these analyses, it is considered that the mobile phone not only emerges within a postmodern society, but also, along with other technological developments, feeds a postmodern mentality.

Dissociative Experiences as Mediators Between Childhood Trauma and Auditory Hallucinations

The purpose of this work was to study the relationship between reported traumatic experiences in childhood and positive psychotic symptoms. We hypothesized that dissociative experiences were potential mediators between childhood trauma and hallucinations, but not delusions. The sample comprised 71 patients diagnosed with psychoses. They were assessed with the Dissociative Experiences Scale (DES-II; Carlson & Putnam, 1993), a questionnaire on trauma (TQ; Davidson, Hughes, & Blazer, 1990), and the Positive and Negative Syndrome Scale (PANSS; Kay, Opler, & Lindenmayer, 1988) delusions and hallucinations items. The results showed that childhood trauma was positively associated with the dissociation scale scores (r = .40) and also the hallucination (r = .36) and delusions scale scores (r = .32). Furthermore, it was demonstrated that the dissociation variable was a potential mediator between childhood trauma and hallucinations, but not between childhood trauma and delusions. Of the 3 DES-II factors, only depersonalization showed a mediating relationship between childhood trauma and hallucinations. The main conclusion is that the impact of childhood trauma on hallucinations may not simply be direct, but mediated by dissociative experiences, especially depersonalization. Clinical implications are also briefly discussed.

Relationship between self-focused attention and dissociation in patients with and without auditory hallucinations.

The purpose of this work was to study the relationship between self-focused attention and dissociative experiences in 4 groups of subjects: patients with a psychotic disorder who suffer from auditory hallucinations, patients with psychoses who have recovered from their hallucinations, patients with psychoses who have never had them, and a fourth nonclinical group. The private self-consciousness scale, revised version by Scheier and Carver, J Appl Soc Psychol. 1985;15:687–699, was used to measure self-focused attention, and the dissociative experience scale (DES-II, Bernstein and Putnam, J Nerv Ment Dis. 1986;174:727–735) was used for dissociation. The results showed that the attention of subjects with hallucinations was more self-focused than the nonclinical group, but did not differentiate significantly from groups of patients without hallucinations. On the other hand, patients with hallucinations and those recovered from them had a higher percentage of dissociative experiences than the rest of the groups in the total DES-II score and in its 3 factors, dissociative amnesia, depersonalization, and absorption. We also found a positive correlation between self-focusing and dissociative experiences in subjects with hallucinations. The depersonalization factor on the DES-II was the only factor predicting auditory hallucinations. The conclusions discuss the relevance of dissociative factors and self-focused attention to understanding the etiology of auditory hallucinations and their contributions to current cognitive models of hallucinations.

Acceptance and Commitment Therapy Applied to Treatment of Auditory Hallucinations

Acceptance and commitment therapy (ACT) represents a new generation of behavior therapies that, after having received empirical support in a variety of disorders characterized by experiential avoidance, also offers a promising new treatment for psychosis. In contrast to the traditional treatment, in which both antipsychotic medication and cognitive-behavioral therapy focus on reducing symptoms, ACT proposes active acceptance and at the same time orientation of the person toward the achievement of worthwhile goals for his or her life in spite of symptoms, such as auditory hallucinations. In this case, a 30-year-old male diagnosed with schizophrenia demonstrates the logic and effectiveness of ACT as well as its applicability as part of the routine activities of a clinical psychologist in a public mental health care center.

A Preliminary Exploration of Trauma, Dissociation, and Positive Psychotic Symptoms in a Spanish Sample

The purpose of this research was to study traumatic and dissociative experiences in a sample of Spanish psychotic patients. A total of 37 psychotic patients filled out the Dissociative Experiences Scale (E. B. Carlson & F. W. Putnam, 1993), a questionnaire on traumas (J. R. E. Davidson, D. Hughes, & D. G. Blazer, 1990), and the Positive and Negative Syndrome Scale delusion and hallucinations items (S. R. Kay, L. A. Opler, & J. P. Lindenmayer, 1988). The results showed that 40.5% of the subjects in the sample had undergone at least 1 traumatic experience as children and 64.9% had as adults. Patients with hallucinations had experienced a higher mean number of childhood traumatic experiences than patients without hallucinations. No significant difference in the mean number of traumatic events was found between patients with and without delusions. There was no significant difference in the mean number of adulthood traumatic events between patients with and without hallucinations and delusions. Subjects with childhood traumas scored higher on the Dissociative Experiences Scale than those who had had such experiences as adults. Patients with hallucinations and delusions also scored higher on the dissociation scale than patients who did not show those positive psychotic symptoms.

Relationship Between Childhood Trauma, Mindfulness, and Dissociation in Subjects With and Without Hallucination Proneness

The purpose of this study was to examine the relationship between childhood traumas, mindfulness, and dissociation (more specifically, absorption and depersonalization) in healthy subjects with and without hallucination proneness. A sample of 318 subjects was given the Launay-Slade Hallucination Scale–Revised (R. P. Bentall & P. Slade, 1985). From this sample, 2 groups were formed: one with high and the other with low hallucination proneness. Furthermore, all participants were given the Tellegen Absorption Scale (A. Tellegen & G. Atkinson, 1974), the Cambridge Depersonalization Scale (M. Sierra & G. E. Berrios, 2000), the Southampton Mindfulness Questionnaire (P. D. J. Chadwick et al., 2008), and the Trauma Questionnaire (J. R. E. Davidson, D. Hughes, & D. G. Blazer, 1990). The results showed that in the group with high hallucination proneness, there were significantly more subjects with traumatic experiences than in the group with low predisposition, although no significant difference in the mean number of traumatic experiences undergone in childhood was found between the 2 groups, although there was a trend toward significance. A correlation analysis showed a significant negative association between mindfulness on the one hand and absorption and depersonalization on the other. A positive relationship was also found between childhood traumas and absorption and depersonalization. Finally, multiple mediation analysis showed that the absorption and depersonalization variables acted as mediators between childhood traumas and hallucination proneness. We discuss the importance of the relationship between the variables studied and hallucination proneness and suggest some approaches for their treatment.

Depersonalization as a Mediator in the Relationship Between Self-Focused Attention and Auditory Hallucinations

The purpose of this work was to study the potentially mediating role of certain dissociative factors, such as depersonalization, between self-focused attention and auditory hallucinations. A total of 59 patients diagnosed with schizophrenic disorder completed a self-focused attention scale (M. F. Scheier & C. S. Carver, 1985), the Cambridge Depersonalization Scale (M. Sierra & G. E. Berrios, 2000), and the hallucination and delusion items on the Positive and Negative Syndrome Scale (S. R. Kay, L. A. Opler, & J. P. Lindenmayer, 1988). The results showed that self-focused attention correlated positively with auditory hallucinations, with delusions, and with depersonalization. It was also demonstrated that depersonalization has a mediating role between self-focused attention and auditory hallucinations but not delusions. In the discussion, the importance of dissociative processes in understanding the formation and maintenance of auditory hallucinations is suggested.

New life for schizophrenia psychotherapy in the light of phenomenology.

Recent contributions to the theoretical conception and empirical evaluation of schizophrenia in the light of phenomenology are opening the way to new perspectives in psychotherapy. The phenomenological conception understands schizophrenia as a disturbance of the basic sense of selfhood (ipseity) characterized by hyper-reflexivity and diminished sense of self. Evaluation consists of examining the anomalous self-experience in a series of domains, which makes the conception presented operable. On this basis, a phenomenologically informed psychotherapy is introduced. Its characteristics are pointed out and early intervention is reviewed (the last frontier in psychosis) from this perspective. Finally, a series of psychotherapies which, although they do not have a phenomenological origin, may be seen from that perspective, are re-examined. These are the narrative, mindfulness and acceptance and commitment therapies.

More Aristotle, Less DSM: The Ontology of Mental Disorders in Constructivist Perspective

This work begins by proposing the need for exploring the mode of being of mental disorders. It is a philosophical study in an Aristotelian perspective, with special emphasis on the anthropological–cultural dimension. It is difficult for such an inquiry to be carried out from within psychiatry or clinical psychology, committed as these fields are to their own logic and practical conditions. The issues are, in any case, more ontological than strictly clinical in nature. We therefore turn to Aristotle, and specifically his doctrine of the four “causes,” to flesh out the social and cultural dimensions of mental disorders. In accordance with the present analysis, the material cause of disorders would be found in the contingencies of life; the formal cause would pertain primarily to the way clinical conditions themselves can serve as models of ‘being ill’ in our society; the efficient cause would correspond to the patients themselves, understood as active (albeit less than fully conscious) agents as well as to the pharmaceutical industry and the mass media; the final cause would be found in different adaptive functions served by the disorder. We conclude that the “mode of being” of most (if not all) mental disorders—in particular, their status as mental disorders—can often have more to do with cultural forms than with biological factors.

Relationship of absorption, depersonalisation, and self-focused attention in subjects with and without hallucination proneness

Introduction The purpose of this work was to study the relationship of absorption, depersonalisation, and self-focused attention in subjects prone to hallucination. Methods A sample of 218 healthy subjects was given the LSHS-R Hallucination Scale (Bentall & Slade, 1985). Three groups, subjects with high, medium, and low hallucination proneness, were formed from this sample. The Tellegen Absorption Scale (TAS; Tellegen & Atkinson, 1974), Cambridge Depersonalisation Scale (CDS; Sierra & Berrios, 2000), and Self-Absorption Scale (SAS; McKenzie & Hoyle, 2008) were also given to all the participants. The Metacognitions Questionnaire (MCQ-30; Wells & Cartwright-Hatton, 2004) was used as a covariant to control for the effects of emotional vulnerability on the dependent variables studied. Results The results showed that subjects highly prone to hallucinations had significantly higher absorption, depersonalisation, and self-focused attention than the subjects in the other two groups. A hierarchical regression analysis showed that absorption and depersonalisation predict hallucination proneness. Conclusions The importance of the absorption, depersonalisation, and self-focused attention variables for understanding the aetiology of hallucinations is discussed in the Conclusions, where some approaches to its treatment are also suggested.