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Sandra Escher

Publications and source records attributed to Sandra Escher.

3 recordsLinked to original sources
PubMed2002

Formation of delusional ideation in adolescents hearing voices: a prospective study.

Previous work suggests that auditory hallucinations in children and adolescents occur frequently in the absence of psychotic illness, although a number of such children go on to develop more severe psychotic symptomatology and need for care. We examined prospectively what factors are associated with formation of delusions in adolescents who are hearing voices. Eighty adolescents (mean age 12.9 years, SD = 3.1) who reported hearing voices were examined at baseline and followed-up three times over a period of 3 years. Fifty percent were receiving professional care, but 50% were not in need of care. Baseline measurement of voice appraisals, attributions, psychopathology, global functioning, dissociation, stressful life events, coping mechanisms, and receipt of professional care were used as predictors of delusion formation, measured as a score of 6 or greater on the extended BPRS items: "suspiciousness," "unusual thought content" and "grandiosity." Thirteen children (16%) displayed evidence of delusional ideation over at least one of the three follow-up periods, of which seven (9%) de novo. Adjusting for presence of baseline delusional ideation, delusion formation over the follow-up period was associated with baseline voice appraisals and attributions such as tone of the voice (hazard ratio voice "variably friendly and hostile" compared to "always friendly": HR = 6.8, 95% CI: 1.1, 41.0), perceived location of the voice (outside vs. inside head: HR = 2.9, 95% CI: 1.0, 8.7), and whether the voice resembled that of a parent (HR = 3.5, 95% CI: 1.0, 12.0); baseline BPRS anxiety/depression (HR = 6.4, 95% CI: 1.9, 21.4), baseline BPRS disorganization (HR = 5.0, 95% CI: 0.98, 26.1) and the baseline amount of reported recent stressful life events (HR continuous life events score: 1.8, 95% CI: 1.0, 3.3). In addition, in older children, the perceived influence of the voices on emotions and behavior was strongly associated with delusion formation (HR = 5.1, 95% CI: 1.0, 25.9). Delusion formation in children hearing voices may be responsive to triggering events and facilitated by feelings of anxiety/depression. The results also highlight the role of attributions associated with external sources, authority figures, perceived influence or "power" over the person, as well as emotional appraisal processes and cognitive disorganization.

Adolescent↗
PubMed2002

Independent course of childhood auditory hallucinations: a sequential 3-year follow-up study.

BACKGROUND: Childhood hallucinations of voices occur in a variety of contexts and have variable long-term outcomes. AIM: To study the course of experience of voices sequentially over a 3-year period in those with and those without a need for mental health care (patient status). METHOD: In a group of 80 children of mean age 12.9 years (s.d. = 3.1), of which around 50% were not receiving mental health care, baseline measurement of voice characteristics, voice attributions, psychopathology, stressful life events, coping mechanisms and receipt of professional care were used to predict 3-year course and patient status. RESULTS: The rate of voice discontinuation over the 3-year period was 60%. Patient status was associated with more perceived influence on behaviour and feelings and more negative affective appraisals in relation to the voices. Predictors of persistence of voices were severity and frequency of the voices, associated anxiety/depression and lack of clear triggers in time and place. CONCLUSIONS: Need for care in the context of experience of voices is associated with appraisal of the voices in terms of intrusiveness and 'omnipotence'. Persistence of voices is related to voice appraisals, suggesting that experience of voices by children should be the target of specific interventions.

Adolescent↗