Biomedical subjects

Vaughan Bell

Publications and source records attributed to Vaughan Bell.

5 recordsLinked to original sources

PubMed2006

Diagnosing delusions: a review of inter-rater reliability.

Although several studies have examined the reliability of diagnosing delusions there is no comprehensive review of the literature. Therefore, the reliability of diagnosing 'delusions in general' and the subcategory of 'bizarre delusions' was reviewed, including both structured interview and standardized instrument methods. The literature suggests that delusions in general can be diagnosed reliably with both structured interview and standardized instruments. However, bizarre delusions are not reliably diagnosed by either, suggesting that this concept may have little clinical validity. Nevertheless, many of the studies reviewed are poorly designed or subject to significant confounds. Criteria are suggested for adequate future studies.

Delusions↗

PubMed2006

'Mind control' experiences on the internet: implications for the psychiatric diagnosis of delusions.

BACKGROUND: The DSM criteria for a delusion indicate that it should not include any beliefs held by a person's 'culture or subculture'. The internet has many examples of people reporting 'mind control experiences' (MCEs) on self-published web pages, many of which suggest a community based around such beliefs and experiences. It was hypothesized that some of these reports are likely to reflect delusional beliefs and the hyperlinks between web reports were likely to show evidence of social structure, demonstrating the 'culture or subculture' exemption to be increasingly redundant in light of new technology. SAMPLING AND METHODS: Texts from web sites reporting MCEs (n = 10), experience of cancer (n = 10), depression (n = 10) and being stalked (n = 10) were identified, and were blind-rated by three independent psychiatrists for the presence of delusions. Hyperlinks from web sites reporting MCEs were used to create a network structure; this was compared with a size-matched, randomly generated network and known social networks from the literature using social network analysis. CONCLUSIONS: The sampled web-published accounts of MCEs are highly likely to be influenced by delusional beliefs. Social network analysis suggests there is significant evidence of an online community based around these beliefs. The fact that individuals can form a community based on the content of a potentially delusional belief presents a paradox for the DSM diagnostic criteria for a delusion, and suggests the need to revise and revisit the original operational definition in the light of these new technological developments.

Culture↗

PubMed2006

Explaining delusions: a cognitive perspective.

There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. This review considers those models that explain delusions as a breakdown of normal belief formation (belief-positive models), approaches that explain the pathology only (belief-negative models) and approaches that view delusions as one end of a distribution of anomalous mental phenomena (the continuum view). A cognitive theory that includes the 'pragmatic pathology' of delusions will be able to address both the phenomenology and the treatment of delusion-related distress.

Attention↗

PubMed2005

The Cardiff Anomalous Perceptions Scale (CAPS): a new validated measure of anomalous perceptual experience.

The study describes the Cardiff Anomalous Perceptions Scale (CAPS), a new validated measure of perceptual anomalies. The 32-item CAPS measure is a reliable, self-report scale, which uses neutral language, demonstrates high content validity, and includes subscales that measure distress, intrusiveness, and frequency of anomalous experience. The CAPS was completed by a general population sample of 336 participants and 20 psychotic inpatients. Approximately 11% of the general population sample scored above the mean of the psychotic patient sample, although, as a group, psychotic inpatients scored significantly more than the general population on all CAPS subscales. A principal components analysis of the general population data revealed 3 components: "clinical psychosis" (largely Schneiderian first-rank symptoms), "temporal lobe disturbance" (largely related to temporal lobe epilepsy and related seizure-like disturbances) and "chemosensation" (largely olfactory and gustatory experiences), suggesting that there are multiple contributory factors underlying anomalous perceptual experience and the "psychosis continuum."

Adolescent↗

PubMed2005

'Internet delusions': a case series and theoretical integration.

BACKGROUND: Delusions involving the internet have been reported as examples of the influence of cultural innovations on delusion formation, although there has been some debate as to whether such innovations simply affect surface content, or whether they have more substantial clinical or psychopathological implications. SAMPLING AND METHODS: Four cases of patients with delusions involving the internet were identified following a general request to local consultant psychiatrists for referrals. RESULTS: The internet had a specific effect on aetiology in one case, and knowledge of the internet seemed to constrain the type of delusion formed in two others. The presence of an internet-related delusion in the final case was used to frame a successful clinical intervention based on the 'collaborative empiricism' method, using cognitive behavioural therapy and collaborative use of the internet to resolve the delusional belief. CONCLUSIONS: Cultural technical innovations may have specific influences on the form, origin and content of delusional beliefs. For some patients the presence of internet-themed delusions may be a good prognostic indicator since, given the rich sources of information available, they may be well suited to treatment with cognitive behavioural therapy.

Adult↗