Dipl.of Mental Health –  CHCPOL003_CHCMHS009 – Assessment: Research Report 1

 

1. Formulate a ‘research question’ that your research will attempt to respond to:

Schizophrenia symptoms include auditory hallucinations and yet mediums, psychics and otherwise healthy people are also known to experience auditory hallucinations, therefore, what factors determine a healthy human experience with auditory hallucinations or a psychotic experience like schizophrenia?

 

2. Provide a background to the issue. Your discussion must make reference to epidemiological or trend related data relevant to the issue, historical developments in sector or policy approaches and current best practice:

Traditional approaches to auditory hallucinations have viewed voice hearing or voice hallucinations as definitive signs of mental illness, thus creating dominant medical treatments aimed at eliminating voices.
We have also seen discouragement of exploring voice hearing experiences within traditional approaches, however, current evidence supports medical and scientific fields moving forward in understanding the physiological differences associated with those who experience auditory hallucinations as a) a schizophrenic diagnosed patient and as b) an otherwise healthy human. (Clements 2015)

Current evidence also supports the concept that by embracing a deeper understanding of this phenomena, we may well facilitate better recovery practices.
Current exploration of auditory voice hallucinations and experiences have begun to see more explorative and self-explorative networks grow in effort and support of individuals experiencing auditory voice hallucinations.

Not only is there a current movement to understanding the distinctive or significant differences in brain biology and responses divulgent of ascertaining discerning functional qualities and factors that separate a healthy human experience of auditory voice hallucinations from a psychotic or schizophrenic experience (Di Biase, Zhang, Lyall, Kubicki, Mandl, Sommer, Pasternak 2019), but also a movement approaching recovery from a self-supportive role through hearing voices networks and self-help groups.

Research on the impact and effectiveness of hearing voices provided a range of positive emotional, social and clinical outcomes. (Longden, Read, Dillion 2018)

The significance of understanding the differences within brain functions proposes opportunities to development new and effective treatments of schizophrenia and other psychotic conditions with a focus on understanding and recovery rather than elimination.
It also extends opportunities of de-intensifying stigma attached to hearing voices, thus creating opportunities that support the self-help networks so that lived experience, peer support and recovery focused practices can become embedded within the mental health sector in collaborative partnerships.

Research also indicates that whilst a relative consensus of 5 to 15 % (Clements 2015) of the general population are healthy auditory hallucinators, limitations exist as to whether or not they would go on to develop clinical risk or frank psychosis, (Di Biase, et al. 2019) therefore a portion of the research will always remain inconclusive.

 

3. Explain why you have chosen to research this issue. Your response must demonstrate understanding of different reasons for undertaking research:

I have always found it quite fascinating that symptoms which signal schizophrenic disorders are also found in otherwise normal, healthy individuals. Therefore, what the determining factors of this distinction are, have been a consistent wonderment of piqued interest for me.

There are so many questions in relation to what mental health defines as hallucinations and how some of the population have such severe and debilitating experiences, whilst other members of the population harness the hallucinations in ways that are beneficial to them or others. The significance of the later can be showcased by the heroine, Joan of Arc and the voices in her head that she defined as communication from ‘god’.

I am passionate about integrating spiritual and mainstream in ways that are more supportive, collective and inclusive to healing, recovery and quality of life, and I feel that this issue is a ‘close to my heart’ opportunity to achieve that.

Auditory voice hallucinations, and other kinds of hallucination experiences like visual, can also be contributed to psychotic illness or healthy human, and feels to be at the very least an extracurricular project to develop an understanding that contributes to easing others within my practice and the mental health sector, and yet potentially a field to specialise in.

 

4. Discuss a minimum of three legal, ethical and/or cultural considerations relevant to research on this topic, including duty of care requirements:

Legal Considerations: Privacy and Confidentiality. Maintaining effective records and recording keeping methods. Respecting individuals wishes and only sharing information with referral services if consent is given.

Ethical Considerations: Duty of Care and wellbeing. Providing the best, most effective, positive and support services and referrals to services as possible. And contributing to as much ease when transitioning through the menopausal stages and mental health implications.

Cultural Considerations: Mindful of cultural beliefs and attitudes. Example, some cultures have a specific view not aligned with mental health or illness diagnosis but rather as a result of punishment or entity attachments.

 

5. Provide an annotated bibliography, reviewing at least 2 scholarly sources of information on your chosen issue that you have read:

Maria Angelique, D.B., Zhang, F., Lyall, A., Kubicki, M., Mandl, R.C.W., Sommer, I.E. & Pasternak, O. 2020, “Neuroimaging auditory verbal hallucinations in schizophrenia patient and healthy populations”, Psychological medicine, vol. 50, no. 3, pp. 403-412. Viewed 28/2/2020 <https://tafecat.tafensw.edu.au/tafecatalog/index.jsp?eResource=https://search.proquest.com/docview/2354627567?accountid=81668>

Neuroimaging Auditory Verbal Hallucinations in Schizophrenia Patient and Healthy Populations.

An in depth scientific article which explores the discerning brain functions generated within healthy populations and schizophrenic patient populations who experience auditory hallucinations.

The article shows research participants comprised of 35 diagnosed schizophrenia patients, 32 healthy voice hearers and 40 healthy controls without history of auditory voice hearing, and reflects a lengthy and well informed recruitment process that included demographic and clinical characteristics, independent psychiatric diagnosis for SCZ-AVH participants and rigorous initial criteria for H-AVH participants, before undergoing psychiatric interviews to confirm their position within the study. Healthy controls were also subject to interviews which lead to their placement of HC within the study.

The premise of this article reflects using brain imaging techniques such as Diffusion and T1 weighted magnetic resonance imagining ascertaining the substrate reactions of functions to correlate any signs of differences within the two distinct auditory hallucinating populations. White matter and grey matter regions were tested and compared for significant alterations with SCZ-AVH and H-AVH groups, relative to a control group (HC).

The article is complex in its nature, with an obvious tendency toward the scientific aspects of brain functions, pathophysiological mechanisms, biological substrates and anatomical connectivity, which results in overlapping abnormalities, pathology and symptom correlations to determine any significant deficits between schizophrenia patients and healthy voice hearers.

With hallucination characteristics measured in four hallucination dimension; Distress ( distress/negative content/control), Frequency (frequency/duration/disruption), Attribution (attribution of voices: location and origin), and Loudness (loudness); the only significant difference recorded was a higher severity in the SCZ-AVH group in relation to distress, frequency and attribution scales.

The article concludes that evidence for overlapping white matter abnormalities across younger SCZ-AVH participants and healthy voice-hearers were found, and that the commonalities could be characterized by cellular specific deficits within white matter microstructures.
Researchers conceded that the structural basis of AVH was not straightforward and that further research and studies could address the complexities within this subject.

 

Longden, E., Read, J. and Dillon, J. (2018) ‘Assessing the Impact and Effectiveness of Hearing Voices Network Self-Help Groups’, Community Mental Health Journal, 54(2), pp. 184–188. doi: 10.1007/s10597-017-0148-1. Viewed 28/2/2020 <https://tafecat.tafensw.edu.au/tafecatalog/index.jsp?eResource=https://search.ebscohost.com/login.aspx?direct=true&AuthType=url,uid&db=a9h&AN=127734694&site=ehost-live&scope=site>

Assessing the Impact and Effectiveness of Hearing Voices Network Self-Help Groups.

This article is deemed as the first of its kind in the systemic assessment and examination of both the impact and effectiveness of self-help groups in the UK called Hearing Voices Network.

The article defines the Hearing Voice Networks as ‘psychiatric service-user/survivor led organizations that promote the needs and perspectives of the individuals who experience voice hearing…that promotes self-help as an important aspect of recovery.’

31 countries now have similar networks, yet the English version is cited as the international gateway for the global Hearing Voices Movement and shares the ethos of emphasizing the importance of developing positive alliance, partnership and co-operation between experts by experience and experts by profession.

In the context of the article, there is a great deal of user based evidence that supports a positive holistic impact to attendees of the networks, with high range positive statements signifying “that it is useful to meet other voice hearers in the groups, that groups provide support around voice hearing that is unavailable elsewhere, that groups feel like a safe and confidential place to discuss difficult things, and that the group helped them improve a range of social, clinical and emotional variables.”

With group participants endorsing the group as providing support that was unavailable to them elsewhere, the HVN, through this article, appear to be a significant contribution into the person centred recovery concept within the diagnosable psychotic condition’s community.

In summary, this article and the focus of its study, provides qualitative research suggesting that the acceptance of the voice hearing experience or auditory voice hallucinations, can facilitate more in depth and inclusive social and self-acceptance, and is a prime example of how clinical recovery and voice alleviation can benefit from instrumental psychosocial recovery practices such as Hearing Voices Networks.
With greater evidence of enhanced self-esteem, social functioning, coping and hopefulness, the article shows how beneficial user lead practices, peer support and lived experience practices, and mental health professional practices combined, can be in facilitating a positive sense and result of recovery of mental health individuals.

 

6. A discussion of the recommendations based on your research you would make to a service or individual workers supporting people experiencing your chosen issue:

Within the context of my research, the only identifiable factors relating to what supports the distinction between a healthy voice hearer and a mentally ill voice hearer; schizophrenic; has been referenced to the brains white matter and grey matter comparisons. Biological references, imagery and brain function observation was able to identify that white matter pathology is associated with auditory voice hallucinations, yet it’s not distinct enough to qualify as major breakthrough in distinction.

Further studies within this field could lead to addressing the complexities of mapping the progressions and indifferences of white and grey matter abnormalities or changes within individuals experiencing auditory voice hallucinations or hearing, in both the context of a psychotic condition and a healthy human aspect.

In support of best practice movements and qualitative controls, more research into the biological factors are required. Intentional research dedicated to recovery aspects from the scientific and medical communities may well prove to be a significant contribution to alleviating stigma, promoting acceptance, inclusivity and quality of living practices.

Further embracing of person centred recover models, such as the Hearing Voices Network, focused on destigmatizing schizophrenia and other voice hearers, from a social, emotional and clinical perspective, will help move the industry into more person focused care and recovery practices that are inclusive for individuals, facilitators and practitioners.

Working in collaboration, and in genuine interest of improving quality of life for schizophrenic individuals, will surely provide the best outcomes for all people.

Industry best practice requires a shift in focus and a shift in perception, to widen the narrow mindedness in order to expand into the best possible practices in women’s health and wellbeing.

 

7. Identify at least two aspects or areas relevant to your chosen issue that you will conduct further research on:

Without a remarkably definitive response or reasoning that shows what the determining factors are for supporting a diagnosis of schizophrenia in some people and while others experiencing similar symptoms of auditory verbal hearing are perceived as normal and healthy, I would suggest that my original question is still open for exploration, all though somewhat more complex in nature than originally put, with a series of continuation questions rather than answers or responses.

What allows for a person to be healthily hearing voices verses hearing voices in a mentally ill construct?

Who determines whether a psychic medium is talking to spirit or is in fact a mentally ill personal experiencing auditory verbal hallucinations on a small scale?

How can I best contribute normalization around this subject, from both the ‘normal’ perspective and the ‘mentally ill’ perspective?

 

References:
Clements, S., Francesca, C. & Mackenzie, L. 2020, ““I’m Not Telling an Illness Story. I’m Telling a Story of Opportunity”: Making Sense of Voice Hearing Experiences”, Community mental health journal, vol. 56, no. 2, pp. 196-205. Viewed 28/2/2020 <https://ses.library.usyd.edu.au/bitstream/handle/2123/14206/CLEMENTS_STEPHANIE_HSBH5006_RESEARCHELECTIVEDISSERTATIONFINAL.pdf;jsessionid=19EDD4A8479D8A65F02BA9A7391C9AC7?sequence=1>

Longden, E., Read, J. and Dillon, J. (2018) ‘Assessing the Impact and Effectiveness of Hearing Voices Network Self-Help Groups’, Community Mental Health Journal, 54(2), pp. 184–188. doi: 10.1007/s10597-017-0148-1. Viewed 28/2/2020 https://tafecat.tafensw.edu.au/tafecatalog/index.jsp?eResource=https://search.ebscohost.com/login.aspx?direct=true&AuthType=url,uid&db=a9h&AN=127734694&site=ehost-live&scope=site

Maria Angelique, D.B., Zhang, F., Lyall, A., Kubicki, M., Mandl, R.C.W., Sommer, I.E. & Pasternak, O. 2020, “Neuroimaging auditory verbal hallucinations in schizophrenia patient and healthy populations”, Psychological medicine, vol. 50, no. 3, pp. 403-412. Viewed 28/2/2020 <https://tafecat.tafensw.edu.au/tafecatalog/index.jsp?eResource=https://search.proquest.com/docview/2354627567?accountid=81668>

McGuire, T 2020, Research Practices, lecture notes, Diploma in Mental Health CHCPOL003 CHCMHS009, TAFE NSW Taree, delivered 24 February 2020

 

 Author: Gemma Rose Green is the Raw & Real Goddess! She has been working with energy and spirit for over 10 years now; working with spirit, nature and universal energies. 
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