The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’
BackgroundThere are high rates of obesity and low self-esteem in patients with psychosis. The occurrence of negative voice content directly about appearance is therefore plausible. Derogatory comments about appearance are likely to be distressing, increase depression and contribute to social withdra...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2019-09-01
|
| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472419000668/type/journal_article |
| _version_ | 1827995672540872704 |
|---|---|
| author | Felicity Waite Rowan Diamond Nicola Collett Eleanor Chadwick Emily Bold Ashley-Louise Teale Kathryn M. Taylor Miriam Kirkham Eve Twivy Chiara Causier Lydia Carr Jessica C. Bird Emma Černis Louise Isham Daniel Freeman |
| author_facet | Felicity Waite Rowan Diamond Nicola Collett Eleanor Chadwick Emily Bold Ashley-Louise Teale Kathryn M. Taylor Miriam Kirkham Eve Twivy Chiara Causier Lydia Carr Jessica C. Bird Emma Černis Louise Isham Daniel Freeman |
| author_sort | Felicity Waite |
| collection | DOAJ |
| description | BackgroundThere are high rates of obesity and low self-esteem in patients with psychosis. The occurrence of negative voice content directly about appearance is therefore plausible. Derogatory comments about appearance are likely to be distressing, increase depression and contribute to social withdrawal.AimsTo systematically assess the occurrence of voice content regarding appearance and identify correlates.MethodSixty patients experiencing verbal auditory hallucinations at least once a week in the context of non-affective psychosis completed a measure assessing positive and negative voice content about appearance. They also completed assessments about body image, self-esteem, psychiatric symptoms and well-being.ResultsFifty-five (91.7%) participants reported hearing voices comment on their appearance. A total of 54 (90%) patients reported negative voice content about their appearance with 30 (50%) patients experienced negative appearance comments on a daily basis. The most common negative comment was ‘the voices tell me that I am ugly’ (n = 48, 80%). There were 39 (65%) patients who reported positive voice content on appearance. The most frequent positive comment was ‘I look as nice as other people’ (n = 26, 43.3%). Negative voice content about appearance was associated with body image concerns, paranoia, voice hearing severity, depression, worry, negative self-beliefs and safety-seeking behaviours. Positive appearance voice content was associated with greater body esteem and well-being and lower levels of depression and insomnia.ConclusionsVoice content about appearance is very common for patients seen in clinical services. Negative voice content may reflect – and subsequently reinforce – negative beliefs about one's appearance, low self-esteem, worry and paranoia.Declaration of interestNone. |
| first_indexed | 2024-04-10T05:00:00Z |
| format | Article |
| id | doaj.art-2b16a40826654eb697967b4821e36160 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T05:00:00Z |
| publishDate | 2019-09-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-2b16a40826654eb697967b4821e361602023-03-09T12:28:55ZengCambridge University PressBJPsych Open2056-47242019-09-01510.1192/bjo.2019.66The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’Felicity Waite0https://orcid.org/0000-0002-2749-1386Rowan Diamond1Nicola Collett2Eleanor Chadwick3Emily Bold4Ashley-Louise Teale5Kathryn M. Taylor6Miriam Kirkham7Eve Twivy8Chiara Causier9Lydia Carr10Jessica C. Bird11https://orcid.org/0000-0001-9457-1506Emma Černis12Louise Isham13https://orcid.org/0000-0003-1752-5236Daniel Freeman14https://orcid.org/0000-0002-2541-2197Research Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Assistant, Department of Psychiatry, University of Oxford, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKResearch Clinical Psychologist, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKProfessor of Clinical Psychology, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, UKBackgroundThere are high rates of obesity and low self-esteem in patients with psychosis. The occurrence of negative voice content directly about appearance is therefore plausible. Derogatory comments about appearance are likely to be distressing, increase depression and contribute to social withdrawal.AimsTo systematically assess the occurrence of voice content regarding appearance and identify correlates.MethodSixty patients experiencing verbal auditory hallucinations at least once a week in the context of non-affective psychosis completed a measure assessing positive and negative voice content about appearance. They also completed assessments about body image, self-esteem, psychiatric symptoms and well-being.ResultsFifty-five (91.7%) participants reported hearing voices comment on their appearance. A total of 54 (90%) patients reported negative voice content about their appearance with 30 (50%) patients experienced negative appearance comments on a daily basis. The most common negative comment was ‘the voices tell me that I am ugly’ (n = 48, 80%). There were 39 (65%) patients who reported positive voice content on appearance. The most frequent positive comment was ‘I look as nice as other people’ (n = 26, 43.3%). Negative voice content about appearance was associated with body image concerns, paranoia, voice hearing severity, depression, worry, negative self-beliefs and safety-seeking behaviours. Positive appearance voice content was associated with greater body esteem and well-being and lower levels of depression and insomnia.ConclusionsVoice content about appearance is very common for patients seen in clinical services. Negative voice content may reflect – and subsequently reinforce – negative beliefs about one's appearance, low self-esteem, worry and paranoia.Declaration of interestNone.https://www.cambridge.org/core/product/identifier/S2056472419000668/type/journal_articleSchizophreniahallucinationsobesityweightbody image |
| spellingShingle | Felicity Waite Rowan Diamond Nicola Collett Eleanor Chadwick Emily Bold Ashley-Louise Teale Kathryn M. Taylor Miriam Kirkham Eve Twivy Chiara Causier Lydia Carr Jessica C. Bird Emma Černis Louise Isham Daniel Freeman The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’ BJPsych Open Schizophrenia hallucinations obesity weight body image |
| title | The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’ |
| title_full | The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’ |
| title_fullStr | The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’ |
| title_full_unstemmed | The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’ |
| title_short | The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly’ |
| title_sort | comments of voices on the appearance of patients with psychosis the voices tell me that i am ugly |
| topic | Schizophrenia hallucinations obesity weight body image |
| url | https://www.cambridge.org/core/product/identifier/S2056472419000668/type/journal_article |
| work_keys_str_mv | AT felicitywaite thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT rowandiamond thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT nicolacollett thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT eleanorchadwick thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT emilybold thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT ashleylouiseteale thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT kathrynmtaylor thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT miriamkirkham thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT evetwivy thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT chiaracausier thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT lydiacarr thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT jessicacbird thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT emmacernis thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT louiseisham thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT danielfreeman thecommentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT felicitywaite commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT rowandiamond commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT nicolacollett commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT eleanorchadwick commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT emilybold commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT ashleylouiseteale commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT kathrynmtaylor commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT miriamkirkham commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT evetwivy commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT chiaracausier commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT lydiacarr commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT jessicacbird commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT emmacernis commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT louiseisham commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly AT danielfreeman commentsofvoicesontheappearanceofpatientswithpsychosisthevoicestellmethatiamugly |