Safety-seeking behaviours and verbal auditory hallucinations in schizophrenia
Abstract
Verbal auditory hallucinations can have a strong impact on the social and professional functioning of individuals diagnosed with schizophrenia. The safety-seeking behaviours used to reduce the threat associated with voices play a significant role in explaining the functional consequences of auditory hallucinations. Nevertheless, these safety-seeking behaviours have been little studied. Twenty-eight patients with schizophrenia and verbal auditory hallucinations were recruited for this study. Hallucinations were evaluated using the Psychotic Symptom Rating Scale and the Belief About Voice Questionnaire and safety behaviours using a modified version of the Safety Behaviour Questionnaire. Our results show that the vast majority of patients relies on safety behaviours to reduce the threat associated with voices. This reliance on safety behaviours is mostly explained by beliefs about origin of voices the omnipotence attributed to hallucinations and the behavioural and emotional reactions to the voices. Safety-seeking behaviours play an important role in maintaining dysfunctional beliefs with respect to voices. They should be better targeted within the cognitive and behavioural therapies for auditory hallucinations.
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Individuals with psychosis experiencing command hallucinations and auditory hallucinations may feel compelled to avoid social interactions to protect against perceived threats made by the voices.
“Individuals with psychosis experiencing command hallucinations and auditory hallucinations may feel compelled to avoid social interactions to protect against perceived threats made by the voices (Chaix et al. 2014; Varese et al. 2011).”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Chaix et al. 2014
Command hallucinations and auditory hallucinations contribute to social avoidance and reduced social functioning.
“In terms of symptomatology, command hallucinations and auditory hallucinations have also been found to contribute to social avoidance and reduced social functioning.”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Chaix et al. 2014
Cites
Chadwick, P., Hughes, S., Russell, D., Russell, I., & Dagnan, D. (2009) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465809990166 · Cited by 219 · cited 2× · see citing works
“The first version of the SBQ (Freeman et al., 2001) does present certain limitations due to the fact that the section devoted to avoidance strategies contains proposed choices. This bias is reduced in our study because we proposed choices for all the categories. Furthermore, the strategies of intimidation, categorised…”
BackgroundMoritz, S., Favrod, J., Andreou, C., Morrison, A. P., Bohn, F., Veckenstedt, R., Tonn, P., & Karow, A. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbs005 · Cited by 112 · see citing works
Self-citationThe role of safety-seeking behaviours in maintaining threat appraisals in psychosis
Gaynor, K., Ward, T., Garety, P., & Peters, E. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.10.008 · Cited by 42 · cited 2× · see citing works
“Finally, a fourth study (Gaynor et al., 2013) compared safety-seeking behaviours in a group of patients requiring care (clinical group), and a group of patients without care (non-clinical group).”
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Social Functioning Interventions in Psychosis: A Systematic Review.
Vinu, M., & Georgiades, A. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70090 · Cited by 9 · see citing works
Une approche psychologique des hallucinations : mécanismes psychologiques (partie I)
Bortolon, C., & Raffard, S. (2021) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2020.08.009
- Authors
- Chaix, J., Ma, E., Nguyen, A., Ortiz Collado, M. A., Rexhaj, S., & Favrod, J.
- Affiliations
- HES-SO University of Applied Sciences and Arts Western Switzerland (CH)
- Corresponding author
- Favrod, Jérôme
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 220
- Issue
- 1-2
- Pages
- 158-162
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2018041413
- Cited by
- 20
- References
- 3
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 1 · 2015: 2
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Funders
- Swiss National Science Foundation (13DPD6-129784)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- safety-seeking behavior, schizophrenia, dysfunctional attitudes, cognitive behavioral therapy, functional disability
- MeSH terms
- Adaptation, Psychological, Adult, Female, Hallucinations, Humans, Male, Middle Aged, Surveys and Questionnaires, Schizophrenia, Schizophrenic Psychology, Voice
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