Academic journal article The Psychological Record

A Pilot Study of the Relations within Which Hearing Voices Participates: Towards a Functional Distinction between Voice Hearers and Controls

Academic journal article The Psychological Record

A Pilot Study of the Relations within Which Hearing Voices Participates: Towards a Functional Distinction between Voice Hearers and Controls

Article excerpt

The Implicit Relational Assessment Procedure (IRAP; Barnes-Holmes, Barnes-Holmes, Power, Hayden, Milne, & Stewart, 2006) is based on Relational Frame Theory (RFT; Hayes, Barnes-Holmes, & Roche, 2001), a modern functional-analytic approach to human language and cognition. For RFT, verbal histories are established by exemplar training and natural language interactions, through which individuals learn to relate stimuli and events never before related together, and can do so indirectly from specific histories of relating stimuli in similar ways. From a measurement perspective, RFT is interested in targeting these relational responses "in flight" and exploring the types of verbal histories that give rise to specific verbal repertoires, such as those involved in human psychological suffering (Barnes-Holmes, Barnes-Holmes, Hussey, & Luciano, 2016; Finn, Barnes-Holmes, Hussey, & Graddy, 2016). The IRAP was designed specifically for this purpose and currently has over 50 published empirical articles supporting its utility (Barnes-Holmes, Barnes-Holmes, Stewart, & Boles, 2010). Indeed, the IRAP shares many methodological features with implicit measures such as the Implicit Association Test (IAT; e.g., Greenwald, Nosek, & Banaji, 2003). For example, both are automated reaction-time based, group measures in which participants' pair stimuli on a computer screen, and the basic assumption is that participants respond more quickly to stimulus pairings that are consistent (e.g., flowers-pretty and insects-ugly) with their pre-experimental verbal histories than those that are inconsistent (e.g., flowers-ugly and insects-pretty) when they are asked to respond quickly on consistent and inconsistent blocks of trials. On the IRAP, the standardized difference scores between response latencies on consistent and inconsistent blocks of trials generate four [D.sub.IRAP] scores, one for each trial-type (e.g., pleasant-pleasant, pleasant-unpleasant, unpleasant-unpleasant, and unpleasant-pleasant). The IRAP has also demonstrated good reliability and predictive validity (Carpenter, Martinez, Vadhan, Barnes-Holmes, & Nunes, 2013: Fischer, 2013; Vahey, Nicholson, & Barnes-Holmes, 2015).

Using the IRAP to Study Clinical Phenomena

There is an increasing focus on the utility of the IRAP among researchers of clinically relevant phenomena (see Vahey et al., 2015, for a meta-analysis). One significant advantage of the IRAP over the IAT is its ability to provide greater precision in terms of understanding the observed patterns of relational responding. That is, while the IAT identifies associations between pairings, the IRAP also specifies the nature o/these pairings. Consider the study by Nicholson and Barnes-Holmes (2012a) that presented two IRAPs, both of which assessed disgust toward pleasant pictures (e.g., neatly folded towels) or unpleasant pictures (e.g., a dirty toilet). Specifically, one IRAP assessed disgust propensity (i.e., the tendency to experience disgust), while the other assessed disgust sensitivity (i.e., how negatively a disgust experience is appraised). In simple terms, the disgust propensity IRAP measured emotional reactions, while the sensitivity IRAP measured behavioral reactions. Participants also undertook a series of behavioral approach tasks (BATs) and explicit measures. The results demonstrated that while responding on both IRAPs predicted obsessive compulsive tendencies on explicit measures of obsessive compulsive disorder (OCD), only the sensitivity IRAP predicted avoidance behaviors on the BAT. That is to say that the behavioral reaction to the event predicted actual behavior, while the emotional reaction to it did not. The IRAP's ability to separate these two constructs of the same overarching feature (disgust) highlighted the potential promise of the measure in clinical domains. Furthermore, the IRAP has recently been shown to predict treatment outcomes with cocaine dependence and correctly classify individuals with suicidal ideation from those without (Carpenter et al. …

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