Development of an instrument for assessment of auditory hallucinations in schizophrenia

Abstract

The purpose of this study was to develop and assess the psychometrics of an instrument for the assessment of au~itory hallucinations in schizophrenia and other psychiatric disorders. Development of the Auditory Hallucination Assessment Scale (AHAS) was guided by Albert Ellis' reformulated model ofRational Emotive Behavior Therapy, the ABCD model. Applied to auditory hallucinations, the ABCD model asserts that distress and maladaptive coping behaviors are consequences not of the hallucination itself, but of the individual's beliefs ~bout the hallucination. An initial draft of the AHAS was submitted to an expert panel for assessment of content validity. The revised version of the AHAS is a 32 item self-report. Likert scale items describe characteristics, beliefs and attitudes about hallucinations and consequences of hallucinations. The psychometric properties of the AHAS were studied in a convenience sample of 151 clients in psychosocial rehabilitation outpatient day programs in two Georgia counties. Participants also completed two other hallucination scales, and one depression scale. Exploratory factor analysis was used to determine the underlying factor structure of the items and to assess the construct validity of the AHAS. The factor analysis resulted in a three-factor model which delineated three differing clinical symptom patterns of auditory hallucinations. The factors were labeled Troublesome Voices, Dangerous Voices, and Nurturing Voices. Rather than dividing the hallucinatory experience into three cognitive components as in the theoretical