AVATAR therapy for distressing auditory hallucinations: mediators of change in AVATAR1, a single blind randomised control trial with supportive counselling as active control
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Le résumé fourni par la source
Abstract AVATAR therapy is an effective relational therapy for persistent distressing auditory verbal hallucinations (voices). A digital representation of the embodied persecutory voice (avatar) is created and used in a series of dialogues in which the voice hearer is supported to be more assertive and the avatar concedes power. In the first mediation analysis of AVATAR therapy examining the role of power-related constructs, we investigate whether treatment effects on total severity, frequency, and distress of voices are mediated by changes in beliefs about voices and the self, voice relationship appraisals and anxiety. Mediation effects were evaluated in relation to decomposing treatment offer and treatment receipt effects using both Intention to treat (ITT) and Complier Average Causal Effect (CACE) analyses. One hundred and fifty participants from AVATAR1, a randomised control trial (RCT) comparing AVATAR therapy to Supportive Counselling took part in this study, with their baseline and end of treatment (12 weeks) data used. As hypothesised, across both ITT and CACE analyses, reductions in perceived voice omnipotence and increased assertiveness in relation to voices emerged as consistent mediators of AVATAR therapy on reductions in overall severity, frequency and distress of auditory hallucinations compared to SC, whereas voice malevolence, perceived power differential, self-esteem and anxiety did not. Exploratory analysis also indicated that increases in acceptance and autonomy in relation to voices mediated the impact of AVATAR therapy on overall voice severity and distress. This mediation analysis refines our understanding of AVATAR therapy and highlights agency, voice omnipotence and acceptance as intervention targets.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- AVATAR therapy for distressing auditory hallucinations: mediators of change in AVATAR1, a single blind randomised control trial with supportive counselling as active control
- Date Crossref
- 12/08/2026
- Éditeur
- openRxiv
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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North East London NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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East London NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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University College London Research Department of Clinical pays non établi dans la noticeUniversité ou école supérieure
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King's College London Department of Biostatistics and Health Informatics pays non établi dans la noticeUniversité ou école supérieure
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South London and Maudsley NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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Ruhr University Bochum pays non établi dans la noticeUniversité ou école supérieure
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South London & Maudsley NHS Foundation Trust pays non établi dans la noticeOrganisation à but non lucratif
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German Center for Mental Health (DZPG) pays non établi dans la noticeInstitution
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Faculty of Psychology Mental Health Research and Treatment Center pays non établi dans la noticeUniversité ou école supérieure
North East London NHS Foundation Trust, East London NHS Foundation Trust et Research Department of Clinical — University College London, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.