The proposed project will try to identify variables associated with compliance with command hallucinations. Pilot data suggests that two variables were positively associated with compliance: recognition of the hallucinatory voice, and the presence a particular type of delusional- belief--one of which the subject makes reference to some aspect of his hallucination as supporting evidence (i.E., a hallucination-related delusion). In the pilot study, it appeared that the danger of the behavior specified by the hallucination was not a factor in compliance. In addition to the two variables identified in pilot data, it is hypothesized that past compliance with command hallucinations, severity of illness (estimated with two measures), and intelligence are associated with compliance. In the first phase of the proposed project lasting approximately on year, the most recent command hallucination will be identified for 60 to 65 psychiatric inpatients with a history of command hallucinations. The status of the six variables cited above will be determined for each subject, and the relationship of the six variables to the dependent variable of compliance will be assessed with a multiple regression analysis. Positive findings from the initial phase of the proposed project will be cross-validated on a second, independent sample of 60 to 65 subjects with a history of command hallucinations. This second phase of the project also will last approximately one year, resulting in a duration of two years for the entire project. The ultimate goal of this project is to identify reliable predictors of dangerous behavior in a small but potentially dangerous (to self and others) subgroup of psychiatric patients: those experiencing command hallucinations.
