Nev Jones - Academia.edu (original) (raw)

Papers by Nev Jones

To advance the area of phenomenology of voices and their interrelatedness to forms of delusions, ... more To advance the area of phenomenology of voices and their interrelatedness to forms of delusions, this study investigated the prevalence and interrelatedness of co-occurring auditory verbal hallucinations (AVHs) and delusions. Additionally, we explored the characterization of distinct subcategories/clusters of AVHs and delusions. Ninety-two participants experiencing psychosis were administered standardized clinical measures. We found a significant diagnostic difference with increased prevalence of co-occurring AVHs and delusions within the schizophrenia group compared to the bipolar with psychosis group. Regardless of diagnosis, there was a significant positive correlation between AVHs and delusions of reference, persecution, control, thought insertion, thought withdrawal and thought broadcasting. However, no significant relationship was found between AVHs and grandiose, somatic, religious, guilty or jealousy-themed delusions. Cluster analysis yielded two distinct cluster groups. Cluster One: Voices and Thought Delusions, and Cluster Two: Voices and Thematic Delusions. Cluster One participants showed elevated disorganized, cognitive and depressive symptoms, but not negative symptoms or excitement. This study underscores the need for expanded clinical and phenomenological research into the intersection of AVHs and delusions, including work that seeks to deconstruct conventional divisions between ostensible symptoms of perception (hallucinations) and belief (delusions).

Objective: To investigate the subjective experience of agency in the onset and early development ... more Objective: To investigate the subjective experience of agency in the onset and early development of psychosis.
Method: We conducted 19 in-depth interviews with a sample of individuals with self-reported diagnoses of schizophrenia and/or affective psychosis. Interviews focused on participants’ experiences of agency and control in the onset and development of positive psychotic symptoms. Interviews were coded and transcripts analyzed by service-user researchers.
Results: The majority of participants reported multiple ways in which they experienced their own agency or intentionality as involved in the initial onset of psychosis, in self-conscious engagement with symptom structure and content, and in their elaboration and development. For many, the moral implications of these felt experiences were considerable, at times leading to shame or guilt.
Conclusion: Clinical accounts often stress the imposed, involuntary experience of symptoms and onset. Our project suggests that at least a subset of subjects with psychosis instead experience themselves as partly or fully “responsible” for onset, and actively involved in the shaping and elaboration of positive symptoms. In both clinical practice and future research, we argue that such complications should be explored and grappled with rather than downplayed.

Keywords: first episode psychosis; psychosis onset; phenomenology; agency

Guidance manual with sections on planning & policy, clinician education, peer support, and evalua... more Guidance manual with sections on planning & policy, clinician education, peer support, and evaluation/research. Includes multiple interviews/Q&As with area experts as well as profiles of exemplary programs and initiatives.

Journal of Community Psychology, 2015

This study investigated predictors of sense of campus belonging among postsecondary students with... more This study investigated predictors of sense of campus belonging among postsecondary students with psychiatric disabilities. Participants were 566 current or past students with self-reported diagnoses of schizophrenia, bipolar disorder, or major depression. Descriptive statistics, multiple regression, and structural equation modeling were used to analyze the data. Regression results showed that campus engagement and psychosocial inclusion variables accounted for substantially more of the variance in sense of campus belonging than available symptomatological variables. Follow-up path modeling demonstrated the strong mediating role of sense of social exclusion, sense of opportunity, student relationships, and participation in clubs and organizations in the relationship of symptoms factors with sense of belonging. Implications for future research and program development are discussed, with an emphasis on moving beyond symptom-centered interventions to those that stress robust campus integration and engagement. C ⃝ 2015 Wiley Periodicals, Inc.

Empirical research on naturalistic hearing voices movement groups (HVG) has been limited to date.... more Empirical research on naturalistic hearing voices movement groups (HVG) has been limited to date. In an effort to better understand facilitator perspectives and variations in the structure of groups in the USA, we conducted a facilitator-led national survey of HVG facilitators. The survey included both close-ended and open-ended questions and was available online for 1 year. Participants were asked about the structure and composition of their groups, their perspectives on membership, clinician involvement, facilitator training and perceived impact of group participation on members. Thirty-two facilitators participated. The results underscore the diversity of HVG in the USA. The authors highlight three findings of interest: (1) participants’ disagreements or uncertainty regarding a narrower HVG focus on experiences that would traditionally be described as “sensory hallucinations” versus a broader subset of extreme or unusual experiences (including “beliefs”); (2) tensions regarding HVG collaboration with clinicians; and (3) insights into impact.

Objective: Research concerning the subjective sensory qualities of auditory hallucinations (AH) i... more Objective: Research concerning the subjective sensory qualities of auditory hallucinations (AH) in people diagnosed with schizophrenia is scarce. Our goal was to investigate the “auditoriness” of AH and their overlap with symptoms grounded in alterations of thought rather than perception.
Method: We undertook a detailed analysis of phenomenological interviews with 80 schizophrenia-spectrum voice-hearers.
Results: We coded the dominant voice patterns of our subjects and found that only a minority (17.5%) reported a dominant pattern of AH which were experienced as literally auditory. Of dominant AH patterns, 11.3% were instead described as only quasi- or partially auditory, 28.8% as involving a combination of distinctly auditory and thought-like voices, and 15% as unambiguously thought-like. In addition, 5% reported exclusively simple, short-duration AH (e.g. hearing a single word), 12.5% the misperception of actual speech or sounds, and 10% predominantly multisensory voices. We also found substantial overlap between voices and symptoms traditionally considered abnormalities of thought rather than sensation.
Conclusion: We believe these findings challenge common assumptions about AH in people diagnosed with schizophrenia, draw attention to potentially important but under-recognized characteristics of voices, and suggest a need for greater recognition of the heterogeneity of voices and the potential clinical as well as theoretical risks of conceptual over-simplification.

Counseling Theories and Techniques for Rehabilitation Health Professionals.

Mental illness stigma continues to be a major barrier for individuals with mental illness. In thi... more Mental illness stigma continues to be a major barrier for individuals with mental illness. In this paper, we define constructs that comprise stigma (e.g., attitudes, stereotypes, prejudice, discrimination), discuss the harmful effects (e.g., label avoidance, public stigma, self-stigma) and present factors that may influence them (e.g., concealability). In order to better understand mental health stigma in Muslim community, we focus on intersectional stigma and present literature on the complex relationships among race/ethnicity, gender, class, religion, and health status among Muslims. In addition, we include literature highlighting culturally specific presentations of symptoms and mental health problems. Finally, we offer suggestions for future stigma research in Muslim communities. And We will surely test you with something of fear and hunger and a loss of wealth and lives and fruits, but give good tidings to the patient (Surat Ai-Baqarah 2:155) Although mental health care has improved significantly over the last decades, many people still choose not to seek treatment or quit prematurely. A number of possible factors contribute to these disparities with stigma being perhaps the most significant. Stigma hurts individuals with mental illness and their communities , creating injustices and sometimes devastating consequences. In this paper, we discuss mental illness stigma and its related constructs, describe the

Background: The “Why Try” phenomenon, a consequence of self-stigma, is a sense of futility that o... more Background: The “Why Try” phenomenon, a consequence of self-stigma, is a sense of futility that occurs when people believe they are unworthy or incapable of achieving personal goals because they apply the stereotypes of mental illness to themselves.

Aims: This study examines a four-stage model of self-stigma (aware, agree, apply, and self-stigma harm) and examines the “why try” effect as a result. We do that by testing a measure of “why try.”

Method: Two hypothetical path models were tested. In the first, applying stereotypes to oneself leads to diminished self-respect and a sense of “why try”. In the second, the effect of applying stereotypes on “why try” is mediated by diminished self-respect. Participants completed the “why try” measure along with measures of self-stigma, public stigma, recovery, and empowerment.

Results: Results show application of stereotypes to oneself predicts diminished self-respect and “why try”. “Why try” was significantly associated with agreement with public stigma, depression, and diminished sense of personal recovery.

Conclusions: Findings from this study reveal the complex impact of self-stigma demonstrating its emotional and behavioral consequences. Implications for impacting self-stigma are discussed.

Disability or distress? Mental health and the politics of disablement

Our goal, in drafting early versions of the current chapter, was to ask hard questions about the ... more Our goal, in drafting early versions of the current chapter, was to ask hard questions about the potential synergies between the disability rights movement (and associated academic theory) and mad movement(s).

Background Auditory hallucinations-or voices-are a common feature of many psychiatric disorders a... more Background Auditory hallucinations-or voices-are a common feature of many psychiatric disorders and are also experienced by individuals with no psychiatric history. Understanding of the variation in subjective experiences of hallucination is central to psychiatry, yet systematic empirical research on the phenomenology of auditory hallucinations remains scarce. We aimed to record a detailed and diverse collection of experiences, in the words of the people who hear voices themselves.

Transcultural Psychiatry

There is a growing literature on what contemporary cultural theorists have broadly termed the ‘po... more There is a growing literature on what contemporary cultural theorists have broadly termed the ‘postsecular’: the abandonment of clear cut boundaries between the secular and non-secular in the industrialized West and an embrace of a complex understanding of what is real that neither accepts nor rejects the supernatural. We think that these new cultural currents affect not only philosophers and theologians, but also the ways in which individuals with psychosis make sense of their experiences. This paper reports on the key findings of an in-depth qualitative analysis of 19 interviews of individuals diagnosed with psychotic disorders. As we report in our analyses, the majority of participants described ongoing and self-conscious struggles to demarcate their experiences as the products of the real world or a ‘crazy’ mind. With equal frequency, participants weighed and debated competing secular and supernatural explanations, often juxtaposing and blending ostensibly different explanatory frameworks. We found that this syncretic process affected not only the content of psychotic experiences—what delusions or hallucinations are about--but also the type of arguments or logics used to justify particular interpretations. We discuss the implications of these observations with respect to clinical practice and the broader phenomenology of psychosis, challenging often over-simplified discourse on “insight” and suggesting that polarization(s) between the “biomedical” and “psychosocial” may be of less relevance to patients’ real world experiences than is often assumed.

Cultural Phenomenology, Critical Neuroscience, and Global Mental Health, 2015

Schizophrenia bulletin, 2014

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verb... more Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations (AVHs), the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH at 3 contextual levels: (1) cultural, social, and historical; (2) experiential; and (3) biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include (1) informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; (2) "front-loading" research in ...

Psychiatric Rehabilitation Journal, 2013

Objective: To address gaps in the literature concerning the relationships among participation in ... more Objective: To address gaps in the literature concerning the relationships among participation in peer-led mental health programs, the development of self-determination in service use, and medication use and engagement with medication prescribers and other traditional providers, we conducted focus groups with individuals involved in Wellness Recovery Action Plan (WRAP) programs. Method: We carried out five focus groups with 54 WRAP participants and/or facilitators, and analyzed transcripts using a grounded theory approach. Results: Emergent themes revealed differences of opinion regarding the role and value of medication adherence, broad agreement on the benefits of WRAP in increasing self-determination and self-awareness, and positive effects of participation on patient self-advocacy, medication-related decision-making and meaningful engagement with traditional providers. Conclusions and Implications for Practice: Findings emphasize the importance of examining the influence of stand-alone peer-led program involvement on relationships with traditional providers and decisions regarding medication use, as well as the heterogeneity of consumer treatment values, choices, and associated outcomes.

Issues in Mental Health Nursing, 2013

Although the hearing voices movement (HVM) has yet to take root in the US to the extent it has in... more Although the hearing voices movement (HVM) has yet to take root in the US to the extent it has in the UK (and parts of Australia and Europe), recent publications and events, including a keynote presentation by UK hearing voices trainer Ron Coleman at the 2012 Annual NAMI convention and a TED 2013 talk in Los Angeles by British voice hearer and psychologist Eleanor Longden, suggest that the tide is starting to turn (Arenella, 2012; Grantham, 2012; Thomas, 2012). At its core, the HVM emphasizes a few basic, but important, points: that antipsychotic pharmacotherapy and various forms of psychotherapy that aim to suppress psychotic experiences are often-for too many people-ineffective or insufficient; that voices and other extreme experiences and beliefs carry important messages that need to be explored rather than silenced, and that voices themselves are often less of the problem than the difficulties individuals have in coping and negotiating with them (Corstens, Escher, & Romme,

Issues in Mental Health Nursing, 2014