As a risk factor of hallucination proneness, the level of mindfulness has not yet been investigated in non-clinical participants. Other potential mediators, such as mental distress (depression, anxiety, and stress) which contribute to hallucination proneness also need to be assessed. This study investigated the mediating effect of mental distress in predicting hallucination proneness based on mindfulness. A number of 168 Iranian university students completed three questionnaires: (1) the five-facet mindfulness questionnaire, (2) the depression, anxiety and stress scale; and (3) the revised hallucination scale. The results showed that there was a significant association between levels of mindfulness and hallucination proneness. Mental distress has a significant effect on four facets of mindfulness questionnaire and an insignificant effect on one facet (awareness) in predicting hallucination. These effects were both direct and indirect. The indirect effect was developed by the mediating role of mental distress.
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Ahmadvand, Z., Heydarinasab, L., & Shairi, M. (2012). Prediction of psychological well-being based on the comonents of mindfulness.
Alcaro, A., Panksepp, J., Witczak, J., Hayes, D. J., & Northoff, G. (2010). Is subcortical–cortical midline activity in depression mediated by glutamate and GABA? A cross-species translational approach. Neuroscience & Biobehavioral Reviews, 34(4), 592–605.
Alfonso, J. P., Caracuel, A., Delgado-Pastor, L. C., & Verdejo-García, A. (2011). Combined goal management training and mindfulness meditation improve executive functions and decision-making performance in abstinent polysubstance abusers. Drug and Alcohol Dependence, 117(1), 78–81.
Alleva, J., Roelofs, J., Voncken, M., Meevissen, Y., & Alberts, H. (2014). On the relation between mindfulness and depressive symptoms: Rumination as a possible mediator. Mindfulness, 5(1), 72–79.
Asghari, A., Saed, F., & Dibajnia, P. (2008). Psychometric properties of the Depression Anxiety Stress Scales-21 (DASS-21) in a non-clinical Iranian sample. International Journal of Psychology, 2(2), 82–102.
Association, W. M. (2001). World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization, 79(4), 373.
Aynsworth, C., Collerton, D., & Dudley, R. (2017). Measures of visual hallucinations: Review and recommendations. Clinical Psychology Review, 57, 164–182.
Badcock, J. C., & Hugdahl, K. (2012). Cognitive mechanisms of auditory verbal hallucinations in psychotic and non-psychotic groups. Neuroscience & Biobehavioral Reviews, 36(1), 431–438.
Badrin, S., Mohamad, N., Yunus, N. A., & Zulkifli, M. M. (2017). A Brief Psychotic Episode with Depressive Symptoms in Silent Right Frontal Lobe Infarct. Korean Journal of Family Medicine, 38(6), 380–382.
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., …, Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342.
Bajaj, B., Robins, R. W., & Pande, N. (2016a). Mediating role of self-esteem on the relationship between mindfulness, anxiety, and depression. Personality and Individual Differences, 96, 127–131.
Bajaj, B., Robins, R. W., & Pande, N. (2016b). Mediating role of self-esteem on the relationship between mindfulness, anxiety, and depression. Personality and Individual Differences(96), 127–131.
Barnhofer, T., Duggan, D. S., & Griffith, J. W. (2011). Dispositional mindfulness moderates the relation between neuroticism and depressive symptoms. Personality and Individual Differences, 51(8), 958–962.
Bauer, S. M., Schanda, H., Karakula, H., Olajossy-Hilkesberger, L., Rudaleviciene, P., Okribelashvili, N., …, Ritter, K. (2011). Culture and the prevalence of hallucinations in schizophrenia. Comprehensive Psychiatry, 52(3), 319–325.
Baumeister, D., Sedgwick, O., Howes, O., & Peters, E. (2017). Auditory verbal hallucinations and continuum models of psychosis: a systematic review of the healthy voice-hearer literature. Clinical Psychology Review, 51, 125–141.
Bentall, R., & Slade, P. D. (1985). Reliability of a scale measuring disposition towards hallucination: A brief report. Personality and Individual Differences, 6(4), 527–529.
Bentall, R. P. (1990). The illusion of reality: A review and integration of psychological research on hallucinations. Psychological bulletin, 107(1), 82.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., …, Velting, D. (2004). Mindfulness: A proposed operational definition. Clinical psychology: Science and Practice, 11(3), 230–241.
Bohlmeijer, E., Ten Klooster, P. M., Fledderus, M., Veehof, M., & Baer, R. (2011). Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form. Assessment, 18(3), 308–320.
Cella, M., Taylor, K., & Reed, P. (2007). Violation of expectancies produces more false positive reports in a word detection task in people scoring high in unusual experiences scale. Personality and Individual Differences, 43(1), 59–70.
Chiang, Y.-H., Beckstead, J. W., Lo, S.-C., & Yang, C.-Y. (2018). Association of auditory Hallucination and anxiety symptoms with depressive symptoms in patients with Schizophrenia: A three-month follow-up. Archives of Psychiatric Nursing, 32(4):585–590
Christopher, M. S., Neuser, N. J., Michael, P. G., & Baitmangalkar, A. (2012). Exploring the psychometric properties of the five facet mindfulness questionnaire. Mindfulness, 3(2), 124–131.
Crowe, S., Barot, J., Caldow, S., d’Aspromonte, J., Dell’Orso, J., Di Clemente, A., …, McIvor, B. (2011). The effect of caffeine and stress on auditory hallucinations in a non-clinical sample. Personality and Individual Differences, 50(5), 626–630.
Curtiss, J., & Klemanski, D. H. (2014). Teasing apart low mindfulness: Differentiating deficits in mindfulness and in psychological flexibility in predicting symptoms of generalized anxiety disorder and depression. Journal of Affective Disorders, 166, 41–47.
de Bruin, E. I., Topper, M., Muskens, J. G., Bögels, S. M., & Kamphuis, J. H. (2012). Psychometric properties of the Five Facets Mindfulness Questionnaire (FFMQ) in a meditating and a non-meditating sample. Assessment, 19(2), 187–197.
Delespaul, P., & van Os, J. (2002). Determinants of occurrence and recovery from hallucinations in daily life. Social Psychiatry and Psychiatric Epidemiology, 37(3), 97–104.
Desrosiers, A., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mapping mindfulness facets onto dimensions of anxiety and depression. Behavior Therapy, 44(3), 373–384.
Desrosiers, A., Vine, V., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mindfulness and emotion regulation in depression and anxiety: common and distinct mechanisms of action. Depression and Anxiety, 30(7), 654–661.
DeVylder, J. E., & Hilimire, M. R. (2015). Suicide risk, stress sensitivity, and self-esteem among young adults reporting auditory hallucinations. Health & Social Work, 40(3), 175–181.
Escudero-Pérez, S., León-Palacios, M. G., Úbeda-Gómez, J., Barros-Albarrán, M. D., López-Jiménez, A. M., & Perona-Garcelán, S. (2016). Dissociation and mindfulness in patients with auditory verbal hallucinations. Journal of Trauma & Dissociation, 17(3), 294–306.
Evans, D. R., & Segerstrom, S. C. (2011). Why do mindful people worry less? Cognitive Therapy and Research, 35(6), 505–510.
Fjorback, L. O., Arendt, M., Ørnbøl, E., Fink, P., & Walach, H. (2011). Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy–a systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124(2), 102–119.
Fraser, J. (2014). Hallucinations, Visual and Auditory.
Gallego, J., Aguilar-Parra, J. M., Cangas, A. J., Langer, Á. I., & Mañas, I. (2014). Effect of a mindfulness program on stress, anxiety and depression in university students. The Spanish Journal of Psychology, 17, E109
García-Ptacek, S., Azorín, D. G., Salmador, R. S., Cuadrado, M., & Porta-Etessam, J. (2013). Hallucinations and aberrant perceptions are prevalent among the young healthy adult population. Neurología (English Edition), 28(1), 19–23.
Garrison, J. R., Moseley, P., Alderson-Day, B., Smailes, D., Fernyhough, C., & Simons, J. S. (2017). Testing continuum models of psychosis: No reduction in source monitoring ability in healthy individuals prone to auditory hallucinations. Cortex, 91, 197–207.
Gawęda, Ł., Holas, P., & Kokoszka, A. (2013). Do depression and anxiety mediate the relationship between meta-cognitive beliefs and psychological dimensions of auditory hallucinations and delusions in schizophrenia? Psychiatry Research, 210(3), 1316–1319.
Goghari, V. M., & Harrow, M. (2016). Twenty year multi-follow-up of different types of hallucinations in schizophrenia, schizoaffective disorder, bipolar disorder, and depression. Schizophrenia research, 176(2–3), 371–377.
Goldsworthy, R., & Whitaker, H. (2015). Hallucinations, Neural Basis of. Goodarzi, M. A. (2009). Psychometric properties of a Persian translation of the Launay-Slade Hallucination Scale in an Iranian population. Perceptual and Motor Skills, 109(3), 911–923.
Habibi, M., Dehghani, M., Pooravari, M., & Salehi, S. (2017). Confirmatory factor analysis of Persian version of Depression, Anxiety and Stress (DASS-42): Non-clinical sample. Razavi International Journal of Medicine. doi:10.5812/rijm.12021
Hartley, S., Haddock, G., & Barrowclough, C. (2012). Anxiety and depression and their links with delusions and hallucinations in people with a dual diagnosis of psychosis and substance misuse: A study using data from a randomised controlled trial. Behaviour Research and Therapy, 50(1), 65–71.
Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.
Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-based interventions for anxiety and depression. Psychiatric Clinics of North America.
Hugdahl, K., Craven, A. R., Nygård, M., Løberg, E.-M., Berle, J. Ø., Johnsen, E., …, Ersland, L. (2015). Glutamate as a mediating transmitter for auditory hallucinations in schizophrenia: A 1H MRS study. Schizophrenia Research, 161(2–3), 252–260.
Ikeda, M., Kataoka, H., & Ueno, S. (2016). Fatigue is associated with the onset of hallucinations in patients with Parkinson's disease: A 3-year prospective study. eNeurologicalSci, 4, 25–29.
Johns, L. C. (2005). Hallucinations in the general population. Current Psychiatry Reports, 7(3), 162–167.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.
Langer, Á. I., Cangas, A. J., & Gallego, J. (2010). Mindfulness-based intervention on distressing hallucination-like experiences in a nonclinical sample. Behaviour Change, 27(3), 176–183.
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.
Lysaker, P., & Salyers, M. (2007). Anxiety symptoms in schizophrenia spectrum disorders: Associations with social function, positive and negative symptoms, hope and trauma history. Acta Psychiatrica Scandinavica, 116(4), 290–298.
Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31.
Mack, A. (2012). Prevalence and correlates of auditory vocal hallucinations in middle childhood. Year Book of Psychiatry & Applied Mental Health, 2012, 69–70.
Morrison, A. P., Wells, A., & Nothard, S. (2002). Cognitive and emotional predictors of predisposition to hallucinations in non-patients. British Journal of Clinical Psychology, 41(3), 259–270.
Ohayon, M. M. (2000a). Prevalence of hallucinations and their pathological associations in the general population. Psychiatry Research, 97(2), 153–164.
Ohayon, M. M. (2000). Prevalence of hallucinations and their pathological associations in the general population. Psychiatry Research, 97(2–3), 153–164.
Olson, K. L., & Emery, C. F. (2015). Mindfulness and weight loss: A systematic review. Psychosomatic medicine, 77(1), 59–67.
Paulik, G., Badcock, J. C., & Maybery, M. T. (2006). The multifactorial structure of the predisposition to hallucinate and associations with anxiety, depression and stress. Personality and Individual Differences, 41(6), 1067–1076.
Perona-Garcelán, S., García-Montes, J. M., López-Jiménez, A. M., Rodríguez-Testal, J. F., Ruiz-Veguilla, M., Ductor-Recuerda, M. J., . . . Pérez-Álvarez, M. (2014). Relationship between self-focused attention and mindfulness in people with and without hallucination proneness. The Spanish Journal of Psychology. doi:10.1017/sjp.2014.23
Ratcliffe, M., & Wilkinson, S. (2016). How anxiety induces verbal hallucinations. Consciousness and Cognition, 39, 48–58.
Razian, S., Heydarinasab, L., Shairi, M. R., & Bozorgmehr, A. (2018). The effect of Mindfulness-Based Stress Reduction (MBSR) on increasing the scales of mindfulness in Iranian people with social anxiety disorder. Modern Journal of Language Teaching Methods (MJLTM), 13(1), 83–91.
Reed, P., Carey, H., Evans, C., & Rutter, L. (2016). Mindfulness training and false perception in individuals with high unusual experiences. Personality and Individual Differences, 93, 51–55.
Shim, M., Im, C.-H., Kim, Y.-W., Lee, S.-H. (2018). Altered cortical functional network in major depressive disorder: A resting-state electroencephalogram study. NeuroImage Clinical, 19, 1000–1007
Simon, A. E., Cattapan-Ludewig, K., Gruber, K., Ouertani, J., Zimmer, A., Roth, B., …, Umbricht, D. (2009). Subclinical hallucinations in adolescent outpatients: an outcome study. Schizophrenia Research, 108(1–3), 265–271.
Sommer, I. E., Daalman, K., Rietkerk, T., Diederen, K. M., Bakker, S., Wijkstra, J., et al. (2008). Healthy individuals with auditory verbal hallucinations; who are they? Psychiatric assessments of a selected sample of 103 subjects. Schizophrenia Bulletin, 36(3), 633–641.
Suyi, Y., Meredith, P., & Khan, A. (2017). Effectiveness of mindfulness intervention in reducing stress and burnout for mental health professionals in Singapore. Explore The Journal of Science and Healing, 13(5), 319–326.
Temmingh, H., Stein, D. J., Seedat, S., & Williams, D. R. (2011). The prevalence and correlates of hallucinations in a general population sample: findings from the South African Stress and Health Study: original. African Journal of Psychiatry, 14(3), 211–217.
Úbeda-Gómez, J., León-Palacios, M., Escudero-Pérez, S., Barros-Albarrán, M., López-Jiménez, A., & Perona-Garcelán, S. (2015). Relationship between self-focused attention, mindfulness and distress in individuals with auditory verbal hallucinations. Cognitive Neuropsychiatry, 20(6), 482–488.
Williams, J. M. G. (2008). Mindfulness, depression and modes of mind. Cognitive Therapy and Research, 32(6), 721.
Yang, C. Y., Lee, T. H., Lo, S. C., & Beckstead, J. W. (2015). The effects of auditory hallucination symptom management programme for people with schizophrenia: a quasi-experimental design. Journal of Advanced Nursing, 71(12), 2886–2897.
Authors would like to express their gratitude to the "Pak Sima" Educational, Research and Treatment Center which has been instrumental in executive stages, preparation and the successful completion of this project. Moreover, the authors thank Muhammed Hussein Mousavinasab for editing this text.
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Hosseini, S.R., Pirkashani, N.G., Farahani, M.Z. et al. Predicting hallucination proneness based on mindfulness in university students: the mediating role of mental distress. Community Ment Health J 57, 203–211 (2021). https://doi.org/10.1007/s10597-020-00633-4
- Hallucination proneness