Trial reportPsychological medicine2018
The COMMAND trial of cognitive therapy to prevent harmful compliance with command hallucinations: predictors of outcome and mediators of change.
Trial report in Psychological medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Clinical Correlates of Compliance, Appeasement and Resistance in Command Hallucinations: A Systematic Review.Clinical psychology & psychotherapyPooled it
- "It Felt Good to Be Able to Say That Out Loud"-Therapeutic Alliance and Processes in AVATAR Therapy for People Who Hear Distressing Voices: Peer-Led Qualitative Study.JMIR mental health · 2026Trial
- Relating behaviours and therapeutic actions during AVATAR therapy dialogue: An observational study.The British journal of clinical psychology · 2021Trial
- Trial
- Article
- How individuals with psychosis develop and maintain resilience to suicidal experiences through psychological therapy: a qualitative study.BMC psychiatry · 2024Article
- Psychological framework to understand interpersonal violence by forensic patients with psychosis.The British journal of psychiatry : the journal of mental science · 2024Article
- Insight-related beliefs and controllability appraisals contribute little to hallucinated voices: a transdiagnostic network analysis study.European archives of psychiatry and clinical neuroscience · 2021Article
- The Role of Sense of Voice Presence and Anxiety Reduction in AVATAR Therapy.Journal of clinical medicine · 2020Article
- Power to the voice hearer - The German version of the voice power differential scale.PloS one · 2020Article
- Using fMRI and machine learning to predict symptom improvement following cognitive behavioural therapy for psychosis.NeuroImage. Clinical · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundActing on harmful command hallucinations is a major clinical concern. Our COMMAND CBT trial approximately halved the rate of harmful compliance (OR = 0.45, 95% CI 0.23-0.88, p = 0.021). The focus of the therapy was a single mechanism, the power dimension of voice appraisal, was also significantly reduced. We hypothesised that voice power differential (between voice and voice hearer) was the mediator of the treatment effect.
methodsThe trial sample (n = 197) was used. A logistic regression model predicting 18-month compliance was used to identify predictors, and an exploratory principal component analysis (PCA) of baseline variables used as potential predictors (confounders) in their own right. Stata's paramed command used to obtain estimates of the direct, indirect and total effects of treatment.
resultsVoice omnipotence was the best predictor although the PCA identified a highly predictive cognitive-affective dimension comprising: voices' power, childhood trauma, depression and self-harm. In the mediation analysis, the indirect effect of treatment was fully explained by its effect on the hypothesised mediator: voice power differential.
conclusionVoice power and treatment allocation were the best predictors of harmful compliance up to 18 months; post-treatment, voice power differential measured at nine months was the mediator of the effect of treatment on compliance at 18 months.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.