The relationship between appraisals of voices (auditory verbal hallucinations) and distress in voice-hearers with schizophrenia-spectrum diagnoses: A meta-analytic review

Tsang, Anthony; Bucci, Sandra; Branitsky, Alison; Kaptan, Safa Kemal; Rafiq, Sonya; Wong, Samantha; Berry, Katherine; Varese, Filippo

doi:10.1016/j.schres.2021.02.013

Cited by 20 publications

(14 citation statements)

References 77 publications

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“…'Maladaptive' appraisals are significant contributors to voice-related distress in patients with SCZ. 14 Our findings have led to a similar conclusion, with voice malevolence and omnipotence strongly correlating with the amount and intensity of voice-related distress in the SCZ group. In addition, participants with SCZ demonstrated evidence of an externalising attributional framework for the origin of their voices.…”

Section: Discussionsupporting

confidence: 79%

‘Is hearing believing?’: A study of voices and beliefs in psychosis and trauma

Rajanthiran¹,

Curtis

Ayalde

et al. 2022

Australas Psychiatry

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Objective This study compared voice characteristics and beliefs in participants diagnosed with post-traumatic stress disorder (PTSD) with dissociation, schizophrenia (SCZ) and both diagnoses of SCZ and PTSD. The relationship between dissociation and voice beliefs was also assessed. Method We identified 56 participants meeting the diagnostic criteria for PTSD with dissociation, SCZ or both diagnoses (PTSD + SCZ) who also experienced auditory hallucinations. Measures included PTSD Symptoms Scales Interview (PSSI-5), Psychotic Symptoms Rating Scale (PSYRAT), Clinician Administered Dissociative States Scale (CADSS), Beliefs about Voices Questionnaire (BAVQ) and Positive and Negative Syndrome Scale (PANSS). Results Beliefs about voices were similar across diagnostic groups. Participants with SCZ were more likely to attribute their voices to an external origin, and participants with dual diagnosis were less able to control their voices. The PTSD-only group scored higher in dissociation scores than either the SCZ-only or dual diagnosis group. Malevolent voice appraisals correlated with dissociation scores only in the dual diagnosis group. Conclusions This research supports the hypothesis that voice beliefs are similar across diagnoses of PTSD and SCZ. However, differences in voice characteristics, emotional responses and relationship to dissociation may need to be considered in the psychological management of voices.

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Section: Discussionsupporting

confidence: 79%

‘Is hearing believing?’: A study of voices and beliefs in psychosis and trauma

Rajanthiran¹,

Curtis

Ayalde

et al. 2022

Australas Psychiatry

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“…First highlighted over 25 years ago, meta-analysis indicates that appraisals concerning malevolence and omnipotence 1 have substantial associations with voice-related distress. 3 This understanding has largely formed the basis for cognitive behavioral techniques for helping patients hearing voices. 4 , 5 Cross-sectional data show that power and malevolence each explain approximately a fifth of the variance in distress in voice hearers.…”

Section: Introductionmentioning

confidence: 99%

“… 4 , 5 Cross-sectional data show that power and malevolence each explain approximately a fifth of the variance in distress in voice hearers. 2 , 3 Variance is therefore left unexplained. There are now endeavors to expand on this approach, for example by assessing perceived control in relation to voices.…”

Section: Introductionmentioning

confidence: 99%

Listening to and Believing Derogatory and Threatening Voices

Sheaves

Johns

Loe

et al. 2022

Schizophrenia Bulletin

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Background and hypothesis A plausible cause of distress for voice hearers is listening to and believing the threats and criticisms heard. Qualitative research indicates that patients have understandable reasons to listen. This study aimed to develop the understanding of distress using this listening and believing framework. Measures were developed of listening and believing voices and the reasons, and associations with distress tested. Study design A cross-sectional study of patients hearing derogatory and threatening voices (N = 591). Listening and Believing–Assessment and Listening and Believing–Reasons item pools were completed, and assessments of distress. Exploratory and confirmatory factor analyses and structural equation modeling (SEM) were conducted. Study results 52% (n = 307) of participants believed their voices most or all the time. Listening and believing had 4 factors: active listening, passive listening, believing, and disregarding. Higher levels of believing, active listening, and particularly passive listening were associated with higher levels of anxiety, depression, and voice distress. Reasons for listening and believing formed 7 factors: to better understand the threat; being too worn down to resist; to learn something insightful; being alone with time to listen; voices trying to capture attention; voices sounding like real people; and voices sounding like known people. Each type of reason was associated with active listening, passive listening, and believing. SEM showed that feeling worn down in particular accounted for listening and believing. Test–retest reliability of measures was excellent. Conclusions A framework of listening and believing negative voices has the potential to inform the understanding and treatment of voice distress.

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“…Alternatively, FP may be a corollary, where FP becomes a secondary inference or elaboration of other primary, sensory-specific phenomena, such as auditory-verbal hallucinations [8]. In a clinical context, given the prior work on the factors that influence distress auditory verbal hallucinationsbenevolence, power, dominance, intrusiveness, or perceived control [88] -it may be that distress because of FP and concomitant hallucinations involves similar risk factors. Scientifically, understanding the causal neural relationships between FP-supporting regions and regions that encode other sensory stimuli may highlight whether FPencoding regions are typically activated earlier and propagated to other regions, or vice versa; Dynamic Causal Modelling [89] and laminar analysis [90] may be particularly useful to test hypotheses.…”

Section: Discussionmentioning

confidence: 99%