The tangled roots of inner speech, voices and delusions

Abstract

The role of inner speech in the experience of auditory verbal hallucinations (AVH) and delusions remains unclear. This exploratory study tested for differences in inner speech (assessed via self-report questionnaire) between 89 participants with psychosis and 37 non-clinical controls. We also tested for associations of inner speech with, i) state/trait AVH, ii) AVH-severity; iii) patients' relations with their voices, and; iv) delusion-severity. Persons with psychosis had greater levels of dialogic inner speech, other people in inner speech, and evaluative/motivational inner speech than non-clinical controls. Those with state, but not trait AVH had greater levels of dialogic and evaluative/motivational inner speech than non-clinical controls. After controlling for delusions, there was a positive relation between AVH-severity and both evaluative/motivational inner speech and other people in inner speech. Participants with greater levels of dialogic inner speech reported better relations both with and between their voices. There was no association between delusion-severity and inner speech. These results highlight the importance of better understanding relations between inner speech and AVH, provide avenues for future research, and underscore the need for research into the interrelatedness of inner speech, voices and delusions, and the complexities involved in disentangling these experiences.

The Role of Inner Speech in Executive Functioning Tasks: Schizophrenia With Auditory Verbal Hallucinations and Autistic Spectrum Conditions as Case Studies

“…Overflowing and Distracting: Sz-AVH subjects may experience more intrusions in IS, and this would negatively affect their performance in verbal, inhibition, shifting, and planning tasks. For instance, in the study conducted by Alderson-Day et al (2014) , vulnerability to AVH experiences correlates with the presence of other people in IS (see also de Sousa et al, 2016 ; Rosen et al, 2018 ). This characteristic may in turn be connected with a higher degree of interference with task completion, as the presence of other people in IS would arguably represent a major distracting factor.…”

The Sensory and Perceptual Scaffolding of Absorption, Inner Speech, and Self in Psychosis

“…Our previous research has shown that absorption is more prevalent and intense in participants with psychosis when compared to non-clinical controls, and was significantly associated with hallucinations and delusions ( 15 ). We have also previously shown that dialogic inner speech is associated with psychosis ( 24 ). In this study we report that in participants with psychosis, dialogic inner speech and evaluative and motivational inner speech were associated with all factors of absorption whereas condensed inner speech was associated with imaginative involvement.…”

“…Inner-speech is defined as a conversation that occurs internally. Inner-speech in participants with psychosis has been shown to be differentially expressed in the presence of sensory and perceptual experiences, when compared to non-clinical controls ( 23 , 24 ). Theoretically, Dialogical Self Theory (DST), posits self as the narrator in which the “I-position” bridges both inner dialogue/speech with oneself and outer dialogue with others ( 25 , 26 ).…”

The relationship with the voices as a dialogical experience: The role of self‐focused attention and dissociation

“…24. For theoretical reasons, the scores on the SAS and DA subscales were used in the analysis of the results and not the total scores on each of them (Perona‐Garcelán et al, ; Rosen et al, ). The first two hypotheses were studied using the Pearson's correlation coefficient.…”