Department of Biological and Medical Psychology, University of Bergen, Jones Lies vei 91, Bergen 5009, Norway; Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium; NORMENT - Norwegian Centre of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway.
Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, Australia.
Clin Psychol Rev. 2019 Feb;67:1-10. doi: 10.1016/j.cpr.2018.11.001. Epub 2018 Nov 14.
Negative voice-content is the best sole predictor of whether the hearer of an auditory-verbal hallucination will experience distress/impairment necessitating contact with mental health services. Yet, what causes negative voice-content and how interventions may reduce it remains poorly understood. This paper offers definitions of negative voice content and considers what may cause negative voice-content. We propose a framework in which adverse life-events may underpin much negative voice-content, a relation which may be mediated by mechanisms including hypervigilance, reduced social rank, shame and self-blame, dissociation, and altered emotional processing. At a neurological level, we note how the involvement of the amygdala and right Broca's area could drive negative voice-content. We observe that negative interactions between hearers and their voices may further drive negative voice-content. Finally, we consider the role of culture in shaping negative voice-content. This framework is intended to deepen and extend cognitive models of voice-hearing and spur further development of psychological interventions for those distressed by such voices. We note that much of the relevant research in this area remains to be performed or replicated. We conclude that more attention needs to be paid to methods for reducing negative voice-content, and urge further research in this important area.
负性言语内容是听觉言语幻觉的听者是否会感到痛苦/受损，从而需要寻求心理健康服务的最佳单一预测指标。然而，负性言语内容的原因以及干预措施如何减少它仍然知之甚少。本文提供了负性言语内容的定义，并探讨了可能导致负性言语内容的原因。我们提出了一个框架，其中包括生活事件等不利因素可能是负性言语内容的基础，这种关系可能通过包括过度警觉、社会地位降低、羞耻感和自责、分离和情绪处理改变等机制来介导。在神经学水平上，我们注意到杏仁核和右侧布罗卡区的参与如何驱动负性言语内容。我们观察到听者和他们的声音之间的负面互动可能会进一步驱动负性言语内容。最后，我们考虑了文化在塑造负性言语内容中的作用。这个框架旨在深化和扩展对声音感知的认知模型，并推动针对那些受声音困扰的人的心理干预措施的进一步发展。我们注意到，该领域的许多相关研究仍有待进行或复制。我们得出的结论是，需要更多地关注减少负性言语内容的方法，并敦促在这一重要领域进行进一步的研究。
