Department of Psychiatry and Psychotherapy, Division for Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Psychiatry, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500, Krems an der Donau, Austria.
Arch Womens Ment Health. 2021 Oct;24(5):709-720. doi: 10.1007/s00737-021-01109-4. Epub 2021 Mar 20.
Voice hearing has been conceptualized as an interrelational framework, where the interaction between voice and voice hearer is reciprocal and resembles "real-life interpersonal interactions." Although gender influences social functioning in "real-life situations," little is known about respective effects of gender in the voice hearing experience. One hundred seventeen participants with a schizophrenia spectrum disorder took part in a semi-structured interview about the phenomenology of their voices and completed standardized self-rating questionnaires on their beliefs about their most dominant male and female voices and the power differentials in their respective voice-voice hearer interactions. Additionally, the voice hearers' individual masculine/feminine traits were recorded. Men heard significantly more male than female dominant voices, while the gender ratio of dominant voices was balanced in women. Although basic phenomenological characteristics of voices were similar in both genders, women showed greater amounts of distress caused by the voices and reported a persistence of voices for longer time periods. Command hallucinations that encouraged participants to harm others were predominantly male. Regarding voice appraisals, high levels of traits associated with masculinity (=instrumentality/agency) correlated with favorable voice appraisals and balanced power perceptions between voice and voice hearer. These positive effects seem to be more pronounced in women. The gender of both voice and voice hearer shapes the voice hearing experience in manifold ways. Due to possible favorable effects on clinical outcomes, therapeutic concepts that strengthen instrumental/agentic traits could be a feasible target for psychotherapeutic interventions in voice hearing, especially in women.
幻听被概念化为一种相互关系的框架，其中声音和声音的听众之间的相互作用是相互的，类似于“现实生活中的人际互动”。虽然性别会影响“现实生活中的”社交功能，但关于性别的各自影响在幻听体验中知之甚少。117 名患有精神分裂症谱系障碍的参与者参加了关于他们的幻听现象学的半结构化访谈，并完成了关于他们最主要的男性和女性声音的信念以及各自声音-声音听众互动中的权力差异的标准化自评问卷。此外，还记录了声音听众的个体男性/女性特质。男性听到的男性主导声音明显多于女性，而女性的主导声音性别比例则平衡。尽管声音的基本现象学特征在两性中相似，但女性因声音而感到的痛苦程度更大，并且报告声音持续的时间更长。鼓励参与者伤害他人的命令性幻觉主要是男性。关于声音评价，与男性特质（=工具性/能动性）相关的高特质水平与对声音的有利评价和声音与声音听众之间的权力平衡感知相关。这些积极影响在女性中似乎更为明显。声音和声音听众的性别以多种方式塑造了幻听体验。由于可能对临床结果有积极影响，因此增强工具性/能动性特质的治疗概念可能是幻听心理治疗干预的一个可行目标，尤其是在女性中。
