Department of Psychology, University of Bath, Bath, UK.
Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.
Br J Clin Psychol. 2022 Nov;61(4):947-963. doi: 10.1111/bjc.12368. Epub 2022 Apr 24.
Research has suggested people who hear voices may be at risk of epistemic injustice. This is a form of discrimination whereby someone is unfairly judged to be an unreliable knower (testimonial injustice) or is unable to contribute to, and therefore access, concepts that make sense of their experience within mainstream society (hermeneutical injustice). Voice-hearing occurs both in people who are mental health service users and in the general population (clinical and non-clinical voice-hearers, respectively). The degree of distress and impairment associated with voices has been shown to relate to how individuals make sense of their experiences and how others respond to their identity as a voice-hearer. The aim of this study was to explore people's experiences of epistemic injustice in relation to voice-hearing and to understand how these may differ between clinical and non-clinical voice-hearers.
A qualitative design was used.
Eight clinical and nine non-clinical voice-hearers partook in semi-structured interviews, which were analysed using thematic analysis.
Three pairs of themes related to (i) identity, (ii) relationships and (iii) power and position were constructed across the clinical and non-clinical groups, and two shared themes within both groups were created relating to testimonial and hermeneutical injustice.
Both clinical and non-clinical voice-hearers described experiencing epistemic injustice in wider society. The presence of a 'safe haven' (e.g. spiritualist churches) for non-clinical voice-hearers ameliorated the impact of this to some degree, by allowing people to make connections with others with similar experiences within a non-judgemental and accepting community.
研究表明，听到声音的人可能面临认知不公正的风险。这是一种歧视形式，即某人被不公平地判断为不可靠的知情者（证言不公正），或者无法为理解其在主流社会中的经验的概念做出贡献，因此无法获得这些概念（解释学不公正）。在精神卫生服务使用者和一般人群中都存在幻听（分别为临床和非临床幻听者）。与幻听相关的痛苦和障碍程度与个人如何理解自己的经历以及他人如何回应他们作为幻听者的身份有关。这项研究的目的是探讨人们在幻听方面的认知不公正的经历，并了解这些经历在临床和非临床幻听者之间可能有何不同。
采用定性设计。
八名临床和九名非临床幻听者参与了半结构式访谈，采用主题分析进行分析。
在临床和非临床两组中构建了三对主题，涉及（i）身份、（ii）关系和（iii）权力和地位，在两组中都创建了两个与证言和解释学不公正有关的共同主题。
临床和非临床幻听者都描述了在更广泛的社会中经历认知不公正。非临床幻听者的“安全港”（例如，灵媒教堂）的存在在某种程度上减轻了这种影响，因为它允许人们在一个非评判和接受的社区中与具有类似经历的人建立联系。
