Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Schizophr Bull. 2023 Jan 3;49(1):151-160. doi: 10.1093/schbul/sbac101.
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.
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.
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.
A framework of listening and believing negative voices has the potential to inform the understanding and treatment of voice distress.
声音感知者感到困扰的一个可能原因是听到并相信所听到的威胁和批评。定性研究表明，患者有可以理解的倾听理由。本研究旨在使用这种倾听和相信的框架来进一步了解困扰。开发了用于倾听和相信声音以及倾听和相信声音的原因的测量方法，并测试了与困扰的关联。
对听到贬损和威胁性声音的患者（N=591）进行横断面研究。完成了倾听和相信评估以及倾听和相信原因项目池，并评估了困扰。进行了探索性和验证性因素分析以及结构方程模型（SEM）。
52%（n=307）的参与者大部分或全部时间都相信他们的声音。倾听和相信有 4 个因素：主动倾听、被动倾听、相信和忽视。更高水平的相信、主动倾听，尤其是被动倾听与更高水平的焦虑、抑郁和声音困扰有关。倾听和相信的原因形成了 7 个因素：为了更好地理解威胁；太累了而无法抵抗；为了获得有见地的信息；独自一人有时间倾听；声音试图引起注意；声音听起来像真实的人；声音听起来像熟人。每种类型的原因都与主动倾听、被动倾听和相信有关。SEM 表明，感到疲惫不堪尤其可以解释倾听和相信。测量的重测信度非常好。
倾听和相信负面声音的框架有可能为理解和治疗声音困扰提供信息。
