Brewin Chris R, Phillips Kirsty, Morton John, Mason Ava J C, Saunders Rob, Longden Eleanor
University College London, UK.
University College London, UK.
J Psychiatr Res. 2022 Dec;156:564-569. doi: 10.1016/j.jpsychires.2022.10.065. Epub 2022 Nov 1.
Although it is recognized that voice-hearers often report a large number and variety of voices there have been few investigations of this multiplicity. Understanding the phenomenology of voice-hearing can provide a firm foundation for theorizing about its causes. In this international online survey of voice-hearers, details were elicited of the content of up to five utterances associated with up to five voices from each respondent. The contents were independently rated and associated with characteristics of each voice such as its perceived age, whether it had changed over time, and whether it was of a familiar person. We investigated predictors (e.g., diagnoses, voice gender, age first heard) of utterance negativity, length, and whether voices referred to themselves. The average number of voices reported was approximately four. The majority were perceived as male and had negative content. Child-aged voices were significantly less negative than all other voices except those perceived as being elderly. Multi-level analyses indicated that there was significant variability at the level of different utterances within voices but variability was more prominent at the level of different voices within an individual. The data were inconsistent with general cognitive models for hearing voices such as the misattribution of inner speech and were more congruent with a dissociation model of voice-hearing. Our findings support approaches based on subtype or dimensional methods of classifying voices, and additionally indicate that research and clinical assessment may benefit from more systematic assessment of multiplicity.
尽管人们认识到幻听患者常常报告听到大量且多样的声音,但对这种多样性的研究却很少。了解幻听的现象学可为探讨其成因提供坚实基础。在这项针对幻听患者的国际在线调查中,我们从每位受访者那里获取了与多达五种声音相关的多达五段话语的内容细节。这些内容由独立人员进行评分,并与每种声音的特征相关联,比如其感知到的年龄、是否随时间变化以及是否来自熟悉的人。我们研究了话语消极性、长度以及声音是否提及自身的预测因素(例如诊断结果、声音性别、首次听到声音的年龄)。报告的声音平均数量约为四种。大多数声音被感知为男性且内容消极。儿童年龄段的声音除了被感知为老年人的声音外,其消极程度明显低于所有其他声音。多层次分析表明,在声音中的不同话语层面存在显著差异,但在个体内不同声音层面的差异更为突出。这些数据与诸如将内心言语错误归因等幻听的一般认知模型不一致,而更符合幻听的解离模型。我们的研究结果支持基于声音分类的亚型或维度方法的研究路径,此外还表明研究和临床评估可能会从对多样性更系统的评估中受益。