Abstract
ABSTRACT Introduction: “Continuum” approaches to psychosis have generated reports of similarities and differences in voice-hearing in clinical and non-clinical populations at the cohort level, but not typically examined overlap or degrees of difference between groups. Methods: We used a computer-aided linguistic approach to explore reports of voice-hearing by a clinical group (Early Intervention in Psychosis service-users; N = 40) and a non-clinical group (spiritualists; N = 27). We identify semantic categories of terms statistically overused by one group compared with the other, and by each group compared to a control sample of non-voice-hearing interview data (log likelihood (LL) value 6.63+=p < .01; effect size measure: log ratio 1.0+). We consider whether individual values support a continuum model. Results: Notwithstanding significant cohort-level differences, there was considerable continuity in language use. Reports of negative affect were prominent in both groups (p < .01, log ratio: 1.12+). Challenges of cognitive control were also evident in both cohorts, with references to “disengagement” accentuated in service-users (p < .01, log ratio: 1.14+). Conclusion: A corpus linguistic approach to voice-hearing provides new evidence of differences between clinical and non-clinical groups. Variability at the individual level provides substantial evidence of continuity with implications for cognitive mechanisms underlying voice-hearing.
Highlights
In clinical settings, hearing voices is typically associated with a diagnosis of schizophrenia (Bauer et al, 2011; Sartorius et al, 1986), though hearing voices can occur in other disorders such as bipolar disorder
While linguistic choices in reports of voice-hearing may not straightforwardly reflect phenomenology, we suggest that the systematic analysis of similarities/differences and continuities/discontinuities in linguistic expression is an essential complement to other approaches to the psychosis continuum
We investigated the extent to which an analysis of the language used by different groups when describing voice-hearing experiences supports or challenges the notion of a psychosis continuum, and explored the degree of overlap between groups in terms of the language used
Summary
Users of Early Intervention in Psychosis (EIP) services were invited to take part if they (i) were aged 16–651; (ii) heard voices at least once a week for a month; (iii) were fluent English speakers; (iv) had normal or corrected-to-normal vision; and, (v) were in the first nine months of using EIP services. Exclusion criteria for service-users were: (i) the presence of a suspected duration of untreated psychosis longer than five years; (ii) any neurological diagnoses; or (iii) having a hearing impairment that required the use of hearing aids. Spiritualists were invited to take part if they were (i) aged 18–75; (ii) reported hearing voices at least once per month for at least the last three months; and (iii) had normal or corrected-to-normal vision. All participants were asked the same interview questions (allowing for distinct elaborations relating to each participant’s experiences). All procedures were approved by either a local NHS Research Ethics Committee or university research ethics committee
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