Abstract
Recent therapeutic approaches to auditory verbal hallucinations (AVH) exploit the person-like qualities of voices. Little is known, however, about how, why, and when AVH become personified. We aimed to investigate personification in individuals’ early voice-hearing experiences. We invited Early Intervention in Psychosis (EIP) service users aged 16–65 to participate in a semistructured interview on AVH phenomenology. Forty voice-hearers (M = 114.13 days in EIP) were recruited through 2 National Health Service trusts in northern England. We used content and thematic analysis to code the interviews and then statistically examined key associations with personification. Some participants had heard voices intermittently for multiple years prior to clinical involvement (M = 74.38 months), although distressing voice onset was typically more recent (median = 12 months). Participants reported a range of negative emotions (predominantly fear, 60%, 24/40, and anxiety, 62.5%, 26/40), visual hallucinations (75%, 30/40), bodily states (65%, 25/40), and “felt presences” (52.5%, 21/40) in relation to voices. Complex personification, reported by a sizeable minority (16/40, 40%), was associated with experiencing voices as conversational (odds ratio [OR] = 2.56) and companionable (OR = 3.19) but not as commanding or trauma-related. Neither age of AVH onset nor time since onset related to personification. Our findings highlight significant personification of AVH even at first clinical presentation. Personified voices appear to be distinguished less by their intrinsic properties, commanding qualities, or connection with trauma than by their affordances for conversation and companionship.
Highlights
A range of scales and measures currently exist for the assessment of auditory verbal hallucinations (AVH) in particular and psychotic experiences more generally, but none have focused on the phenomenology of AVH personification in detail
Those more focused on AVH are typically tailored towards establishing overall “severity” scores and rarely go beyond voice identity in their exploration of personification (e.g., Haddock et al, 1999)
Our earlier phenomenology survey (Woods et al, 2015) was developed as part of an interdisciplinary research project (Hearing the Voice; Fernyhough, 2014; Woods et al, 2014; Woods and Fernyhough, 2014) and it successfully characterized a range of heterogeneous experiences that are not emphasized in work with existing AVH scales and surveys
Summary
Citation for published item: Alderson-Day, Ben and Woods, Angela and Moseley, Peter and Dodgson, Guy and Deamer, Felicity and Common, Stephanie and Fernyhough, Charles (2021) 'Voice-hearing and personication : characterizing social qualities of auditory verbal hallucinations in early psychosis.', Schizophrenia bulletin., 47 (1). pp. 228-236. The Hearing the Voice Phenomenological Interview: background and example. A range of scales and measures currently exist for the assessment of auditory verbal hallucinations (AVH) in particular and psychotic experiences more generally, but none have focused on the phenomenology of AVH personification in detail. Those more focused on AVH are typically tailored towards establishing overall “severity” scores and rarely go beyond voice identity in their exploration of personification (e.g., Haddock et al, 1999). For some people that might involve sound, while for others it might feel more like someone or something is communicating with you Others describe their voices as a form of telepathy, or loud thoughts.
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