Disrupted emotion processes are commonly linked to the onset and maintenance of auditory verbal hallucinations. However, a comprehensive approach using an extended emotion model has not previously been applied to voice-hearers to distinguish impairments in emotion processes from non-clinical populations. The present study hypothesised voice-hearers, as compared to controls, would have (1) higher reactivity to negative emotions and lower reactivity to positive emotions, (2) more difficulties regulating negative and positive emotions, (3) more maladaptive strategy use, and (4) higher alexithymia. T-tests tested these hypotheses, comparing self-report measures of emotional reactivity, emotion regulation and alexithymia in voice-hearers(n = 50) to controls (n = 53). There were no group differences in emotional reactivity to positive or negative emotions. Compared to controls, voice-hearers showed difficulties in both positive and negative emotion regulation, were more likely to use expressive suppression, and were more likely to be alexithymic. These findings may help researchers and clinicians identify difficulties in voice-hearers' emotion processing, providing better direction for case formulation and treatment.
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