Abstract Traditionally, hallucinations have been understood as abnormalities of perception and delusions as abnormalities of cognition. However, descriptive psychopathologists have long noted the presence of “silent” or thought-like AVHs as well as AVHs with ambiguous perceptual and cognitive qualities. Some researchers have proposed that delusions of reference, control, and communication may at times overlap with or even be indistinguishable from AVHs. This study reports the analyses into the intercept of AVHs and forms of delusions. Ninety-two participants experiencing psychosis participated in the study. Inclusion criteria for the study included participants between the ages of 21–60 who met criteria for schizophrenia or bipolar disorder/psychosis and were currently experiencing AVHs. To advance the area of phenomenology of voices and their interrelatedness to forms of delusions, this study investigated the prevalence and interrelatedness of co-occurring auditory verbal hallucinations (AVHs) and delusions. Additionally, we explored the characterization of distinct subcategories/clusters of AVHs and delusions. Group comparisons of prevalence of co-occurring AVHs and delusions show a significant increased prevalence within the schizophrenia group (χ(1, N = 92) = 11.47, < .001). To identify specific subtypes, we conducted 2-step cluster analysis of preclustering and standard hierarchical clustering algorithm of SCID items pertaining to voices and delusions. The analysis yielded 2 distinct cluster groups. Cluster One: Voices and Thought Delusions and Cluster Two: Voices and Thematic Delusions. The primary cluster predictor algorithm show that delusions of control, thought insertion, thought withdrawal, and thought broadcasting are more discrete variables in identifying cluster subtypes. An independent sample t-test was conducted to compare PANSS 5-factor subscale items between cluster groups. These results show that, participants in the Voices and Thought Delusions cluster experienced increased positive, cognitive, and depressive factor scores. Our analyses provisionally support a reframing of AVHs and thought delusions as endpoints on a shared continuum of attenuated sense of basic self (ipseity). Within this disturbance of ipseity, aspects of agency, authorship, and mineness are experienced as foreign, not self-generated, and with absence of intentionality. These cluster groups begin to disentangle the intrasubjectivity of voices and delusion by characterizing Cluster One: AVH and Thought Delusions as a structure that centers on alterations of basic ipseity and internal/external boundaries, while Cluster Two: AVH and Thematic Delusions centers on exaggerated processes of social internalization (guilt) or externalization (jealousy/delusions of infidelity).
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