The ice in voices: Understanding negative content in auditory-verbal hallucinations

Frank Laroi*, Neil Thomas, Andre Aleman, Charles Fernyhough, Sam Wilkinson, Felicity Deamer, Simon McCarthy-Jones

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

18 Citations (Scopus)
306 Downloads (Pure)

Abstract

Negative voice-content is the best sole predictor of whether the hearer of an auditory-verbal hallucination will experience distress/impairment necessitating contact with mental health services. Yet, what causes negative voice-content and how interventions may reduce it remains poorly understood. This paper offers definitions of negative voice content and considers what may cause negative voice-content. We propose a framework in which adverse life-events may underpin much negative voice-content, a relation which may be mediated by mechanisms including hypervigilance, reduced social rank, shame and self-blame, dissociation, and altered emotional processing. At a neurological level, we note how the involvement of the amygdala and right Broca's area could drive negative voice-content. We observe that negative interactions between hearers and their voices may further drive negative voice-content. Finally, we consider the role of culture in shaping negative voice-content. This framework is intended to deepen and extend cognitive models of voice-hearing and spur further development of psychological interventions for those distressed by such voices. We note that much of the relevant research in this area remains to be performed or replicated. We conclude that more attention needs to be paid to methods for reducing negative voice-content, and urge further research in this important area.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalClinical Psychology Review
Volume67
DOIs
Publication statusPublished - Feb-2019

Keywords

  • Abuse
  • Attribution
  • Intention
  • Psychosis
  • Schizophrenia
  • Threat
  • Adverse life experiences
  • COGNITIVE-BEHAVIORAL THERAPY
  • ADVERSE LIFE EVENTS
  • SCHIZOPHRENIC-PATIENTS
  • EMOTION REGULATION
  • HEARING VOICES
  • PSYCHOTIC SYMPTOMS
  • CHILDHOOD TRAUMA
  • PHYSICAL ABUSE
  • DELUSIONS
  • DEPRESSION

Cite this