Voice-Hearing and Personification: Characterizing Social Qualities of Auditory Verbal Hallucinations in Early Psychosis
Ben Alderson‐day, Angela Woods, Peter Moseley, Stephanie Common, Felicity Deamer, Guy Dodgson, Charles Fernyhough
Schizophrenia Bulletin June 19, 2020 Peer reviewed DOI: 10.1093/schbul/sbaa095 via OpenAlex
Summary
The study investigates how and why auditory verbal hallucinations (AVH) become personified in individuals experiencing them. Among 40 participants aged 16-65 from Early Intervention in Psychosis services, 40% reported complex personification of voices, which was associated with perceiving voices as conversational and companionable. The onset of distressing voices was typically more recent, with an average of 12 months. Negative emotions such as fear and anxiety were commonly reported, along with visual hallucinations and bodily states.
Study at a glance
| Design | qualitative study |
|---|---|
| Sample size | 40 |
| Population | individuals aged 16-65 receiving Early Intervention in Psychosis services |
| Key finding | Complex personification of auditory verbal hallucinations is reported by 40% of individuals, associated with experiencing voices as conversational and companionable. |
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.