Momentary dynamics of inner speech varieties, auditory verbal hallucinations, and affect in schizophrenia spectrum disorders: an experience sampling study.
Psychological medicine January 12, 2026 Lawrence Kin-Hei Chung, Thomas J Whitford, Anson Kai Chun Chau et al.
People with schizophrenia who hear voices experience inner speech—the silent, internal monologue—more frequently and with a different character than healthy individuals. Using repeated daily surveys on electronic devices, researchers found that voice-hearers reported more moments of inner speech and higher intensity of evaluative, other people's voices, condensed, and positive inner speech, though not dialogic inner speech. When voice-hearers experienced more intense dialogic, evaluative, other people's, or condensed inner speech, they also reported more severe auditory verbal hallucinations. Negative emotions strengthened the link between evaluative inner speech and hallucination severity. The findings suggest inner speech contributes to voice-hearing and that emotional state may be a target for therapy.