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

Larøi, Frank; Thomas, Neil; Aleman, André; Fernyhough, Charles; Wilkinson, Sam; Deamer, Felicity; McCarthy-Jones, Simon

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.

• Journal Article Type: Review
• Acceptance Date: Jan 16, 2019
• Online Publication Date: Nov 14, 2018
• Publication Date: 2019-02
• Deposit Date: Sep 21, 2021
• Publicly Available Date: Sep 22, 2021
• Journal: Clinical Psychology Review
• Print ISSN: 0272-7358
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 67
• Pages: 1-10
• DOI: https://doi.org/10.1016/j.cpr.2018.11.001
• Keywords: Psychiatry and Mental health; Clinical Psychology
• Public URL: https://uwe-repository.worktribe.com/output/7816058
• Additional Information: This article is maintained by: Elsevier; Article Title: The ice in voices: Understanding negative content in auditory-verbal hallucinations; Journal Title: Clinical Psychology Review; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.cpr.2018.11.001; Content Type: article; Copyright: © 2018 The Authors. Published by Elsevier Ltd.