Hearing voices: A systematic review of the impact of social isolation and an empirical study exploring negative content and voice-related distress.

Silver, Jessica Helen 2021. Hearing voices: A systematic review of the impact of social isolation and an empirical study exploring negative content and voice-related distress. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Preface Around 10% of people will experience hearing voices, also known as auditory verbal hallucinations, at some point in their lives. Auditory hallucinations, the experience of hearing in the absence of external sound, exist along a spectrum of normal human experience. The experience can be both brief and comforting as well as persistent, negative, and disabling. People who hear voices do not always have an associated mental health condition, but some do. Experts by Experience have led the Hearing Voices Movement which emphasises that the experience of hearing voices should not be thought of as an abnormality to be eradicated per se, but rather a meaningful part of human experience. Psychological research and interventions are catching up with this perspective and are seeking to better understand and focus on reducing distress associated with hearing voices, if present, rather than reducing the voices themselves. This empirical study examined the impact that ways of thinking about and responding to voices has on distress in voice hearers. The systematic review aimed to understand the potential impact of social isolation arising from COVID-19 restrictions on auditory hallucinations in the general population. The empirical study aimed to further our understanding of how distress associated with hearing voices is maintained. Previous research has found the content of voices, especially those which are negative, is an important factor in associated distress. This research looked at whether there are ways in which people who hear voices think about or respond cognitively to the voices, which increases their distress. The research was conducted online with adults who identified as hearing voices, both those who receive support from mental health services and those who do not. The participants were from diverse ethnic backgrounds. The results showed that both negative content and voice- 5 related distress were higher in those who had recently been in contact with mental health services. When examining what might mediate the relationship between negative content and voice-related distress, both responding mindfully to voices and the interpretation of loss of control, were mediating factors. The results support the use of psychological interventions that have an element of mindfulness training as well as Cognitive Behavioural Therapy that targets unhelpful cognitions such as the interpretation of loss of control. However, further research on interventions for hearing voices would benefit from including a comparison between approaches. Furthermore, the development of validated tools for measuring specific aspects of hearing voices such as negative content and voice-related distress would be helpful for future research that builds on these findings. The systematic review examined the relationship between social isolation and auditory hallucinations in the general population in order to understand the potential effects of COVID-19 restrictions on auditory hallucinations. Previous theories have proposed that social isolation can trigger auditory hallucinations in those who are vulnerable to developing them. The review looked at research that examined social isolation and auditory hallucinations since 2001 to account for the changes that mobile phones and the internet have had on social connection. 16 studies were identified by searching electronic databases and reference lists. The studies were conducted in seven different countries between 2004 and 2021. The types of social isolation examined were COVID-19 restrictions, hospital quarantine, and general social isolation. Although the included studies were found to be of good quality, few of them directly examined the relationship between social isolation and auditory hallucinations. One study, conducted prior to COVID-19, found social isolation was not associated with auditory hallucinations. Another study, looking at the impact of COVID- 6 19 restrictions, found no change in severity of pre-existing auditory hallucinations. Many of the studies included in the review, despite having measured auditory hallucinations separately, combined all types of hallucinations or psychosis symptoms together when conducting their analysis. For example, in two studies social isolation was found to be associated with an increase in all types of hallucinations in an older population. However, it is not known whether this relationship would remain if just auditory hallucinations were examined. The review highlighted age, coronavirus infection, and pre-existing levels of isolation might influence whether social isolation affects auditory hallucinations. Further research looking at these factors and how they interact is needed to better understand the impact that COVID-19 restrictions may have on auditory hallucinations. In turn, this may indicate interventions that would alleviate the detrimental effects of social isolation arising from COVID-19 restrictions. Both the systematic review and empirical paper contribute to our understanding of hearing voices in relation to factors that may increase voice-related distress and how the current COVID-19 pandemic may impact upon voice hearing. As distress relating to hearing voices exists both within the context of and independent of mental health diagnoses, it is important for research to examine this phenomenon outside of the constraints of psychiatric diagnosis in order to further the development of interventions to alleviate distress

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	22 September 2021
Last Modified:	22 Sep 2022 01:30
URI:	https://orca.cardiff.ac.uk/id/eprint/144338

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