Hearing voices: the impact of emotion, interpersonal relating and beliefs about voices, on people who hear voices (that other people do not hear)

Abstract

Background Beliefs about voices, their origin, intent and powerfulness can all impact on the voice hearer, their level of distress and their need for help. Interpersonal difficulties can exacerbate distress and be reflected in the person’s relationship with their voices. Emotion regulation strategies, which may be functional or dysfunctional help the person manage their reaction. This study aims to investigate beliefs about voices, symptoms and interpersonal issues as well as how well these areas predict emotion regulation strategies Methods Two groups of participants (18 with low and 16 with high omnipotence scores) were recruited through their mental health workers. The participants completed six self-report measures that assessed beliefs, emotion regulation strategies, interpersonal difficulties, dimensions of voice hearing and symptoms. Results Omnipotence scores differentiated some of the interpersonal issues and only one symptom subscale (phobic anxiety); those who scored high on the omnipotence subscale experienced more difficulties. For the emotion regulation subscales, lower omnipotence scorers differed significantly from the higher omnipotence scorers, using more external functional and dysfunctional strategies. Regression analysis showed that ‘distress’ incorporating the PSYRATS emotion subscale, the BSI grand total and the IIP-32 total predicted the use of dysfunctional emotion regulation strategies, but omnipotence beliefs did not add much to this. Conclusions Overall voice hearers experience a range of beliefs about their voices. Those with higher omnipotence beliefs find it difficult to socialise, be involved with other people, and are too dependent and caring with reference to other people. Omnipotent beliefs did not, in general, differentiate symptoms or emotion regulation strategies. This would suggest that beliefs may not be what determines distress and subsequent help seeking. Distress and interpersonal issues predict the use of emotion regulation strategies with little being added to the prediction by omnipotent beliefs; this suggests that there may be an alternative to the single symptom approach. Further research is required to assess the contribution made by emotion regulation to the development, maintenance and course of voice hearing. Assessment and interventions with reference to emotion regulation also require investigation.