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Cited by 8Schizophrenia research and treatmentHallucinations in medical conditionsMental Health and Psychiatry

Listening to and believing derogatory and threatening voices

Open access
Sheaves, Bryony, Johns, Louise, Loe, Bao S, Bold, Emily, Černis, Emma, The McPin Hearing Voices Lived Experience Advisory Panel, Molodynski, Andrew, Freeman, Daniel·2023·Schizophrenia Bulletin
DOI 10.1093/schbul/sbac101PMC PMC9810006
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Abstract

BACKGROUND AND HYPOTHESIS: A plausible cause of distress for voice hearers is listening to and believing the threats and criticisms heard. Qualitative research indicates that patients have understandable reasons to listen. This study aimed to develop the understanding of distress using this listening and believing framework. Measures were developed of listening and believing voices and the reasons, and associations with distress tested. STUDY DESIGN: A cross-sectional study of patients hearing derogatory and threatening voices (N = 591). Listening and Believing-Assessment and Listening and Believing-Reasons item pools were completed, and assessments of distress. Exploratory and confirmatory factor analyses and structural equation modeling (SEM) were conducted. STUDY RESULTS: 52% (n = 307) of participants believed their voices most or all the time. Listening and believing had 4 factors: active listening, passive listening, believing, and disregarding. Higher levels of believing, active listening, and particularly passive listening were associated with higher levels of anxiety, depression, and voice distress. Reasons for listening and believing formed 7 factors: to better understand the threat; being too worn down to resist; to learn something insightful; being alone with time to listen; voices trying to capture attention; voices sounding like real people; and voices sounding like known people. Each type of reason was associated with active listening, passive listening, and believing. SEM showed that feeling worn down in particular accounted for listening and believing. Test-retest reliability of measures was excellent. CONCLUSIONS: A framework of listening and believing negative voices has the potential to inform the understanding and treatment of voice distress.

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  • Sometimes the person hears a voice telling them that they are vulnerable and will be attacked, which is then believed.

    “Sometimes the person hears a voice telling them that they are vulnerable and will be attacked, which is then believed (Sheaves et al., 2023).”

    From A counterweight model for understanding and treating persecutory delusions. (2025) · cites this paper as Sheaves et al., 2023

    The Discussion reports that participants heard threatening voices and that about half strongly believed the threats and criticisms. It does not specify voices telling people they are vulnerable and will be attacked; that particular message goes beyond what our copy reports. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Being worn down-a construct comprising mental defeat, low confidence in relation to voices, and fatigue-is associated with more listening to and believing derogatory and threatening voice content.

    “In quantitative tests, being worn down—a construct comprising mental defeat, low confidence in relation to voices, and fatigue—has been associated with more listening to and believing derogatory and threatening voice content. 14”

    From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [14]

  • The ability to monitor the source of sensory information and the executive functions that underpin decision making are plausible cognitive mediators of the relationship between sleep disruption and believing negative voice content.

    “The ability to monitor the source of sensory information and the executive functions that underpin decision making are plausible cognitive mediators of the relationship between sleep disruption and believing negative voice content. 14”

    From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [14]

  • Disrupted top-down allocation of attention may mediate the path between sleep loss and greater listening to negative voices.

    “It is plausible that disrupted top-down allocation of attention mediates the path between sleep loss and greater listening to negative voices. 14”

    From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [14]

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Authors
Sheaves, B., Johns, L., Loe, B. S., Bold, E., Černis, E., Panel, T. M. H. V. L. E. A., Molodynski, A., & Freeman, D.
Affiliations
  • Oxford Health NHS Foundation Trust (GB)
  • University of Cambridge (GB)
Corresponding author
Sheaves, Bryony
ORCID
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2022-08-10
Volume
49
Issue
1
Pages
151-160
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
DOI
10.1093/schbul/sbac101
PMC
PMC9810006
OpenAlex
W4290989355
Cited by
8
References
36
Citations by year
2026: 1 · 2025: 4 · 2024: 1 · 2023: 2
FWCI
1.14
Type
journal article
Language
en
Open access
Licence
Locations
  • Schizophrenia Bulletin (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
Funders
  • Higher Education England
  • National Institute for Health and Care Research (ICA-CDRF-2017-03-088)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
voice hearing
MeSH terms
Anxiety, Cross-Sectional Studies, Emotions, Hallucinations, Humans, Reproducibility of Results

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