Voices to reckon with: perceptions of voice identity in clinical and non-clinical voice hearers
Open accessAbstract
The current review focuses on the perception of voice identity in clinical and non-clinical voice hearers. Identity perception in auditory verbal hallucinations (AVH) is grounded in the mechanisms of human (i.e., real, external) voice perception, and shapes the emotional (distress) and behavioral (help-seeking) response to the experience. Yet, the phenomenological assessment of voice identity is often limited, for example to the gender of the voice, and has failed to take advantage of recent models and evidence on human voice perception. In this paper we aim to synthesize the literature on identity in real and hallucinated voices and begin by providing a comprehensive overview of the features used to judge voice identity in healthy individuals and in people with schizophrenia. The findings suggest some subtle, but possibly systematic biases across different levels of voice identity in clinical hallucinators that are associated with higher levels of distress. Next we provide a critical evaluation of voice processing abilities in clinical and non-clinical voice hearers, including recent data collected in our laboratory. Our studies used diverse methods, assessing recognition and binding of words and voices in memory as well as multidimensional scaling of voice dissimilarity judgments. The findings overall point to significant difficulties recognizing familiar speakers and discriminating between unfamiliar speakers in people with schizophrenia, both with and without AVH. In contrast, these voice processing abilities appear to be generally intact in non-clinical hallucinators. The review highlights some important avenues for future research and treatment of AVH associated with a need for care, and suggests some novel insights into other symptoms of psychosis.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Few reviews about AVHs in a non-clinical sample exist and they were limited in scope, theoretical, or focused on comparison between clinical and non-clinical voice-hearers.
“in the last decades, there have been few reviews about AVHs in a non-clinical sample, and they were limited in scope (e.g., they focused on specific mechanisms or experience) [38], theoretical, centred on the continuum [14] or focused on the comparison between clinical and non-clinical voice-hearers [20, 39–42].”
From The “common” experience of voice-hearing and its relationship with shame and guilt: a systematic review (2022) · cites this paper as [40]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 97 · Cited by 39
Research works printed but not linked: 71
- Alba-Ferrara L. Fernyhough C. Weis S. Mitchell R. L. C. Hausmann M. (2012a). Contributions of emotional prosody comprehension deficits to the formation of auditory verbal hallucinations in schizophrenia. Clin. Psychol. Rev. 32, 244– 250 10.1016/j.cpr.2012.02.003 22459787 · DOI
- Alba-Ferrara L. Weis S. Damjanovic L. Rowett M. Hausmann M. (2012b). Voice identity recognition failure in patients with schizophrenia. J. Nerv. Ment. Dis. 200, 784– 790 10.1097/NMD.0b013e318266f835 22922236 · DOI
- Aleman A. Vercammen A. (2012). Functional neuroimaging of hallucinations, in Hallucinations: Research and Practice, eds Blom J. D. Sommer I. E. C. (New York, NY: Springer), 267– 281
- Allen P. Modinos G. Hubl D. Shields G. Cachia A. Jardri R. (2012). Neuroimaging auditory hallucinations in schizophrenia: from neuroanatomy to neurochemistry and beyond. Schizophr. Bull. 38, 695– 703 10.1093/schbul/sbs066 22535906 PMC3406523 · DOI · Paper page
- Andrew E. M. Gray N. S. Snowden R. J. (2008). The relationship between trauma and beliefs about voices: a study of psychiatric and non-psychiatric vice hearers. Psychol. Med. 38, 1409– 14117 10.1017/S003329170700253X 18177529 · DOI · Paper page
- Badcock J. C. (2010). The cognitive neuropsychology of auditory hallucinations: a parallel auditory pathways framework. Schizophr. Bull. 36, 576– 584 10.1093/schbul/sbn128 18835839 PMC2879695 · DOI
- Badcock J. C. Hugdahl K. (2012b). Examining the continuum model of auditory hallucinations: a review of cognitive mechanisms, in Hallucinations: Research and Practice, eds Blom J. D. Sommer I. E. C. (New York, NY: Springer), 317– 328
- Baumann O. Belin P. (2010). Perceptual scaling of voice identity: common dimensions for different vowels and speakers. Psychol. Res. 74, 110– 120 10.1007/s00426-008-0185-z 19034504 · DOI
- Beavan V. Read J. (2010). Hearing voices and listening to what they say. The importance of voice content in understanding and working with distressing voices. J. Nerv. Ment. Dis. 198, 201– 205 10.1097/NMD.0b013e3181d14612 20215997 · DOI
- Beavan V. Read J. Cartwright C. (2011). The prevalence of voice-hearers in the general population: a literature review. J. Ment. Health 20, 281– 292 10.3109/09638237.2011.562262 21574793 · DOI
- Belin P. Bestelmeyer P. E. Latinus M. Watson R. (2011). Understanding voice perception. Br. J. Psychol. 102, 711– 725 10.1111/j.2044-8295.2011.02041.x 21988380 · DOI
- Belin P. Fecteau S. Bédard C. (2004). Thinking the voice: neural correlates of voice perception. Trends Cogn. Sci. 8, 129– 135 10.1016/j.tics.2004.01.008 15301753 · DOI
- Bentall R. P. (2003). Madness Explained: Psychosis and Human Nature. London: Penguin Books
- Birchwood M. Chadwick P. D. (1997). The omnipotence of voices: testing the validity of a cognitive model. Psychol. Med. 27, 1345– 1353 9403906
- Birchwood M. Gilbert P. Gilbert J. Trower P. Meaden A. Hay J. (2004). Interpersonal and role related schema influence the relationship with the dominant voice in schizophrenia: a comparison of three models. Psychol. Med. 34, 1571– 1580 15724887
- Birchwood M. Meaden A. Trower P. Gilbert P. Plaistow J. (2000). The power and entrapment of voices: subordination and entrapment by voices and significant others. Psychol. Med. 30, 337– 344 10824654
- Bruce V. Young A. (1986). Understanding face recognition. Br. J. Psychol. 77, 305– 327 3756376
- Bruckert L. Bestelmeyer P. Latinus M. Rouger J. Charest I. Rousselet G. A. (2010). Vocal attractiveness increases by averaging. Curr. Biol. 20, 116– 120 10.1016/j.cub.2009.11.034 20129047 · DOI
- Chadwick P. D. Birchwood M. (1994). The omnipotence of voices. A cognitive approach to auditory hallucinations. Br. J. Psychiatry 39, 839– 844 8173822
- Chhabra S. Badcock J. C. Maybery M. Leung D. (2012a). Voice identity discrimination in Schizophrenia. Neuropsychologia 50, 2730– 2735 10.1016/j.neuropsychologia.2012.08.006 22910275 · DOI
- Chhabra S. Badcock J. C. Maybery M. (2012b). Memory binding in clinical and non-clinical psychotic experiences: how does the continuum model fare? Cogn. Neuropsychiatry. [Epub ahead of print]. 10.1080/13546805.2012.709183 23066885 · DOI
- Combs D. R. Penn D. L. Michael C. O. Basso M. R. Wiedeman R. Siebenmorgan M. (2009). Perceptions of hostility by persons with and without persecutory delusions. Cogn. Neuropsychiatry 14, 30– 52 10.1080/13546800902732970 19214841 · DOI
- Daalman K. Boks M. P. Diederen K. M. de Weijer A. D. Blom J. D. Kahn R. S. (2011). The same or different? A phenomenological comparison of auditory verbal hallucinations in healthy and psychotic individuals. J. Clin. Psychiatry 72, 320– 325 21450152
- David A. S. (2004). The cognitive neuropsychiatry of auditory verbal hallucinations: an overview. Cogn. Neuropsychiatry 9, 107– 123 10.1080/13546800344000183 16571577 · DOI
- Evensen J. Rossberg J. I. Haahr U. ten Velden Hegelstad W. Joa I. Johannessen J. O. (2011). Contrasting monosymptomatic patients with hallucinations and delusions in first-episode psychosis patients: a five-year longitudinal follow-up study. Psychopathology 44, 90– 97 10.1159/000319789 21228615 PMC3031149 · DOI
- Gainotti G. (2011). What the study of voice recognition in normal subjects and brain-damaged patients tells us about models of familiar people recognition. Neuropsychologia 49, 2273– 2282 10.1016/j.neuropsychologia.2011.04.027 21569784 · DOI
- Garrido L. Eisner F. McGettigan C. Stewart L. Sauter D. Hanley J. R. (2009). Developmental phonagnosia: a selective deficit of vocal identity recognition. Neuropsychologia 47, 123– 131 10.1016/j.neuropsychologia.2008.08.003 18765243 · DOI
- Gray K. Jenkins A. C. Heberlein A. S. Wegner D. M. (2011). Distortions of mind perception in psychopathology. Proc. Natl. Acad. Sci. U.S.A. 108, 477– 479 10.1073/pnas.1015493108 21187372 PMC3021012 · DOI
- Gregory S. W. Webster S. W. (1996). A nonverbal signal in voices of interview partners effectively predicts communication accommodation and social status perceptions. J. Pers. Soc. Psychol. 70, 1231– 1240 8667163
- Hailstone J. C. Crutch S. J. Vestergaard M. D. Patterson R. D. Warren J. D. (2010). Progressive associative phonagnosia: a neuropsychological analysis. Neuropsychologia 48, 1104– 1114 10.1016/j.neuropsychologia.2009.12.011 20006628 PMC2833414 · DOI
- Hayward M. Berry K. Ashton A. (2011). Applying interpersonal theories to the understanding of and therapy for auditory hallucinations: a review of the literature and directions for further research. Clin. Psych. Rev. 31, 1313– 1323 10.1016/j.cpr.2011.09.001 21996292 · DOI
- Hill K. Linden D. E. J. (2013). Hallucinatory experiences in non-clinical populations, in The Neuroscience of Hallucinations, eds Jardri R. Cachia A. Thomas P. Pins D. (New York, NY: Springer), 21– 41
- Hillenbrand J. M. (2005). The role of fundamental frequency and formants in the perception of speaker sex. J. Acoust. Soc. Am. 118, 1932– 1933 10.3758/APP.71.5.1150 19525544 · DOI
- Hoekert M. Kahn R. S. Pijnenborg M. Aleman A. (2007). Impaired recognition and expression of emotional prosody in schizophrenia: review and meta-analysis. Schizophr. Res. 96, 135– 145 10.1016/j.schres.2007.07.023 17766089 · DOI
- Hugdahl K. Loberg E. M. Falkenberg L. E. Johnsen E. Kompus K. Kroken R. A. (2012). Auditory verbal hallucinations in schizophrenia as aberrant lateralized speech perception: evidence from dichotic listening. Schizophr. Res. 140, 59– 64 10.1016/j.schres.2012.06.019 22796149 · DOI
- Hu C. Wang Q. Short L. Fu G. (2012). Speech spectrum's correlation with speakers' Eysenck Personality Traits. PLoS ONE 7: e33906 10.1371/journal.pone.0033906 22439014 PMC3306316 · DOI
- Kantrowitz J. T. Leitman D. I. Lehrfeld J. M. Laukka P. Juslin P. N. Butler P. D. (2013). Reduction in tonal discriminations predicts receptive emotion processing deficits in schizophrenia and schizoaffective disorder. Schizophr. Bull. 39, 86– 93 10.1093/schbul/sbr060 21725063 PMC3523919 · DOI
- Kelleher I. Connor D. Clarke M. C. Devlin N. Harley M. Cannon M. (2012). Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychol. Med. 42, 1857– 1863 10.1017/S0033291711002960 22225730 · DOI
- Klofstad C. A. Anderson R. C. Peters S. (2012). Sounds like a winner: voice pitch influences perception of leadership capacity in both men and women. Proc. R. Soc. B 279, 2698– 2704 10.1098/rspb.2012.0311 22418254 PMC3350713 · DOI
- Ko S. J. Judd C. M. Blair I. V. (2006). What the voice reveals: within- and between-category stereotyping on the basis of voice. Person. Soc. Psychol. Bull. 32, 806– 819 10.1177/0146167206286627 16648205 · DOI
- Ko S. J. Judd C. M. Stapel D. A. (2009). Stereotyping based on voice in the presence of individuating information: Vocal femininity affects perceived competence but not warmth. Person. Soc. Psychol. Bull. 35, 198– 211 10.1177/0146167208326477 19141624 · DOI
- Koeda M. Takahashi H. Yahata N. Matsuura M. Asai K. Okubo Y. (2006). Language processing and human voice perception in schizophrenia: a functional magnetic resonance imaging study. Biol. Psychiatry 59, 948– 957 10.1016/j.biopsych.2006.01.013 16616721 · DOI
- Kompus K. Westerhausen R. Hugdahl K. (2011). The “paradoxical” engagement of the primary auditory cortex in patients with auditory verbal hallucinations: a meta-analysis of functional neuroimaging studies. Neuropsychologia 49, 3361– 3369 10.1016/j.neuropsychologia.2011.08.010 21872614 · DOI
- Larøi F. (2012). How do auditory verbal hallucinations in patients differ from those in non-patients? Front. Hum. Neurosci. 6: 25 10.3389/fnhum.2012.00025 22375112 PMC3282922 · DOI
- Latinus M. Belin P. (2011). Human voice perception. Curr. Biol. 21, R143– R145 10.1016/j.cub.2010.12.033 21334289 · DOI
- Lawrence C. Jones J. Cooper M. (2010). Hearing voices in a non-psychiatric population. Behav. Cogn. Psychother. 38, 363– 373 10.1017/S1352465810000172 20441666 · DOI
- Leitman D. I. Laukka P. Juslin P. N. Saccente E. Butler P. Javitt D. C. (2010). Getting the cue: sensory contributions to auditory emotion recognition impairments in schizophrenia. Schizophr. Bull. 36, 545– 556 10.1093/schbul/sbn115 18791077 PMC2879690 · DOI
- Leitman D. I. Wolf D. H. Laukka P. Ragland J. D. Valdez J. N. Turetsky B. I. (2011). Not pitch perfect: sensory contributions to affective communication impairment in schizophrenia. Biol. Psychiatry 70, 611– 618 10.1016/j.biopsych.2011.05.032 21762876 · DOI
- Leudar I. Thomas P. McNally D. Glinski A. (1997). What voices can do with words: pragmatics of verbal hallucinations. Psychol. Med. 27, 885– 898 9234466
- Mawson A. Cohen K. Berry K. (2010). Reviewing evidence for the cognitive model of auditory hallucinations: the relationship between cognitive voice appraisals and distress during psychosis. Clin. Psychol. Rev. 30, 248– 258 10.1016/j.cpr.2009.11.006 20071062 · DOI
- McCarthy-Jones S. Trauer T. Mackinnon A. Sims E. Thomas N. Copolov D. L. (2012). A new phenomenological survey of auditory hallucinations: evidence for subtypes and implications for theory and practice. Schizophr. Bull. [Epub ahead of print]. 10.1093/schbul/sbs156 23267192 PMC3885292 · DOI
- Mullennix J. W. Johnson K. A. Topcu-Durgun M. Farnsworth L. M. (1995). The perceptual representation of voice gender. J. Acoust. Soc. Am. 98, 3080– 3095 8550934
- Paulik G. (2012). The role of social schema in the experience of auditory hallucinations: a systematic review and a proposal for the inclusion of social schema in a cognitive behavioural model of voice hearing. Clin. Psychol. Psychother. 19, 459– 472 10.1002/cpp.768 21774037 · DOI
- Pérez-Álvarez M. García-Montes J. M. Perona-Garcelán S. Vallina-Fernandez O. (2008). Changing relationships with voices: new therapeutic perspectives for treating hallucinations. Clin. Psychol. Psychother. 15, 75– 85 10.1002/cpp.563 19115430 · DOI
- Pernet C. R. Belin P. (2012). The role of pitch and timbre in voice gender categorization. Front. Psychol. 3: 23 10.3389/fpsyg.2012.00023 22347205 PMC3271351 · DOI
- Peters E. R. Williams S. L. Cooke M. A. Kuipers E. (2012). It's not what you hear, it' the way you think about it: appraisals as determinants of affect and behaviour in voice hearers. Psychol. Med. 42, 1507– 1514 10.1017/S0033291711002650 22115329 · DOI
- Pisanski K. Rendall D. (2011). The prioritization of voice fundamental frequency or formants in listeners' assessments of speaker size, masculinity, and attractiveness. J. Acoust. Soc. Am. 129, 2201– 2212 10.1121/1.3552866 21476675 · DOI
- Puts D. A. Apicella C. L. Cárdenas R. A. (2012). Masculine voices signal men's threat potential in foraging and industrial societies. Proc. R. Soc. B. 279, 601– 609 10.1098/rspb.2011.0829 21752821 PMC3234546 · DOI
- Relander K. Rämä P. (2009). Separate neural processes for retrieval of voice identity and word content in working memory. Brain Res. 1252, 143– 151 10.1016/j.brainres.2008.11.050 19063872 · DOI
- Romme M. Escher A. (1989). Hearing voices. Schizophr. Bull. 15, 209– 216 10.1093/schbul/15.2.209 2749184 · DOI · Paper page
- Sayer J. Ritter S. Gournay K. (2000). Beliefs about voices and their effects on coping strategies. J. Adv. Nursing 31, 1199– 1205 10.1046/j.1365-2648.2000.01375.x 10840254 · DOI
- Sell A. Bryant G. A. Cosmides L. Tooby J. Sznycer D. von Rueden C. (2010). Adaptations in humans for assessing physical strength from the voice. Proc. R. Soc. B. 277, 3509– 3518 10.1098/rspb.2010.0769 20554544 PMC2982226 · DOI
- Shea T. L. Sergejew A. A. Burnham D. Jones C. Rossell S. L. Copolov D. L. (2007). Emotional prosodic processing in auditory hallucinations. Schizophr. Res. 90, 214– 220 10.1016/j.schres.2006.09.021 17107773 · DOI
- Smeets F. Lataster T. Dominguez M. D. Hommes J. Lieb R. Wittchen H. U. (2012). Evidence that onset of psychosis in the population reflects early hallucinatory experiences that through environmental risks and affective dysregulation become complicated by delusions. Schizophr. Bull. 38, 531– 542 10.1093/schbul/sbq117 21030456 PMC3329993 · DOI
- Stephane M. Thuras P. Nasrallah H. Georgopoulos A. P. (2003). The internal structure of the phenomenology of auditory verbal hallucinations. Schizophr. Res. 61, 185– 193 10.1016/S0920-9964(03)00013-6 12729870 · DOI
- Stevens A. A. (2004). Dissociating the cortical basis of memory for voices, words and tones. Cogn. Brain Res. 8, 162– 171 10.1016/j.cogbrainres.2003.10.008 14736575 · DOI
- Tigue C. C. Borak D. J. O'Connor J. J. M. Schandl C. Feinberg D. R. (2012). Voice pitch influences voting behavior. Evol. Hum. Behav. 33, 210– 216 10.1098/rspb.2012.0311 22418254 PMC3350713 · DOI
- von Kriegstein K. Smith D. R. R. Patterson R. D. Ives D. T. Griffiths T. D. (2007). Neural representation of auditory size in the human voice and in sounds from other resonant sources. Curr. Biol. 17, 1123– 1128 10.1016/j.cub.2007.05.061 17600716 PMC2335591 · DOI
- Whiteside S. P. (1998). Identification of a speaker's sex: a study of vowels. Percept. Mot. Skills 86, 579– 584 9638758
- Zäske R. Schweinberger S. R. (2011). You are only as old as you sound: auditory aftereffects in vocal age perception. Hear. Res. 282, 283– 288 10.1016/j.heares.2011.06.008 21771649 · DOI
- Zhang Z. J. Hao G. F. Shi J. B. Mou X. D. Yao Z. J. Chen N. (2008). Investigation of the neural substrates of voice recognition in Chinese schizophrenic patients with auditory verbal hallucinations: an event-related functional MRI study. Acta Psychiat. Scand. 118, 272– 280 10.1111/j.1600-0447.2008.01243.x 18759811 · DOI
- Authors
- Badcock, J. C., & Chhabra, S.
- Affiliations
- The University of Western Australia (AU)
- Corresponding author
- Badcock, Johanna C.
- ORCID
- Badcock, Johanna C.
- Venue
- Frontiers in Human Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2013
- Volume
- 7
- Pages
- 114-114
- ISSN
- 1662-5161 (ISSN-L)
- PMC
- PMC3615181
- OpenAlex
- W2060404084
- Cited by
- 39
- References
- 97
- Citations by year
- 2025: 1 · 2024: 4 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 6 · 2015: 2 · 2014: 3 · 2013: 3
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Human Neuroscience (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Phonetics and Phonology Research
- Keywords
- auditory verbal hallucinations, vocal identity, voice perception, schizophrenia, voice recognition, speaker discrimination, voice memory, psychotic symptoms, emotional distress, help-seeking
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review