Hearing nasty voices: Developing new ways to measure the experience
Research type
Research Study
Full title
Hearing nasty voices: Developing new ways to measure the experience
IRAS ID
274009
Contact name
Bryony Sheaves
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
1 years, 4 months, 30 days
Research summary
Research Summary:
Hearing voices is one of the most common symptoms of schizophrenia. We aim to learn why some patients listen to and believe the content of distressing voices. This will enable the later development of psychological therapies which enable patients to disengage from distressing voice content. A crucial step in this process is to develop two questionnaires:i) an assessment of the degree that people listen and believe distressing voices
ii) an assessment of the reasons why people listen and believe distressing voices.The items making up each of these questionnaires have come from i) interviews with people who hear distressing voices, ii) a lived experience advisory panel and iii) clinical psychologists with experience of working with people who hear voices.
The questionnaires will be tested to check that they measure what we intend them to measure (validity) and are reliable. We will also remove redundant questions which will shorten the questionnaires.
To do this we will conduct one study in two part (A&B). Part A will assess the reliability and validity of the two new measures (30-40 minutes). Shortened versions of the questionnaires will be developed and reliability and validity reassessed in a new sample (part B, 30-40 minutes). A sub-sample of participants in part B will complete the new measures (10 minutes) one week later to assess whether the results are stable over time (test-retest reliability).
A large number of participants are required to assess validity and reliability. We will therefore recruit participants via the Clinical Research Network (CRN), which has research assistants based in NHS Trusts across the country. The study is funded by the National Institute of Health Research. Participant will be reimbursed £5 for participation. Recruiting via the CRN is a method which has been successfully used by our research group, with no risks identified.
Summary of Results:
Hearing voices is one of the most common symptoms of a schizophrenia diagnosis, experienced by around 70% of people with this diagnosis. Two thirds of voice hearers experience voices which make derogatory and threatening comments. Our theoretical perspective is that when the patient listens to this negative voice content, and believes the comments to be true, this will exacerbate distress. Our previous work interviewing patients who hear derogatory and threatening voices (DTVs) indicates that there are understandable reasons to listen and believe.
This study aimed to develop questionnaires to assess key constructs within this new psychological framework and carry out the first quantitative test of the theory.
38 participating NHS Trusts recruited 591 patients who hear derogatory and threatening voices. They completed item pools to assess the degree of listening to and believing DTVs, and the reasons for doing so. 52% believed the derogatory and threatening comments most or all of the time. Listening was formed of actively listening out for the DTVs and/or passively listening (without any intention). Higher endorsement of listening and believing DTVs predicted higher distress. There were seven groups of reasons for listening and believing: 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 listening and believing DTVs. Feeling worn down was particularly strongly associated with listening and believing. A framework of listening and believing negative voices has the potential to inform the understanding and psychological treatment of voice distress.REC name
South Central - Oxford B Research Ethics Committee
REC reference
19/SC/0610
Date of REC Opinion
18 Dec 2019
REC opinion
Favourable Opinion