Abstract
Objective: Previous research suggests that the distress experienced by clinical voice hearers is associated with the perceived relationship between voice and hearer, independent of beliefs about voices and depression. The current study aimed to extend this research by comparing the interpersonal styles of non-clinical and clinical voice hearers, and determining whether relating styles were associated with distress. Design: The study employed a cross-sectional, quantitative design, and used between-subjects and correlational methods. Setting: Clinical participants were recruited from adult mental health services across three NHS trusts. Non-clinical participants were recruited via the media, across the U.K. Participants: 32 clinical voice hearers and 18 non-clinical voice hearers. Main Outcome Measures: Individuals were assessed using the distress scale of PSYRATS, the Voice and You self-report questionnaire, the Beliefs About Voices Questionnaire - Revised, and the Beck Depression Inventory-II. Results: For clinical voice hearers, distress was significantly associated with perceptions of the voice as dominating and intrusive, and hearers distancing themselves from the voice. However, these associations were not independent of beliefs about voices’ omnipotence or malevolence. For non-clinical voice hearers, distress was significantly associated with distancing by the voice hearer. Non-clinical voice hearers were found to be significantly less distressed than clinical voice hearers and to have significantly less maladaptive relationships on measures of voice dominance, intrusiveness and hearer distance. Conclusions: The way in which voice hearers appraise their relationship with the voice is associated with distress. Clinically, the development of less maladaptive relationships between voice and voice hearer may reduce distress.