Intersections of phenomenology, voice beliefs and distress in bipolar disorder: a comparison with schizophrenia.
Lindsay Smith, Susan L. Rossell, Neil Thomas, Wei Lin Toh
Behavioural and Cognitive Psychotherapy 2024 DOI: 10.1017/s1352465823000395 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 98 |
| Population | Adults with bipolar disorder or schizophrenia who experience auditory verbal hallucinations |
| Topics | Philosophy of mind |
| Keywords | Auditory verbal hallucinations Bipolar disorder Voice-hearing Voices |
| Citations | 4 |
| Key findings | Voice-related distress is not significantly higher in bipolar disorder than in schizophrenia, but internal attributions for voices are greater in bipolar disorder, and resistance to voices along with mood symptoms uniquely predicts distress in bipolar disorder. |
Abstract
Auditory verbal hallucinations (AVH), or voice-hearing, can be a prominent symptom during fluctuating mood states in bipolar disorder (BD). The current study aimed to: (i) compare AVH-related distress in BD relative to schizophrenia (SCZ), (ii) examine correlations between phenomenology and voice beliefs across each group, and (iii) explore how voice beliefs may uniquely contribute to distress in BD and SCZ. Participants were recruited from two international sites in Australia (BD=31; SCZ=50) and the UK (BD=17). Basic demographic-clinical information was collected, and mood symptoms were assessed. To document AVH characteristics, a 4-factor model of the Psychotic Symptoms Rating Scale and the Beliefs about Voices Questionnaire-Revised were used. Statistical analyses consisted of group-wise comparisons, Pearson's correlations and multiple hierarchical regressions. It was found that AVH-related distress was not significantly higher in BD than SCZ, but those with BD made significantly more internal attributions for their voices. In the BD group, AVH-related distress was significantly positively correlated with malevolence, omnipotence and resistance, However, only resistance, alongside mania and depressive symptoms, significantly contributed to AVH-related distress in BD. Our findings have several clinical implications, including identification of voice resistance as a potential therapeutic target to prioritise in BD. Factoring in the influence of mood symptoms on AVH-related distress as well as adopting more acceptance-oriented therapies may also be of benefit.