Intersections of phenomenology, voice beliefs and distress in bipolar disorder: a comparison with schizophrenia.
Lindsay M 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.
Comparable studies
Other cross-sectional and survey studies on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Survey of entity encounter experiences occasioned by inhaled N,N-dimethyltryptamine: Phenomenology, interpretation, and enduring effects. People who had a memorable entity encounter after taking N,N-dimethyltryptamine | 2020 | Survey | n = 2,561 |
| Future directions in meditation research: Recommendations for expanding the field of contemplative science Meditators | 2018 | Cross-sectional online survey | n = 1,120 |
| The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams | 2014 | Online survey | n = 684 |
| The neurophenomenology of early psychosis: An integrative empirical study. Ultra-high risk for psychosis patients, first episode psychosis patients, and healthy... | 2019 | Cross-sectional | n = 123 |
| Spontaneous Spiritual Awakenings: Phenomenology, Altered States, Individual Differences, and Well-Being People reporting their most powerful Spontaneous Spiritual or Kundalini Awakening | 2021 | Mixed within and between-participants self-report survey design | n = 152 |
Citations in the library
Cited by 2
- Hearing voices and other altered perceptual experiences across psychotic, mood, and anxiety disorders: from phenomenology and mechanisms to future directions. Schizophrenia September 29, 2025
- The Phenomenology of Visual and Other Nonauditory Hallucinations in Affective and Nonaffective Psychosis: A Mixed Methods Analysis. The Journal of Nervous and Mental Disease April 1, 2024
Cites 5
- On the phenomenology of auditory verbal hallucinations in affective and non-affective psychosis. Psychiatry Research June 4, 2020
- The phenomenology of auditory verbal hallucinations in bipolar disorder. Psychology and Psychotherapy Theory Research and Practice February 7, 2023
- A new phenomenological survey of auditory hallucinations: evidence for subtypes and implications for theory and practice. Schizophrenia Bulletin January 2014
- Auditory hallucinations: a comparison of beliefs about voices in individuals with schizophrenia and borderline personality disorder. Clinical Psychology & Psychotherapy 2013
- Beliefs about voices and their effects on coping strategies. Journal of Advanced Nursing May 2000