Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-28T12:13:41.063Z Has data issue: false hasContentIssue false
  • English
  • Français

The phenomenology of auditory verbal hallucinations in emotionally unstable personality disorder and post-traumatic stress disorder

Published online by Cambridge University Press:  06 August 2020

S. Wallis ,
P. Denno ,
J. Ives ,
P. Mallikarjun ,
S. J. Wood ,
F. Oyebode ,
M. Broome  and
R. Upthegrove
S. Wallis
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England
P. Denno
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England
J. Ives
Affiliation:
Population and Health Science Institute, Bristol Medical School, University of Bristol, Bristol, UK
P. Mallikarjun
Affiliation:
Institute for Mental Health, University of Birmingham, Birmingham, England
S. J. Wood
Affiliation:
Institute for Mental Health, University of Birmingham, Birmingham, England Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, Australia
F. Oyebode
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England Birmingham and Solihull Mental Health Foundation Trust, Birmingham, England
M. Broome
Affiliation:
Institute for Mental Health, University of Birmingham, Birmingham, England
R. Upthegrove*
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England Institute for Mental Health, University of Birmingham, Birmingham, England
*
*Address for correspondence: R. Upthegrove, Institute for Mental Health, University of Birmingham, IMH, 52 Prichatts Road, Edgbaston, BirminghamB152TT, (Email: r.upthegrove@bham.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To explore the phenomenology of auditory verbal hallucinations (AVHs) in a clinical sample of young people who have a ‘non-psychotic’ diagnosis.

Methods:

Ten participants aged 17–31 years with presentation of emotionally unstable personality disorder or post-traumatic stress disorder and frequent AVHs were recruited and participated in a qualitative study exploring their subjective experience of hearing voices. Photo-elicitation and ethnographic diaries were used to stimulate discussion in an otherwise unstructured walking interview.

Results:

‘Non-psychotic’ voices comprised auditory qualities such as volume and clarity. Participants commonly personified their voices, viewing them as distinct characters with which they could interact and form relationships. There appeared to be an intimate and unstable relationship between participant and voice, whereby voices changed according to the participants’ mood, insecurities, distress and circumstance. Equally, participants reacted to provocation by the voice, leading to changes in mood and circumstance through emotional and physical disturbances. In contrast to our previous qualitative work in psychosis, voice hearing was not experienced with a sense of imposition or control.

Conclusions:

This phenomenological research yielded in-depth and novel accounts of ‘non-psychotic’ voices which were intimately linked to emotional experience. In contrast to standard reports of voices in disorders such as schizophrenia, participants described a complex and bi-directional relationship with their voices. Many other features were in common with voice hearing in psychosis. Knowledge of the phenomenology of hallucinations in non-psychotic disorders has the potential to inform future more successful management strategies. This report gives preliminary evidence for future research.

Keywords

Auditory hallucinationvoicepersonality disorderpost-traumatic stress disorderinterview
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 39 , Issue 2: Themed Issue: Psychiatric Anthropology , June 2022 , pp. 196 - 206
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

These authors contributed equally to this work.

References

Anderson, J (2004). Talking whilst walking: a geographical archaeology of knowledge. Area 36, 254–261.CrossRefGoogle Scholar
Beavan, V (2011). Towards a definition of “hearing voices”: a phenomenological approach. Psychosis: Psychological, Social and Integrative Approaches 3, 63–73.CrossRefGoogle Scholar
Birchwood, M, Iqbal, Z, Upthegrove, R (2005). Psychological pathways to depression in schizophrenia: studies in acute psychosis, post psychotic depression and auditory hallucinations. European Archives of Psychiatry and Clinical Neuroscience 255, 202–212.CrossRefGoogle ScholarPubMed
Birchwood, M, Meaden, A, Trower, P, Gilbert, P, Plaistow, J (2000). The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychological Medicine 30, 337–344.CrossRefGoogle ScholarPubMed
Broome, MR, Owen, GS, Stringers, A (2012). The Maudsley Reader in Phenomenological Psychiatry. Cambridge University Press: Cambridge, UK.Google Scholar
Choong, C, Hunter, M, Woodruff, P (2007). Auditory hallucinations in those populations that do not suffer from schizophrenia. Current Psychiatry Reports 9, 206–212.CrossRefGoogle Scholar
Adelman, K, Boks, M, Diederen, K, Weijer, A, Blom, JD, Kahn, R, Sommer, I (2010). Same or different? Auditory verbal hallucinations in healthy and psychotic individuals. Schizophrenia Research 117, 188–189.Google Scholar
Erdner, A, Magnusson, A (2011). Photography as a method of data collection: helping people with long-term mental illness to convey their life world. Perspectives in Psychiatric Care 47, 145–150.CrossRefGoogle ScholarPubMed
Heckers, S, Barch, DM, Bustillo, J, Gaebel, W, Guru, R, Malaspina, D, Owen, MJ, Schultz, S, Tandon, R, Tsuang, M, Van Os, J, Carpenter, W (2013). Structure of the psychotic disorders classification in DSM-5. Schizophrenia Research 150, 11–14.CrossRefGoogle ScholarPubMed
Hislop, J, Arber, S, Meadows, R, Venn, S (2005). Narratives of the night: the use of audio diaries in researching sleep. Sociological Research Online 10, 13–25.CrossRefGoogle Scholar
Jaspers, K (1997). General Psychopathology. John Hopkins University Press: Baltimore, Maryland.Google Scholar
Kraepelin, E (1913). Lectures on clinical psychiatry. Revised and edited by Thomas Johnstone: authorized translation from the second German edition. In (ed. Johnstone, T.) 3rd English ed. Baillie, Tindall & Cox: London.Google Scholar
Longden, E, Madill, A, Waterman, MG (2012). Dissociation, trauma, and the role of lived experience: toward a new conceptualization of voice hearing. Psychological Bulletin 138, 28–76.CrossRefGoogle Scholar
Maxwell, JA (2010). Using numbers in qualitative research. Qualitative Inquiry 16, 475–482.CrossRefGoogle Scholar
Mccarthy-Jones, S, Longden, E (2015). Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions? Frontiers in Psychology 6, 1071.CrossRefGoogle ScholarPubMed
Mccarthy-Jones, S, Trauer, T, Mackinnon, A, Sims, E, Thomas, N, Copolov, DL (2014). A new phenomenological survey of auditory hallucinations: evidence for subtypes and implications for theory and practice. Schizophrenia Bulletin 40, 231–235.CrossRefGoogle ScholarPubMed
Merrett, Z, Rossell, SL, Castle, DJ (2016). Comparing the experience of voices in borderline personality disorder with the experience of voices in a psychotic disorder: a systematic review. Australian & New Zealand Journal of Psychiatry 50, 640–648.CrossRefGoogle Scholar
Moyle, W (2002). Unstructured interviews: challenges when participants have a major depressive illness. Journal of Advanced Nursing 39, 266–273.CrossRefGoogle ScholarPubMed
Nayani, TH, David, AS (1996). The auditory hallucination: a phenomenological survey. Psychological Medicine 26, 177–189.CrossRefGoogle ScholarPubMed
Oyebode, F (2008). Sims’ Symptoms in the Mind: an Introduction to Descriptive Psychopathology. In (ed. SIMS, A. C. P.) 4th ed./Femi Oyebode ed.Saunders/Elsevier: Edinburgh.Google Scholar
Oyebode, F (2013). One Century of Karl Jaspers’ General Psychopathology. Oxford University Press: Oxford, England.Google Scholar
Paton, C, Crawford, MJ, Bhatti, SF, Patel, MX, Barnes, TR (2015). The use of psychotropic medication in patients with emotionally unstable personality disorder under the care of UK mental health services. The Journal of Clinical Psychiatry 76, 512–518.CrossRefGoogle ScholarPubMed
Patton, MQ (1999). Enhancing the quality and credibility of qualitative analysis. Health Services Research 34, 1189–1208.Google ScholarPubMed
Sandhu, A, Ives, J, Birchwood, M, Upthegrove, R (2013). The subjective experience and phenomenology of depression following first episode psychosis: a qualitative study using photo-elicitation. Journal of Affective Disorders 149, 166–174.CrossRefGoogle ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry 59(Suppl 20), 22–33.Google ScholarPubMed
Silverman, D (2011). Interpreting Qualitative Data: Methods for Analyzing Talk, Text and Interaction. SAGE Publications: Newbury Park, CA.Google Scholar
Upthegrove, R, Birchwood, M, Ross, K, Brunett, K, McCollum, R, Jones, L (2010). The evolution of depression and suicidality in first episode psychosis. Acta Psychiatrica Scandinavica 122, 211–218.CrossRefGoogle ScholarPubMed
Upthegrove, R, Ives, J, Broome, MR, Caldwell, K, Wood, SJ, Oyebode, F (2016). Auditory verbal hallucinations in first episode psychosis: a phenomenological investigation. BJPsych Open 2, 88–95.CrossRefGoogle ScholarPubMed
Van Manen, M (1997). Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Althouse Press: London.Google Scholar
Waters, F, Allen, P, Aleman, A, Fernyhough, C, Woodward, TS, Badcock, JC, Barkus, E, Johns, L, Varese, F, Menon, M, Vercammen, A, Larøi, F (2012). Auditory hallucinations in schizophrenia and nonschizophrenia populations: a review and integrated model of cognitive mechanisms. Schizophrenia Bulletin 38, 683–693.CrossRefGoogle ScholarPubMed
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar
Woods, A, Jones, N, Alderson-Day, B, Callard, F, Fernyhough, C (2015). Experiences of hearing voices: analysis of a novel phenomenological survey. The Lancet Psychiatry 2, 323–331.CrossRefGoogle ScholarPubMed
Woods, A, Jones, N, Bernini, M, Callard, F, Alderson-Day, B, Badcock, JC, Bell, V, Cook, CCH, Csordas, T, Humpston, C, Krueger, J, Laroi, F, Mccarthy-Jones, S, Moseley, P, Powell, H, Raballo, A, Smailes, D, Fernyhough, C (2014). Interdisciplinary approaches to the phenomenology of auditory verbal hallucinations. Schizophrenia Bulletin 40, S246–S254.CrossRefGoogle Scholar