In the largest sample of voice hearing reports studied to date, Dr. Ruvanee Vilhauer and Himadhari Sharma examine the accounts of voice hearing in the general public through online posts. Published in the journal, Psychosis, the data collected in this study revealed that most people discussing voice hearing experiences online did not have a psychiatric diagnosis and that features of voice hearing previously thought to be typical, such as commands, were only reports by about 1/5th of the individuals included in the sample.
“This study shows that there is still much we don’t understand about auditory verbal hallucinations or voice hearing experiences,” the authors stated in an email correspondence about their work. “It is particularly important to find ways of studying these experiences in the nonclinical population.”
In a previous review, stigma about auditory verbal hallucination (voice hearing), perpetuated by negative representations in popular culture, negatively affects voice hearers and creates barriers to accessing care and increases distress. Researchers highlight the importance of peer support networks, such as the Hearing Voices Movement, as an essential resource where individuals can discuss their experiences without feeling stigmatized. In the present research, the authors aimed to examine and characterize instances of voice hearing in the general population.
“What we presently know comes from clinical studies, studies comparing VH [voice hearing] phenomenology in clinical and nonclinical samples, and a handful of studies using only nonclinical participants,” the researchers write. “The focus on clinical participants could limit our ability to understand the range of VH experiences present in the general population.”
In an attempt to circumvent the various barriers and limitations in existing research on voice hearing, the authors looked at “unsolicited, anonymous online reports of VH in the general population.” The researchers hope that the anonymity of the online posts increases disclosure, results in less inhibited descriptions, and decreases social desirability bias (saying what you think is the right thing to say).
The researchers analyzed 499 publicly available, anonymous, online posts about voice hearing. Posts were drawn from Yahoo! Answers with the keyword search “hearing voices.” The authors excluded posts that were unrelated to hallucinatory experiences, repeats, jokes or false reports, not self-reports, descriptions of inner speech experiences, did not occur in clear consciousness (e.g., occurred during sleep or intoxicated states). To analyze the data, the authors conducted a content analysis and identified themes in the posts.
Overall, their analysis revealed that only 16% of the posts indicated the presence of a mental illness diagnosis (not explicitly associated with voice hearing) or a prescription for psychotropic medications. Twenty-one percent of posts described voices as commanding or instructing, a subcategory of 62 out of these 107 posts wrote that the voices had violent content, 59 that the commands were violent, and three reported that the commands were not violent while the voices had violent content.
Of the 107posts, 68 mentioned voices with non-violent content. Most posts (25%) attributed the voices to familiar people such as family members, coworker, teachers, etc. 20% of the posts reported that the voices might belong to supernatural entities, and 16% felt that the voices might be their own.
The authors concluded that their study provides evidence that voice hearing, especially among nonclinical populations, is not well understood. They found that individuals may experience voices consistent with various etiological models, highlighting the range of experiences across nonclinical samples.
“This study suggests that unclear voices and voices perceived as not self-relevant are more common than previously assumed, while commanding voices, previously been considered typical of AVH, are relatively uncommon.”
Vilhauer, R. P., & Sharma, H. (2018). Unsolicited reports of voice hearing in the general population: a study using a novel method. Psychosis, 1-12. (Link)