Voice-Hearing and Personification: Characterizing Social Qualities of Auditory Verbal Hallucinations in Early Psychosis

Ben Alderson-day, Angela Woods, Peter Moseley, Stephanie Common, Felicity Deamer, Guy Dodgson, Charles Fernyhough

Research output: Contribution to journalArticlepeer-review


Recent therapeutic approaches to auditory verbal hallucinations (AVH) exploit the person-like qualities of voices. Little is known, however, about how, why, and when AVH become personified. We aimed to investigate personification in individuals’ early voice-hearing experiences. We invited Early Intervention in Psychosis (EIP) service users aged 16–65 to participate in a semistructured interview on AVH phenomenology. Forty voice-hearers (M = 114.13 days in EIP) were recruited through 2 National Health Service trusts in northern England. We used content and thematic analysis to code the interviews and then statistically examined key associations with personification. Some participants had heard voices intermittently for multiple years prior to clinical involvement (M = 74.38 months), although distressing voice onset was typically more recent (median = 12 months). Participants reported a range of negative emotions (predominantly fear, 60%, 24/40, and anxiety, 62.5%, 26/40), visual hallucinations (75%, 30/40), bodily states (65%, 25/40), and “felt presences” (52.5%, 21/40) in relation to voices. Complex personification, reported by a sizeable minority (16/40, 40%), was associated with experiencing voices as conversational (odds ratio [OR] = 2.56) and companionable (OR = 3.19) but not as commanding or trauma-related. Neither age of AVH onset nor time since onset related to personification. Our findings highlight significant personification of AVH even at first clinical presentation. Personified voices appear to be distinguished less by their intrinsic properties, commanding qualities, or connection with trauma than by their affordances for conversation and companionship.
Original languageEnglish
Pages (from-to)228–236
Number of pages9
JournalSchizophrenia Bulletin
Issue number1
Early online date16 Jul 2020
Publication statusPublished - 23 Jan 2021

Bibliographical note

© The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Funding: This research was supported by a Wellcome Trust Collaborative Award (WT108720) awarded to B.A.D., A.W., and C.F.


  • cognitive behavioral therapy
  • early intervention
  • psychopathology
  • schizophrenia
  • social cognition
  • Hallucinations/etiology
  • Psychotic Disorders/complications
  • Humans
  • Middle Aged
  • Speech Perception/physiology
  • Male
  • Schizophrenia/physiopathology
  • Cognitive Behavioral Therapy
  • Social Interaction
  • Early Intervention, Educational
  • Young Adult
  • Adolescent
  • Adult
  • Female
  • Interview, Psychological
  • Qualitative Research


Dive into the research topics of 'Voice-Hearing and Personification: Characterizing Social Qualities of Auditory Verbal Hallucinations in Early Psychosis'. Together they form a unique fingerprint.

Cite this