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. 2022 May:243:225-231.
doi: 10.1016/j.schres.2019.07.019. Epub 2019 Aug 1.

The effects of voice content on stress reactivity: A simulation paradigm of auditory verbal hallucinations

David Baumeister  1 , Emmanuelle Peters  2 , Jens Pruessner  3 , Oliver Howes  4 , Paul Chadwick  5
Affiliations

The effects of voice content on stress reactivity: A simulation paradigm of auditory verbal hallucinations

David Baumeister et al. Schizophr Res. 2022 May.

Abstract

Objectives: Psychosis is associated with increased subjective and altered endocrine and autonomic nervous system stress-reactivity. Psychosis patients often experience auditory verbal hallucinations, with negative voice content being particularly associated with distress. The present study developed a voice-simulation paradigm and investigated the effect of simulated voices with neutral and negative content on psychophysiological stress-reactivity, and the effect of mindful voice-appraisals on stress-reactivity.

Method: Eighty-four healthy participants completed the Montreal Imaging Stress Task with simultaneous presentation of one of three randomly allocated auditory stimuli conditions: negative voices, neutral voices or non-voice ambient sounds. Subjective stress-levels and mindful voice-appraisals were assessed using questionnaire measures, and cortisol and α-amylase levels were measured using saliva samples.

Results: ANOVA revealed a significant effect of condition on subjective stress-levels (p = .002), but not cortisol (p = .63) or α-amylase (p = .73). Post-hoc analyses showed that negative voices increased subjective stress-levels relative to neutral voices (p = .002) and ambient sounds (p = .01), which did not differ from each other (p = .41). Mindful voice-appraisals were associated with less distress across conditions (p = .003), although negative voices were also associated with less mindful appraisals (p < .001).

Conclusions: Negative voice content, rather than voices or auditory stimuli per se, is linked to greater subjective but not physiological stress-reactivity. Mindful appraisals may partially moderate this effect. These findings highlight the importance of voice content for the impact of voice-hearing, and highlight the potential value of mindfulness training to treat voice distress in psychosis.

Keywords: Auditory hallucinations; HPA axis; Psychosis; Stress.

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Figures

Fig. 1
Fig. 1
Flow diagram of experimental procedures; time between 1st and 2nd, and 2nd and 3rd VAS = 10 min, time between subsequent VAS = 15 min (MIST: Montreal Imaging Stress Scale. SMQ: Southampton Mindfulness Questionnaire; VAS: Visual Analogue Scale).
Fig. 2
Fig. 2
VAS scores by group by timepoint (mean ± SE).
Fig. 3
Fig. 3
Delta scores from pre- to post-MIST for overall and individual VAS item scores by individual.
Fig. 4
Fig. 4
Cortisol by group by timepoint (mean ± SE).
Fig. 5
Fig. 5
α-Amylase by group by timepoint (mean ± SE).
Fig. 6
Fig. 6
Scatterplot of Delta VAS scores and SMQ scores with correlation line.
See this image and copyright information in PMC

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