Depression and hearing voices
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Depression and Hearing Voices: Insights from Recent Research
The Interpersonal Nature of Voice-Hearing and Depression
Power and Perceived Expressed Emotion of Voices
Research has shown that the relationship between individuals and the voices they hear can significantly impact their mental health. A study explored how appraisals of voice power and emotional support predict depression and suicidal thoughts. It was found that individuals who rated their voices as high in both power and expressed emotion (EE) experienced significantly higher levels of depression. Conversely, those who perceived their voices as emotionally supportive had the lowest levels of depression and suicidal thinking, highlighting the protective role of supportive voice relationships1.
Coping Defenses and Depression in Adolescents
In adolescents, the way they cope with hearing voices can predict the onset of depression. A study followed 80 adolescents over three years and found that those with higher levels of self-initiated coping defenses, except for active problem-solving, were more likely to develop depression. This suggests that feeling overwhelmed by auditory hallucinations and adopting a defensive coping style can increase the risk of depression2.
Therapeutic Interventions and Their Impact
Group Mindfulness-Based Interventions
Group Person-Based Cognitive Therapy (PBCT), which integrates cognitive therapy and mindfulness, has been shown to reduce depression in individuals distressed by hearing voices. A randomized controlled trial demonstrated that participants who received PBCT reported significantly lower levels of depression post-treatment, with these effects maintained at a six-month follow-up. This suggests that PBCT can effectively address key dimensions of the voice-hearing experience and support lasting mood improvements3.
Resistance to Voices and Depression
Beliefs about and reactions to voices play a crucial role in the course of depression among individuals with schizophrenia. Research indicates that malevolent voices are associated with higher levels of depression, while benevolent voices are linked to more positive emotions. However, resistance strategies, particularly emotional resistance, often backfire and exacerbate depressive symptoms. This highlights the importance of addressing emotional resistance in therapeutic practices to mitigate depression5.
Acoustic Features of Voice and Depression
Vocal Differences in Depressed Individuals
Several studies have investigated the acoustic features of voices in depressed individuals. Significant differences in vocal parameters, such as loudness and mel-frequency cepstrum coefficients (MFCCs), have been consistently observed between depressed and healthy individuals. These acoustic features can serve as potential biomarkers for identifying depression. For instance, the second dimension of MFCC (MFCC 2) has been found to effectively discriminate between depressive patients and healthy controls, suggesting its utility in differential diagnosis4 7 9.
Voice Acoustical Measurement and Depression Severity
Voice acoustical measurements have been shown to correlate with clinical ratings of depression severity. Parameters such as speaking rate, pitch variability, and percent pause time have been linked to Hamilton Depression Rating Scale (HDRS) scores. These findings support the use of voice analysis as a complementary tool in assessing and tracking the severity of depression6.
Conclusion
The relationship between hearing voices and depression is complex and multifaceted. Factors such as the perceived power and emotional support of voices, coping strategies, and acoustic features of voice all play significant roles. Therapeutic interventions like PBCT and addressing emotional resistance to voices can help mitigate depression. Additionally, vocal acoustic features offer promising biomarkers for identifying and assessing depression. Understanding these dynamics is crucial for developing effective treatments and support systems for individuals experiencing auditory hallucinations and depression.
Sources and full results
Most relevant research papers on this topic
Power and perceived expressed emotion of voices: their impact on depression and suicidal thinking in those who hear voices.
High appraisals of voice power and emotional support lead to increased depression, while low appraisals of power and emotional support show the lowest levels of depression and suicidal thinking in those who hear voices.
Observational StudyCoping defence and depression in adolescents hearing voices
Greater levels of self-initiated coping defenses in adolescents experiencing auditory hallucinations are associated with an increased risk of developing depression.
Observational StudyGroup mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial
Group Person-Based Cognitive Therapy (PBCT) effectively reduces voice-related distress, promotes meaningful behavior change, and has lasting effects on mood in people with psychosis.
RCT
Highly CitedAcoustic differences between healthy and depressed people: a cross-situation study
Acoustic differences between depressed and healthy people exist in 12 scenarios, with three features (loudness, MFCC5, and MFCC7) potentially identifying depression through voice analysis.
Observational Study
Very Rigorous JournalHighly Cited[Influence of resistance to voices on depression].
Resistance to auditory hallucinations in schizophrenia patients increases depression, as they perceive malevolent voices as more malevolent and engage with benevolent voices, leading to more positive emotions.
Observational StudyVoice acoustical measurement of the severity of major depression
Voice acoustic analyses can objectively track the severity of Major Depression, providing a powerful complement to standard clinical interviews.
Observational StudyHighly CitedMajor depressive disorder discrimination using vocal acoustic features.
The second dimension of MFCC (MFCC 2) significantly differs between depressive patients and healthy controls, potentially aiding in the detection of major depressive disorder.
Observational Study
Rigorous JournalHighly CitedAcoustic features of voice in adults suffering from depression
Acoustic features of voice, particularly vAm and APQ, are different and discriminant in people with depression compared to healthy controls and those with psychogenic voice disorder.
Depression, beliefs, voice content and topography: A cross-sectional study of schizophrenic patients with auditory verbal hallucinations
Schizophrenic patients with auditory verbal hallucinations are at higher risk for depression and suicidal ideation, and should be screened for these conditions.
Observational Study