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Voice-hearing across the continuum: a phenomenology of spiritual voices

Moseley, Peter; Powell, Adam; Woods, Angela; Fernyhough, Charles; Alderson-Day, Ben

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Peter Moseley


Background and Hypothesis: Voice-hearing in clinical and nonclinical groups has previously been compared using standardized assessments of psychotic experiences. Findings from several studies suggest that nonclinical voice-hearing is distinguished by reduced distress and increased control. However, symptom-rating scales developed for clinical populations may be limited in their ability to elucidate subtle aspects of nonclinical voices. Moreover, such experiences often occur within specific contexts and belief systems, such as spiritualism. We investigated similarities and differences in the phenomenology of clinical voice-hearing and nonclinical voice-hearer (NCVH). Study Design: We conducted a comparative interdisciplinary study which administered a semi-structured interview to NCVH individuals (N = 26) and psychosis patients (N = 40). The nonclinical group was recruited from spiritualist communities. We used content analysis and inductive thematic analysis to create a coding frame which was used across both spiritual and patient groups to compare phenomenological features of voice-hearing. Study Results: The findings were consistent with previous results regarding distress and control. Additionally, in the NCVH group, multiple modalities were often integrated into 1 entity, and there were high levels of associated visual imagery, and subtle differences in the location of voices relating to perceptual boundaries. Most NCVHs reported voices before encountering spiritualism, suggesting that their onset was not solely due to deliberate practice. Conclusions: Nonclinical spiritual voice-hearing has important similarities and differences to voices in psychosis. Future research should aim to understand how spiritual voice-hearers cultivate and control voice-hearing after its onset, which may inform interventions for people with psychosis with distressing voices.


Moseley, P., Powell, A., Woods, A., Fernyhough, C., & Alderson-Day, B. (2022). Voice-hearing across the continuum: a phenomenology of spiritual voices. Schizophrenia Bulletin: The Journal of Psychoses and Related Disorders, 48(5), 1066-1074.

Journal Article Type Article
Acceptance Date May 12, 2022
Online Publication Date Jun 23, 2022
Publication Date 2022-09
Deposit Date May 16, 2022
Publicly Available Date Jan 31, 2023
Journal Schizophrenia Bulletin
Print ISSN 0586-7614
Electronic ISSN 1745-1701
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 48
Issue 5
Pages 1066-1074


Published Journal Article (502 Kb)

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Copyright Statement
© The Author(s) 2022. 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 (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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