The associations of stress, pleasure and emotion to voice-hearing: An ecological momentary assessment study.

Abstract

Background: Negative emotions and stress are theorised to play a role in the onset and maintenance of voice-hearing experiences. However, previous research has not explored these temporal relationships in daily life using differentiated psychological constructs.

Aim: Using ecological momentary assessment, this study examined the moment-to-moment relationships between negative and positive emotion valence and intensity, stressful and pleasurable events, and voice-hearing onset.

Materials & methods: Forty voice-hearers completed seven days of smartphone-based surveys, rating their emotions and their intensity, perceived stress and pleasure of life events, and presence of voice-hearing.

Results: Multilevel modelling showed that stressful events, but not pleasurable events, were significantly predictive of voice-hearing, both concurrently and in the next time point. Neither negative nor positive emotion intensity predicted voice-hearing, nor did they moderate the relationship between voice-hearing onset and stressful or pleasurable events, respectively.

Discussion: These findings suggest that factors which differentiate perception of stressful events from self-reported negative emotions may be useful intervention targets, such as mitigating prolonged external stressors, reducing sensitivity to external stressors and targeting negative perceptions or resistance to these stressors.

Conclusion: Clinically, our findings underscore the relevance of stress and a negative perception of externally oriented events, with further research needed to explore useful interventions for targeting these mechanisms.