A linguistic approach to the psychosis continuum : (dis)similarities and (dis)continuities in how clinical and non-clinical voice-hearers talk about their voices

Collins, Luke and Semino, Elena and Demjén, Zsófia and Hardie, Andrew and Moseley, Peter and Woods, Angela and Alderson-Day, Ben (2020) A linguistic approach to the psychosis continuum : (dis)similarities and (dis)continuities in how clinical and non-clinical voice-hearers talk about their voices. Cognitive Neuropsychiatry, 25 (6). pp. 447-465. ISSN 1354-6805

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Abstract

Introduction: 'Continuum' approaches to psychosis have generated reports of similarities and differences in voice-hearing in clinical and non-clinical populations. Previous research has reported similarities/differences at the cohort level, but not typically examined overlap or degrees of difference between groups.Methods: We used a computer-aided linguistic approach to explore the language used to describe voice-hearing by a clinical group (Early Intervention in Psychosis service-users; N=40) and a non-clinical group (spiritualists; N=27). We identify semantic categories of terms statistically overused by one group compared with the other, and by each group compared to a control sample of non-voice-hearing interview data (log likelihood (LL) value 6.63+=p<.01; effect size measure: log ratio 1.0+). We examined relative frequencies of these terms at the individual level to consider if the dispersion of terms supports a continuum model.Results: Notwithstanding significant cohort-level differences, there were varying degrees of overlap between the groups and considerable continuity in language use. Reports of negative affect were prominent in both groups (p<.01, log ratio:1.12+). Challenges of cognitive control were also evident in both cohorts, with references to 'disengagement' accentuated in service-users (p<.01, log ratio:1.14+).Conclusion: A corpus linguistic approach to voice-hearing provides new evidence of differences between clinical and non-clinical groups. By considering variability at the individual level, we provide substantial evidence of continuity with implications for cognitive mechanisms underlying voice-hearing.