Developing a codebook for assessing auditory hallucination complexity using mixed methods

IntroductionIn recent years there has been a notable expansion of psychotherapeutic approaches to treat people experiencing auditory verbal hallucinations (AVH). While many psychotherapists conceptualize voices as “dissociative parts” and apply therapeutic techniques derived from the field of dissoc...

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Main Authors: Igor J. Pietkiewicz, Radosław Tomalski, Anna M. Hełka
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1441919/full
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author Igor J. Pietkiewicz
Radosław Tomalski
Anna M. Hełka
author_facet Igor J. Pietkiewicz
Radosław Tomalski
Anna M. Hełka
author_sort Igor J. Pietkiewicz
collection DOAJ
description IntroductionIn recent years there has been a notable expansion of psychotherapeutic approaches to treat people experiencing auditory verbal hallucinations (AVH). While many psychotherapists conceptualize voices as “dissociative parts” and apply therapeutic techniques derived from the field of dissociation, research investigating AVH from this perspective is limited. Despite the acknowledgment that voices encountered in dissociative identity disorder (DID) often exhibit high complexity and autonomy, there is a critical need for assessment tools capable of exploring voice complexity across different clinical groups. Such tools hold significant potential for aiding clinicians to identify patients who may benefit more from dissociation-based therapy approaches. This study aims to operationalize the concept of voice complexity (VC) by identifying its different dimensions and indicators. MethodsUsing concept mapping procedures, 12 healthcare professionals and two voice-hearers participated in brainstorming, and 24 people with clinical backgrounds performed sorting and rating tasks. ResultsSeven dimensions of VC were identified: System Complexity, Content Complexity, Voice’s Interest Complexity, Interaction Complexity with Voice-Hearer, Voice’s Own Life, Voice Influence, and Voice’s Vocal Characteristics. A codebook for assessing VC with indicators for varying levels of complexity across these dimensions was developed and can be used with the Structured Clinical Interview for Voice-Hearers. Inter-rater reliability, measured by comparing the assessments of two interview transcripts by seven raters using Kendall’s Coefficient, indicated substantial agreement in one interview (W = .613) and almost perfect agreement in the second (W = .805). DiscussionThe new instrument has promise as an effective tool for comparative studies exploring VC in diverse clinical and non-clinical populations, with potential implications for clinical practice and future research.
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spelling doaj-art-fafa40f08e214a1bb94745fb5fb5b2de2025-08-20T02:50:27ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-12-011510.3389/fpsyt.2024.14419191441919Developing a codebook for assessing auditory hallucination complexity using mixed methodsIgor J. Pietkiewicz0Radosław Tomalski1Anna M. Hełka2Research Centre for Trauma and Dissociation, Ignatianum University in Cracow, Cracow, PolandResearch Centre for Trauma and Dissociation, Ignatianum University in Cracow, Cracow, PolandInsititute of Psychology, SWPS University, Warsaw, PolandIntroductionIn recent years there has been a notable expansion of psychotherapeutic approaches to treat people experiencing auditory verbal hallucinations (AVH). While many psychotherapists conceptualize voices as “dissociative parts” and apply therapeutic techniques derived from the field of dissociation, research investigating AVH from this perspective is limited. Despite the acknowledgment that voices encountered in dissociative identity disorder (DID) often exhibit high complexity and autonomy, there is a critical need for assessment tools capable of exploring voice complexity across different clinical groups. Such tools hold significant potential for aiding clinicians to identify patients who may benefit more from dissociation-based therapy approaches. This study aims to operationalize the concept of voice complexity (VC) by identifying its different dimensions and indicators. MethodsUsing concept mapping procedures, 12 healthcare professionals and two voice-hearers participated in brainstorming, and 24 people with clinical backgrounds performed sorting and rating tasks. ResultsSeven dimensions of VC were identified: System Complexity, Content Complexity, Voice’s Interest Complexity, Interaction Complexity with Voice-Hearer, Voice’s Own Life, Voice Influence, and Voice’s Vocal Characteristics. A codebook for assessing VC with indicators for varying levels of complexity across these dimensions was developed and can be used with the Structured Clinical Interview for Voice-Hearers. Inter-rater reliability, measured by comparing the assessments of two interview transcripts by seven raters using Kendall’s Coefficient, indicated substantial agreement in one interview (W = .613) and almost perfect agreement in the second (W = .805). DiscussionThe new instrument has promise as an effective tool for comparative studies exploring VC in diverse clinical and non-clinical populations, with potential implications for clinical practice and future research.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1441919/fullconcept mappingmixed methodsinterview for voice-hearersassessmentvoice complexityauditory hallucinations
spellingShingle Igor J. Pietkiewicz
Radosław Tomalski
Anna M. Hełka
Developing a codebook for assessing auditory hallucination complexity using mixed methods
Frontiers in Psychiatry
concept mapping
mixed methods
interview for voice-hearers
assessment
voice complexity
auditory hallucinations
title Developing a codebook for assessing auditory hallucination complexity using mixed methods
title_full Developing a codebook for assessing auditory hallucination complexity using mixed methods
title_fullStr Developing a codebook for assessing auditory hallucination complexity using mixed methods
title_full_unstemmed Developing a codebook for assessing auditory hallucination complexity using mixed methods
title_short Developing a codebook for assessing auditory hallucination complexity using mixed methods
title_sort developing a codebook for assessing auditory hallucination complexity using mixed methods
topic concept mapping
mixed methods
interview for voice-hearers
assessment
voice complexity
auditory hallucinations
url https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1441919/full
work_keys_str_mv AT igorjpietkiewicz developingacodebookforassessingauditoryhallucinationcomplexityusingmixedmethods
AT radosławtomalski developingacodebookforassessingauditoryhallucinationcomplexityusingmixedmethods
AT annamhełka developingacodebookforassessingauditoryhallucinationcomplexityusingmixedmethods