BACKGROUND Around two-thirds of patients with auditory hallucinations experience derogatory and threatening voices (DTVs). Understandably, when these voices are believed then common consequences can be depression, anxiety and suicidal ideation. There is a need for treatment targeted at promoting distance from such voice content. The first step in this treatment development is to understand why patients listen to and believe voices that are appraised as malevolent. AIMS To learn from patients their reasons for listening to and believing DTVs. METHOD Theoretical sampling was used to recruit 15 participants with non-affective psychosis from NHS services who heard daily DTVs. Data were obtained by semi-structured interviews and analysed using grounded theory. RESULTS Six higher-order categories for why patients listen and/or believe voices were theorised. These were: (i) to understand the voices (e.g. what is their motive?); (ii) to be alert to the threat (e.g. prepared for what might happen); (iii) a normal instinct to rely on sensory information; (iv) the voices can be of people they know; (v) the DTVs use strategies (e.g. repetition) to capture attention; and (vi) patients feel so worn down it is hard to resist the voice experience (e.g. too mentally defeated to dismiss comments). In total, 21 reasons were identified, with all participants endorsing multiple reasons. CONCLUSIONS The study generated a wide range of reasons why patients listen to and believe DTVs. Awareness of these reasons can help clinicians understand the patient experience and also identify targets in psychological intervention.

中文翻译：

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为什么精神病患者会倾听并相信贬损和威胁的声音？患者给出的21个理由

背景 大约三分之二的幻听患者会听到贬义和威胁的声音 (DTV)。可以理解的是，当这些声音被相信时，常见的后果可能是抑郁、焦虑和自杀意念。需要针对提高与此类语音内容的距离的处理。这种治疗开发的第一步是了解为什么患者会倾听并相信被评价为恶意的声音。目的 向患者了解他们收听和相信数字电视的原因。方法 理论抽样用于从 NHS 服务中招募 15 名每天收听 DTV 的非情感性精神病患者。数据通过半结构化访谈获得，并使用扎根理论进行分析。结果 关于为什么患者倾听和/或相信声音的六个高阶类别被理论化。它们是：(i) 理解这些声音（例如他们的动机是什么？）；(ii) 对威胁保持警惕（例如为可能发生的事情做好准备）；(iii) 依赖感官信息的正常本能；(iv) 声音可以来自他们认识的人；(v) DTV 使用策略（例如重复）来吸引注意力；(vi) 患者感到非常疲惫以至于难以抗拒语音体验（例如，精神上的挫败以至于无法拒绝评论）。总共确定了 21 个原因，所有参与者都支持多个原因。结论 该研究产生了患者收听和相信数字电视的广泛原因。意识到这些原因可以帮助临床医生了解患者的体验，并确定心理干预的目标。