Voices in the Structure of Psychotic Experiences: the Role of Social Anxiety and Metacognitive Strategies

Abstract

The article is devoted to the study of the dynamics of auditory hallucinations in the structure of psychotic experiences, the role of social anxiety and metacognitive strategies (self–focused attention, suppression, rumination) in the genesis and maintenance of psychotic experience. The relevance is dictated by the need to clarify the patterns of psychological mechanisms of voices in the structure of psychotic experiences. The aim of the study was that in addition to determining correlational and regression relationships of psychological variables with psychotic experiences, including voices, we should explicate mediator models of the indirect influence of social anxiety on the genesis of auditory hallucinations in the context of the psychotic experiences phases increasing. Sample: 122 non–clinical and clinical (psychiatric patients) groups. Methods: Psychopathological Symptom Expression Questionnaire; Psychotic Experiences Questionnaire; Social Anxiety and Social Anxiety Disorder Questionnaire; Self–Focused Attention Questionnaire; White Bear Thought Suppression Inventory. Results. As psychotic experiences increase, the direct statistical links of psychotic experience with social anxiety and metacognitive strategies decrease, reaching near-zero values at the height of mental alienation. The predictors of voices include social anxiety, suppression, rumination, self-focused attention, obsessions, and paranoia. The mediator analysis allowed us to determine the role of metacognitive phenomena, obsessions in the modulation of the connection of social anxiety with voices in the structure of the components of psychotic experience. Conclusions. While for more severe psychotic experiences the significant mediator of the link to social anxiety is obsessions, for moderate severity it is suppression, rumination, self–focused attention. Voices are not so much perceptual anomalies as embodiments of interpersonal influences, often with negative content. Reconfiguration of statistical models allows the explication of the indirect effects of the connection between psychotic experiences and social anxiety in the absence of a direct effect.