Voice hallucinations in deaf people with schizophrenia

This project explored the perceptual characteristics of voice hallucinations in deaf people with schizophrenia. Data was collected from 27 deaf people with a medical diagnosis of schizophrenia using an adapted Q-sort factor analysis methodology. Perceptual characteristics mapped onto experience of audition (age became deaf and degree of hearing loss). Congenitally, profoundly deaf people never 'heard' voices but perceived subvisual percepts of sign language articulations or the lip movements of seen speech.


These pictorial cards were developed as part of research exploring the nature of voice hallucinations in d/Deaf people.
Card 1
Card 2
Card 3
Card 4
Card 5

A card-sorting task was used. The methodology and findings are documented in this paper:

Atkinson, J.R., Gleeson, K., Cromwell, J. O'Rourke, S. (2007). Exploring the Perceptual Characteristics of Voice-Hallucinations in Deaf People. Cognitive Neuropsychiatry, 12(4), 339-361. (click here to download the pdf version)

The cards may be a useful resource for clinicians assessing or conducting therapy for d/Deaf people with experience of voice hallucinations and other hallucinatory phenomena. Please feel free to use these cards for this purpose. Please note that the copyright remains with the first author. Any mention of the cards in publications should reference Atkinson et al., 2007. If you wish to use the cards for research purposes, please contact me on joanna.atkinson@ucl.ac.uk.

The cards may be helpful in facilitating communication where there is a difficulty establishing whether the person has current or past experience of voice hallucinations. it is suggested that a highly fluent signer signs each statement and hands the person the card. For each card they decide whether or not they have ever experienced this phenomenon (YOU BEEN? YES? OR NO?). The cards are then sorted into YES, NO, and DON'T KNOW piles which should have clearly written labels. The person can change their mind and reclassify any card at any time. In my experience, a person will typically answer NO or DON'T KNOW if they don't understand the statement or if it is outside the realm of their own experience. Where they recognise the statement as relating to their own experience, they typically put the card in the YES pile and often provide spontaneous elaboration.
The YES pile can then be sorted into further piles for different probe questions relating to frequency, severity, distress experienced and so on, depending on what information the clinician wishes to elicit. The cards can also be used to evaluate treatment outcomes.

Feedback from our participants suggests that the majority enjoyed the task. Some said that they derived a sense of empathy from the cards as they felt they depicted their own experiences and showed that other d/Deaf people have hallucinations, too. The cards may, therefore, be helpful during therapy sessions as talking points.

Currently research is planned to replicate this study with hearing participants to enable a comparison between deaf and hearing voice-hearers. We expect to find more diversity in the phenomena reported by hearing people with voice hallucinations than currently documented in the literature.