Voice-Hearing in the General Population: The Relationship Between Inner Speech, Absorption, and Voice-Like Hallucinations

Background and Hypothesis Inner speech models have been influential in explaining why some people hear voices in both general and clinical populations. To explore this, scholars developed a scale which linked inner speech to hallucination proneness in the general population. We predicted that we could replicate this finding across cultures, but that absorption would also be a significant predictor, with inner speech mediating absorption’s effect on voice hearing—providing an alternative conception of the inner speech model. Design We investigated the relationship between inner speech, absorption, and voice hearing in two studies. In Study 1, surveys were administered to undergraduates across five countries (total N = 825, N = 217 completing both the Varieties of Inner Speech Questionnaire and Tellegen Absorption scales). In Study 2, surveys were administered to online participants in the USA (N = 1000). Results We found that both inner speech and absorption predicted voice hearing in Studies 1 and 2. Study 2 suggested that absorption and inner speech have a complex relationship with one another, one best described by a model of moderated mediation. Conclusions We argue that absorption, which we characterize as an attitude toward the mind, may be an important, causally antecedent factor to inner speech in generating voice-like experiences in the general population. We believe this better captures the expansive range of phenomenological experiences represented in voice hearing. Perhaps a voice is less like a misattributed thought and more like a very vivid thought which, because it is felt as vivid, is experienced as sensory.