A significant proportion of healthy individuals experience psychosis-like symptoms such as voice-hearing at some point in their lives usually AVHs present as transient experiences, for example during childhood and adolescence, periods of bereavement or in the form of hypnagogic or hypnopompic false auditory perceptions ( de Leede-Smith & Barkus, 2013). There is accumulating evidence that the experience of auditory verbal hallucinations (AVHs) is not uncommon in healthy individuals, and is not necessarily an indicator of psychopathology. Healthy voice-hearers may be a key resource in informing transdiagnostic approaches to research of auditory hallucinations. ![]() Overall the results of the present systematic review support a continuum view rather than a diagnostic model, but cannot distinguish between ‘quasi’ and ‘fully’ dimensional models. Risk factors such as familial and childhood trauma appear similar between clinical and non-clinical voice-hearers. ![]() Whilst healthy voice-hearers show similar brain activity during hallucinatory experiences to clinical voice-hearers, other neuroimaging measures, such as mismatch negativity, have been inconclusive. Transition to mental health difficulties is increased in HVHs, yet only occurs in a minority and is predicted by previous mood problems and voice distress. Cognitive biases, reduced global functioning, and psychiatric symptoms such as delusions, appear more prevalent in healthy voice-hearers than in healthy controls, yet less than in clinical samples. Groups differ significantly in beliefs about voices, control over voices, voice-related distress, and affective difficulties. Subjective perceptual experience of voices, such as loudness or location (i.e., inside/outside head), is similar in clinical and non-clinical groups, although clinical voice-hearers have more frequent voices, more negative voice content, and an older age of onset. Seventy articles were identified for full-text analysis, of which 36 met criteria for inclusion. A systematic literature search was conducted, resulting in a total of 398 article titles and abstracts that were scrutinised for appropriateness to the present objective. The aims of the present systematic review are to provide a comprehensive overview of this research and examine how healthy voice-hearers may best be conceptualised in relation to the diagnostic versus ‘quasi-‘ and ‘fully-dimensional’ continuum models of psychosis. ![]() Recent decades have seen a surge of research interest in the phenomenon of healthy individuals who experience auditory verbal hallucinations, yet do not exhibit distress or need for care.
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