title: The relationship between dissociation and voices: A systematic literature review and meta-analysis.
abstract: There are an increasing number of studies exploring the association between voice-hearing (auditory verbal hallucinations) and dissociative experiences. The current study provides a systematic literature review and meta-analytic synthesis of quantitative studies investigating the relationship between voice-hearing and dissociation. A systematic search identified and included 19 clinical studies, comprising 1620 participants, and 12 non-clinical studies, comprising 2137 participants, published between 1986 and 2014. Nineteen of these studies provided sufficient data to be included within the meta-analysis. The narrative review findings suggested that dissociative experiences may be implicated in voice-hearing, and may potentially be a mediating factor within the well-established trauma and voice-hearing relationship. Similarly, the meta-analytic findings suggested that the majority of the identified studies showed a significant positive relationship between dissociative experiences and voice-hearing. The magnitude of the summary effect was large and significant (r=.52), indicating a robust relationship between these two phenomena. However, considerable heterogeneity within the meta-analytic results and methodological limitations of the identified studies were evident, highlighting areas for future investigation. As the majority of the studies were cross-sectional by design, we recommended future research to include longitudinal designs with a view to exploring directional effects. Additionally, future studies should control for potential confounding factors. Clinical implications of the findings were also considered.
authors.affiliation: School of Psychological Sciences, The University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK.
authors.forename: Marie
authors.initials: M
authors.lastname: Pilton
authors.affiliation: Spectrum Centre for Mental Health Research, Division of Health Research, Furness Building, Lancaster University, LA1 4YG, UK.
authors.forename: Filippo
authors.initials: F
authors.lastname: Varese
authors.affiliation: School of Psychological Sciences, The University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Berry
authors.affiliation: School of Psychological Sciences, The University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK. Electronic address: sandra.bucci@manchester.ac.uk.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bucci
mesh_terms: D015897:Comorbidity; D004213:Dissociative Disorders / Q000453:epidemiology; D006212:Hallucinations / Q000453:epidemiology; D006801:Humans
keywords: Auditory verbal hallucinations; Dissociation; Voices