The cognitive behavioural model of voice hearing states that it is not the occurence of voices per se that causes distress but the beliefs people hold about them that produce negative behavioural and emotional consequences. Whether voices are seen as malevolent or benevolent, powerful or benign is influenced - according to this theory - by core beliefs that are in turn influenced by people's life history. A Welsh study of 43 voice hearers compared those with predominantly positive beliefs about their voices to those with predominantly negative beliefs. Both groups had had a high prevalence of traumatic life events but those with negative beliefs about their voices were more likely to be experiencing a form of post-traumatic stress disorder (PTSD) and were more likely to have experienced childhood sexual abuse. Current trauma symptoms (re-experience, avoidance and hyper-arousal) were found to be a significant predictor of beliefs about voices and also accounted for a significant proportion of the variance in anxiety and depression.
Andrew, E.M., Gray, N.S. and Snowden, R.J. - The relationship between trauma and beliefs about hearing voices: a study of psychiatric and non-psychiatric voice hearers Psychological Medicine October 2008, 38(10), 1409-1417