Psychological models in adults have indicated several factors that might play a role in maintaining the distress associated with hearing voices, including negative inter-relating between the hearer and the voices and persecutory beliefs about the voices. Additionally, negative relating with voices can be mirrored in the difficult relationships that hearers have with social others. By contrast, little is known about distressing voice-hearing in young people and its possible links with social relating. This project focused on young people’s experiences of voice-hearing and aimed to provide preliminary evidence on the factors that contribute to voice-related distress and the association between voice-hearing and young people’s social relating. The design involved a cross-sectional survey study of adolescents with distressing voice-hearing (N=34) which tested hypotheses deriving from cognitive-behavioural models of voice-related distress developed with adults. It included comparing this group with a clinical group of young people without voice-hearing experiences (N= 34)to investigate how social relating may differ for young voice-hearers, all receiving care from secondary mental health services (Chapter 3). The project revealed a potential role for styles of relating to voices and beliefs about voices in maintaining distress. Although relating to voices did not mirror the way young voice-hearers related to social others, their overall relating style was more negative compared to non-voice-hearing peers.Doctoral Training Partnerships: a range of postgraduate training is funded by the Research Councils. For information on current funding routes, see the common terminology at https://www.ukri.org/apply-for-funding/how-we-fund-studentships/. Training grants may be to one organisation or to a consortia of research organisations. This portal will show the lead organisation only.

The data collection method used was face-to-face research assessments using questionnaires and semi structured interview tools. Participant eligibility criteria All participants for this project were recruited from Children and Adolescent Mental Health Services (CAMHS) and Early Intervention in Psychosis services (EIP) within a NHS Foundation Trust and they were between 14-18 years of age. Two groups of young people were recruited; one with current voice-hearing experiences and one without. To belong to the voice-hearing group, participants should have been experiencing voice-hearing that is not attributed to an organic illness, acute intoxication, solely to drug use or solely after waking up/before falling asleep (hypnagogic/ hypnopompic). The comparison clinical group consisted of young people receiving care from the same services, CAMHS and EIP and were not experiencing voice-hearing. There was no restriction in diagnostic criteria for either of the groups. Recruitment strategy Recruitment took place via referrals from clinical teams or via parental or self-referrals. Strategies for recruitment included advertising the study to from Children and Adolescent Mental Health Services (CAMHS) and Early Intervention in Psychosis services (EIP) within a NHS Foundation Trust with emails, posters, leaflets. For clinician referrals, mental health professionals in CAMHS and EIP services (e.g., care coordinators) were asked to inform service users about the study and refer them following the young person’s verbal consent. For those under 16 years of age, parental verbal consent was also needed and communication with a person with parental responsibility was necessary, as they needed to provide their informed written consent for the young person to take part. All referred young people were given a Participant Information Sheet and a Parental Responsibility Information sheet. Following a minimum of 24 hours to process the information, the principal investigator contacted the participants and/or the person with parental responsibility to answer any questions and arrange the first research meeting, after ensuring eligibility to take part. The research assessment took an average of approximately 5 hours and 40 minutes. To ensure young people felt comfortable, the research assessment was spread over two or more sessions depending on participant’s preference and needs. Participants were also offered the option to bring a trusted friend or a family member during the research assessment. Breaks were incorporated into the assessment sessions and participants were reminded they can stop or pause whenever they wish. During the session, snacks and refreshments were offered to the participants. To remove practical barriers relating to travelling, a few options were offered regarding the assessment location. The researcher could meet the young person at their place of residence, at their college, at their closest NHS service, at their GP surgery or at the University that sponsored the project. Although most of the research assessments took part during normal working hours (9am - 5pm), when this was not possible due to the young person’s schedule, evenings and weekends were offered for research appointments.