{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:30:47Z","timestamp":1759883447857,"version":"build-2065373602"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"South-east Network for Social Sciences","award":["ES\/P00072X\/1"],"award-info":[{"award-number":["ES\/P00072X\/1"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Conceptually, there may be some overlap between measures of voice hearing experiences and measures assessing broader outcome domains. Despite this possibility, it is unknown whether measures of voice hearing and broader outcomes are assessing similar or separate concepts. This study aimed to examine whether measures of voice hearing are distinct from measures of emotional states, well-being and recovery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Study 1 examined whether the Hamilton Program for Schizophrenia Voices Questionnaire is distinct from the Depression Anxiety Stress Scale-21 and the Short Warwick-Edinburgh Mental Well-being Scale using secondary data (<jats:italic><jats:italic>n<\/jats:italic><\/jats:italic>\u2009=\u2009401). Study 2 examined whether the Psychotic Symptoms Rating Scale for Auditory Hallucinations is distinct from the Hospital Anxiety Depression Scale and the CHoice of Outcome in Cbt for psychoses short form using baseline data from two randomized controlled trials (<jats:italic><jats:italic>n<\/jats:italic><\/jats:italic>\u2009=\u2009187).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In Study 1, a six-factor model was found to be reasonable and accounted for 54.04% of the total variance (F1: 13%, F2: 11.26%, F3: 8.55%, F4: 4.04%, F5: 7.30%, F6: 9.9%). In Study 2, a five-factor model was identified and accounted for 39.99% of the total variance (F1: 15.52%, F2: 7.47%, F3: 6.53%, F4: 6.70%, F5: 3.78%). Within both studies, the items from the voice hearing measures loaded uniquely onto factors that contained no items from other measures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Findings show that measures of voice hearing are distinct from broad outcome measures and therefore are measuring separate concepts. This confirms the psychometric properties of the voice hearing measures and provides some clarity around outcomes and their measurement.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0333069","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T17:26:01Z","timestamp":1759857961000},"page":"e0333069","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Are measures of voice hearing distinct from measures of emotional states, recovery and well-being? A factor analysis study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3835-7278","authenticated-orcid":true,"given":"Sofia","family":"Loizou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy P.","family":"Field","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Fowler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6567-7723","authenticated-orcid":true,"given":"Mark","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"pone.0333069.ref001","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.schres.2017.12.014","article-title":"A systematic review and discussion of symptom specific cognitive behavioural approaches to delusions and hallucinations","volume":"203","author":"TM Lincoln","year":"2019","journal-title":"Schizophr Res"},{"key":"pone.0333069.ref002","article-title":"Psychological therapies for auditory hallucinations (voices): current status and key directions for future research","author":"N Thomas","year":"2014","journal-title":"Schizophr Bull"},{"key":"pone.0333069.ref003","doi-asserted-by":"crossref","first-page":"102191","DOI":"10.1016\/j.cpr.2022.102191","article-title":"Measuring the longitudinal course of voice hearing under psychological interventions: A systematic review","volume":"97","author":"S Loizou","year":"2022","journal-title":"Clin Psychol Rev"},{"key":"pone.0333069.ref004","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1348\/014466505X29657","article-title":"The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample","volume":"44","author":"JD Henry","year":"2005","journal-title":"Br J Clin Psychol"},{"issue":"6","key":"pone.0333069.ref005","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"AS Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"issue":"1","key":"pone.0333069.ref006","first-page":"73","article-title":"Quantifying self-reports of auditory verbal hallucinations in persons with psychosis","volume":"39","author":"RJ Van Lieshout","year":"2007","journal-title":"Canadian Journal of Behavioural Science \/ Revue canadienne des sciences du comportement"},{"issue":"4","key":"pone.0333069.ref007","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1017\/S0033291799008661","article-title":"Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS)","volume":"29","author":"G Haddock","year":"1999","journal-title":"Psychol Med"},{"issue":"8","key":"pone.0333069.ref008","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1017\/S0033291704002636","article-title":"Interpersonal and role-related schema influence the relationship with the dominant \u201cvoice\u201d in schizophrenia: a comparison of three models","volume":"34","author":"M Birchwood","year":"2004","journal-title":"Psychol Med"},{"issue":"3","key":"pone.0333069.ref009","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s001270200000","article-title":"Determinants of occurrence and recovery from hallucinations in daily life","volume":"37","author":"P Delespaul","year":"2002","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"5","key":"pone.0333069.ref010","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/acps.12080","article-title":"Anxiety and depression in psychosis: a systematic review of associations with positive psychotic symptoms","volume":"128","author":"S Hartley","year":"2013","journal-title":"Acta Psychiatr Scand"},{"issue":"1","key":"pone.0333069.ref011","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1375\/bech.18.1.51","article-title":"An Examination of the Power of the Voices in Predicting the Mental State of People Experiencing Psychosis","volume":"18","author":"S Lucas","year":"2001","journal-title":"Behav change"},{"key":"pone.0333069.ref012","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.schres.2006.06.018","article-title":"Emotion and psychosis: links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations","volume":"86","author":"B Smith","year":"2006","journal-title":"Schizophr Res"},{"issue":"5","key":"pone.0333069.ref013","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1080\/09638239718617","article-title":"Depression, beliefs, voice content and topography: A cross-sectional study of schizophrenic patients with auditory verbal hallucinations","volume":"6","author":"W Soppitt","year":"1997","journal-title":"Journal of Mental Health"},{"issue":"1","key":"pone.0333069.ref014","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1093\/schbul\/sbp117","article-title":"CHoice of Outcome In Cbt for psychosEs (CHOICE): the development of a new service user-led outcome measure of CBT for psychosis","volume":"36","author":"KE Greenwood","year":"2010","journal-title":"Schizophr Bull"},{"issue":"3","key":"pone.0333069.ref015","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1093\/schbul\/sbaa173","article-title":"Exploring the Development, Validity, and Utility of the Short-Form Version of the CHoice of Outcome In Cbt for PsychosEs: A Patient-Reported Outcome Measure of Psychological Recovery","volume":"47","author":"R Webb","year":"2021","journal-title":"Schizophr Bull"},{"issue":"7","key":"pone.0333069.ref016","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1177\/1403494815588862","article-title":"Measuring mental well-being: A validation of the Short Warwick-Edinburgh Mental Well-Being Scale in Norwegian and Swedish","volume":"43","author":"A Haver","year":"2015","journal-title":"Scand J Public Health"},{"issue":"1","key":"pone.0333069.ref017","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s12955-017-0728-3","article-title":"Psychometric properties of the short Warwick Edinburgh mental well-being scale (SWEMWBS) in service users with schizophrenia, depression and anxiety spectrum disorders","volume":"15","author":"JA Vaingankar","year":"2017","journal-title":"Health Qual Life Outcomes"},{"key":"pone.0333069.ref018","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.schres.2020.03.003","article-title":"Construction and validation of the Approve questionnaires - Measures of relating to voices and other people","volume":"220","author":"M Hayward","year":"2020","journal-title":"Schizophr Res"},{"key":"pone.0333069.ref019","volume-title":"Voice impact scale (VIS): Evaluating the psychometric properties of an expert-developed self-report measure for capturing outcomes from psychological therapy for hearing voices","author":"C Strauss","year":"2024"},{"issue":"3","key":"pone.0333069.ref020","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","article-title":"The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories","volume":"33","author":"PF Lovibond","year":"1995","journal-title":"Behav Res Ther"},{"issue":"2","key":"pone.0333069.ref021","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1037\/1040-3590.10.2.176","article-title":"Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample","volume":"10","author":"MM Antony","year":"1998","journal-title":"Psychological Assessment"},{"key":"pone.0333069.ref022","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1477-7525-7-15","article-title":"Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a Rasch analysis using data from the Scottish Health Education Population Survey","volume":"7","author":"S Stewart-Brown","year":"2009","journal-title":"Health Qual Life Outcomes"},{"issue":"1","key":"pone.0333069.ref023","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1186\/s12955-018-1060-2","article-title":"Responsiveness of the Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS): evaluation a clinical sample","volume":"16","author":"N Shah","year":"2018","journal-title":"Health Qual Life Outcomes"},{"key":"pone.0333069.ref024","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. 2022. Available from: https:\/\/www.R-project.org"},{"key":"pone.0333069.ref025","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/BF02289447","article-title":"A rationale and test for the number of factors in factor analysis","volume":"30","author":"JL Horn","year":"1965","journal-title":"Psychometrika"},{"key":"pone.0333069.ref026","volume-title":"The essentials of factor analysis","author":"D Child","year":"1990"},{"key":"pone.0333069.ref027","unstructured":"Revelle W. How to use the psych package for mediation\/moderation\/regression analysis. 2021. Available from: https:\/\/personality-project.org\/r\/tutorials\/HowTo\/mediation.pdf"},{"issue":"2","key":"pone.0333069.ref028","doi-asserted-by":"crossref","DOI":"10.18637\/jss.v048.i02","article-title":"lavaan: AnRPackage for Structural Equation Modeling","volume":"48","author":"Y Rosseel","year":"2012","journal-title":"J Stat Soft"},{"key":"pone.0333069.ref029","volume-title":"Structural Equation Modeling with LISREL, PRELIS and SIMPLIS: Basic Concepts, Applications and Programming","author":"BM Byrne","year":"1998"},{"issue":"1","key":"pone.0333069.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives","volume":"6","author":"L Hu","year":"1999","journal-title":"Structural Equation Modeling: A Multidisciplinary Journal"},{"key":"pone.0333069.ref031","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.schres.2016.04.001","article-title":"Group mindfulness-based intervention for distressing voices: A pragmatic randomised controlled trial","volume":"175","author":"P Chadwick","year":"2016","journal-title":"Schizophr Res"},{"issue":"5","key":"pone.0333069.ref032","doi-asserted-by":"crossref","DOI":"10.1192\/bjo.2021.983","article-title":"Increasing access to cognitive\u2013behavioural therapy for patients with psychosis by evaluating the feasibility of a randomised controlled trial of brief, targeted cognitive\u2013behavioural therapy for distressing voices delivered by assistant psychologists: the GiVE2 trial","volume":"7","author":"M Hayward","year":"2021","journal-title":"BJPsych open"},{"key":"pone.0333069.ref033","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.schres.2006.04.024","article-title":"The Psychotic Symptom Rating Scales (PSYRATS): their usefulness and properties in first episode psychosis","volume":"89","author":"R Drake","year":"2007","journal-title":"Schizophr Res"},{"key":"pone.0333069.ref034","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.cein.2004.12.005","article-title":"Are there gender differences in affective disturbance in schizophrenia?","volume":"8","author":"R Allan","year":"2004","journal-title":"Clinical Effectiveness in Nursing"},{"key":"pone.0333069.ref035","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.schres.2020.12.032","article-title":"Validation of the Hamilton Program for Schizophrenia Voices Questionnaire: Associations with emotional distress and wellbeing, and invariance across diagnosis and sex","volume":"228","author":"C Berry","year":"2021","journal-title":"Schizophr Res"},{"issue":"6","key":"pone.0333069.ref036","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.pnpbp.2010.05.005","article-title":"The usefulness of a self-report questionnaire measuring auditory verbal hallucinations","volume":"34","author":"SH Kim","year":"2010","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"issue":"2","key":"pone.0333069.ref037","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1002\/mpr.203","article-title":"The multidimensional measurement of the positive symptoms of psychosis","volume":"16","author":"C Steel","year":"2007","journal-title":"Int J Methods Psychiatr Res"},{"issue":"3","key":"pone.0333069.ref038","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.psychres.2015.06.014","article-title":"Evaluation of auditory hallucinations in patients with schizophrenia: A validation study of the Malay version of Psychotic Symptom Rating Scales (PSYRATS)","volume":"228","author":"S Wahab","year":"2015","journal-title":"Psychiatry Res"},{"key":"pone.0333069.ref039","article-title":"Symptom dimensions of the psychotic symptom rating scales in psychosis: a multisite study","author":"TS Woodward","year":"2014","journal-title":"Schizophr Bull"},{"key":"pone.0333069.ref040","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/1471-244X-12-161","article-title":"French version validation of the psychotic symptom rating scales (PSYRATS) for outpatients with persistent psychotic symptoms","volume":"12","author":"J Favrod","year":"2012","journal-title":"BMC Psychiatry"},{"issue":"1","key":"pone.0333069.ref041","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.comppsych.2010.04.014","article-title":"Psychometric evaluation of the Psychotic Symptom Rating Scales","volume":"52","author":"K-T Kronm\u00fcller","year":"2011","journal-title":"Compr Psychiatry"},{"key":"pone.0333069.ref042","unstructured":"Albano T. Factor Analysis. In Introduction to Educational and Psychological Measurement Using R. 2010. Available from: https:\/\/www.thetaminusb.com\/intro-measurement-r"},{"issue":"2","key":"pone.0333069.ref043","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1192\/bjp.164.2.190","article-title":"The omnipotence of voices. A cognitive approach to auditory hallucinations","volume":"164","author":"P Chadwick","year":"1994","journal-title":"Br J Psychiatry"},{"issue":"6","key":"pone.0333069.ref044","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1017\/S0033291797005552","article-title":"The omnipotence of voices: testing the validity of a cognitive model","volume":"27","author":"M Birchwood","year":"1997","journal-title":"Psychol Med"},{"issue":"5","key":"pone.0333069.ref045","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jagp.2013.07.001","article-title":"Characteristics of auditory hallucinations and associated factors in older adults with schizophrenia","volume":"22","author":"CI Cohen","year":"2014","journal-title":"Am J Geriatr Psychiatry"},{"issue":"1","key":"pone.0333069.ref046","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1017\/S1352465813000611","article-title":"Hear today, not gone tomorrow? An exploratory longitudinal study of auditory verbal hallucinations (hearing voices)","volume":"42","author":"N Hartigan","year":"2014","journal-title":"Behav Cogn Psychother"},{"key":"pone.0333069.ref047","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.schres.2021.02.013","article-title":"The relationship between appraisals of voices (auditory verbal hallucinations) and distress in voice-hearers with schizophrenia-spectrum diagnoses: A meta-analytic review","volume":"230","author":"A Tsang","year":"2021","journal-title":"Schizophr Res"},{"key":"pone.0333069.ref048","volume-title":"A First Course in Factor Analysis","author":"AL Comrey","year":"1992","edition":"2"},{"issue":"2","key":"pone.0333069.ref049","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1080\/00273170902794206","article-title":"Exploratory Factor Analysis With Small Sample Sizes","volume":"44","author":"JCF de Winter","year":"2009","journal-title":"Multivariate Behav Res"},{"key":"pone.0333069.ref050","volume-title":"Using multivariate statistics","author":"BG Tabachnick","year":"2007","edition":"5"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0333069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T17:26:10Z","timestamp":1759857970000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0333069"}},"subtitle":[],"editor":[{"given":"Hong Wang","family":"Fung","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,7]]},"references-count":50,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0333069","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,7]]}}}