Research Article| Volume 44, P114-121, June 2023

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The phenomenology of auditory verbal hallucinations among clients with schizophrenia: The association with acceptance and autonomous action responses


      • Most of patients with schizophrenia have AVH with moderate to severe levels especially emotional characteristics.
      • Patients with schizophrenia respond with low acceptance and autonomous actions toward AVH.
      • A strong negative correlation was found between acceptance and autonomous action responses and phenomenological characteristics of AVH.
      • Acceptance and autonomous action responses must be improved by applying ACT among patients with schizophrenia.



      Living with the experience of hearing voices without trying to ignore or suppress them is referred to as accepting auditory verbal hallucinations (AVH). It varies depending on the phenomenology of AVH itself; some clients may find it challenging to acquire new coping mechanisms with the voices.


      Examine the association between the phenomenology of AVH and acceptance or autonomous action among clients with schizophrenia.


      A descriptive correlational study was conducted on 200 clients with schizophrenia using the following instruments; Sociodemographic and clinical data tools, Psychotic Symptom Rating Scales (PSYRATS-AH), and Voices Acceptance and Action Scale (VAAS).


      Most patients have moderate to severe levels of AVH (95.5 %), with a mean score of 25.34. The emotional characteristics reflected the high mean score (11.24). A highly statistically negative correlation was found between the total Voices Acceptance and Action Scale and severity of AVH (P = −0.448, sig = 0.000). A predictable significant effect of user acceptance and autonomous actions response coping with decreasing the severity of AVH was found (adjusted r square = 0.196, sig = 0.000) and model equation = Severity of Verbal auditory hallucinations = 31.990–0.257 X Total of Voice Acceptance and Autonomous Action Scale (VAAS).


      The severity of all phenomenological characteristics of AVH can be successfully reduced by using voice acceptance and autonomous action responses rather than resistance or engagement responses. Subsequently, it must be improved and learned by psychiatric nurses the patients with schizophrenia in the hospitals by applying Acceptance and Commitment Therapy as a crucial intervention.


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