Abstract
Background
Despite Auditory Verbal Hallucinations (AVHs) have been long associated with mental illness, they represent a common experience also in the non-clinical population, yet do not exhibit distress or need for care.
Objectives
This paper aims to provide a systematic review of studies that investigated the relationship between auditory hallucinations, shame, and guilt in people without relevant signs of psychiatric issues.
Methods
We searched studies reporting information about voices characteristics, the relationship between voices and hearers, hearer's reactions, and beliefs (1946-2021) and those that explored the differences between “patients” and “non-patients”, paying peculiar attention to shame and guilt issues. Included papers were evaluated for risk of bias.
Results
Eleven studies that explored the relationship between AVHs, shame and guilt, were extracted. Phenomenological, pragmatic, as well as neuropsychological features of hearing voices in non-clinical populations, allowed us to note a dynamic relationship and the constellation of subjective experiences that can occur. The role of guilt was characterized by few studies and mixed results, while shame was mainly common.
Conclusions
Due to the high heterogeneity detected and the scarce sources available, further studies should focus on both the aetiology and the bidirectional relationship between hearing voices, shame, and guilt in non-clinical people. This might favour the development and implication of different treatments considering emotion regulation, distress tolerance and interpersonal sensitivity on the other people.