No abstract

Voluntary control over voice-hearing experiences is one of the most consistent predictors of functioning among voice-hearers. However, control over voice-hearing experiences is likely to be more nuanced and variable than may be appreciated through coarse clinician-rated measures, which provide little information about how control is conceptualized and developed. We aimed to identify key factors in the evolution of control over voice-hearing experiences in treatment-seeking (N=7) and non-treatment-seeking (N=8) voice-hearers. Treatment-seeking voice-hearers were drawn from local chapters of the Connecticut Hearing Voices Network, and non-treatment-seeking voice-hearers were recruited from local spiritually oriented organizations. Both groups participated in a clinical assessment, and a semi-structured interview meant to explore the types of control exhibited and how it is fostered. Using Grounded Theory, we identified that participants from both groups exerted direct and indirect control over their voice-hearing experiences. Participants that developed a spiritual explanatory framework were more likely to exert direct control over the voice-hearing experiences than those that developed a pathologizing framework. Importantly, despite clear differences in explanatory framework and distress because of their experiences, both groups underwent similar trajectories to develop control and acceptance over their voice-hearing experiences. Understanding these factors will be critical in transforming control over voice-hearing experiences from a phenomenological observation to an actionable route for clinical intervention.

Behavioral and epidemiological investigators have moved toward gathering online data in recent months. The number of PubMed search hits for online data collection has exploded in 2021 compared with the yearly number of search hits for the decade preceding the COVID-19 pandemic. Online data collection opens up great opportunities to inexpensively gather large amounts of data in short periods of time. However, it also leaves researchers susceptible to malingering and fraud, which have been shown to be common in some settings. 1 Psychiatric research may be especially susceptible to fraud and poor data quality in these settings because of its reliance on behavior and subjective reports of symptomatology. Here, we offer a perspective on strategies to maximize the benefits of online data collection while minimizing attendant risks.Without geographic limitations, researchers are able to avail themselves of a pool of participants potentially located far away from research hubs, strengthening representation of rural groups, preventing potential generalizability problems that come with repeated participation of small groups of individuals, and enhancing a greater understanding of experiences across racial and ethnic backgrounds and differences in care across these groups. Online data collection can also be far less taxing on resources than in-person data collection. Adequate recruitment and data collection from large samples can take many years. When collecting online data, the tasks of scheduling and meeting with participants are moot, and participants can perform research-related tasks at any time of day with little to no assistance from investigators, freeing staff to focus on other tasks.Despite its conveniences, however, online data collection is not without risks. Data collection without appropriate safeguards can lead to poor or unknown data quality. Fortunately, simple, low-cost strategies for data quality control can significantly mitigate this risk.Risk mitigation starts with recruitment. Online platforms can certainly attract attention to a study, but also allow access by individuals who may offer inaccurate information to either maximize the likelihood of meeting inclusion criteria or minimize the time expended on studies because their primary motivation may be financial compensation. Engaging existing networks may offer a safer alternative, particularly if those networks offer clinical support, social support, or other specialized services; in essence, the more specialized the group, the less likely it will have been discovered by individuals outside of the target population who might be driven to feign group membership and accompanying symptoms. Anecdotally, our recent study showed a marked uptick in numbers of fraudulent or repeated participation on broad engagement with social media, whereas