Listening to and believing nasty voices questionnaires

The scales are suitable for: Any person who hears voices that make threats or are
critical/derogatory towards them. We refer to these as nasty voices. The scales have
been validated with data from a participant group who hear nasty voices and have a
range of different mental health diagnoses.

Individuals with lived experience of hearing nasty voices collaborated on the design and
testing of the scales.

The psychometric properties of the scales are available in the following paper:

Sheaves, B., Johns, L., Loe, B., Bold, E., Černis, E., The McPin Hearing Voices Lived Experience Advisory
Panel, Molodynski, A., & Freeman, D. (2022). Listening to and Believing Derogatory and Threatening
Voices. Schizophrenia Bulletin, https://doi.org/10.1093/schbul/sbac101

Scoring instructions:

Listening and believing - assessment

The listening and believing assessment scale includes four sub-scales: active listening,
passive listening, believing and disregarding derogatory and threatening (‘nasty’)
voices. Items making up each of these four sub-scales can be totalled to make for
example a total ‘believing’ score. The active listening, passive listening and
disregarding questions (the first 12 items) can also be summed to create a total
‘listening and believing score’. Here, higher scores indicate a more severe problem with
listening to and believing derogatory and threatening voices. The disregarding sub-
scale is the reverse, whereby higher scores indicate a greater ability to disregard or tune
out the nasty voices, and lower scores indicate a more severe problem.

Listening and believing – reasons

There are three different versions of this questionnaire:

1. The full questionnaire (28 items) is recommended for a comprehensive clinical

assessment of the reasons for listening to and believing nasty voices. It can be
used to assess individual groups of reasons for listening and believing (e.g.
listening to understand the nasty voices; I listen because I’m too worn down
etc). The total score of individual sub-scales can be used (listening to
understand; being too worn down, etc). Additionally, all items can be summed
to create a total reasons for listening and believing score.
2. The short form scale (16 items) is comprised of items that are the most
predictive items for listening to and believing. These 16 items can be summed
to create a total listening and believing - reasons (short form) score.

1
 3. The very brief version (5 items) comprises the top five most predictive items for
listening to and believing nasty voices, across five different sub-scales. This is
designed for a ‘light touch’ assessment of the reasons for listening and
believing. The five items can be summed to create a total score.

Contents

Listening to and believing nasty voices – assessment scale 3

Listening to and believing nasty voices – reasons: 28 item full version 6
Listening to and believing nasty voices – reasons: 16 item short-form version 12
Listening to and believing nasty voices – reasons: 5-item very brief version 15

2
Listening and believing - Assessment

Name _________________________________________
Date ________________________

Below are a range of statements about listening to and believing nasty voices.
These are any voices which threaten you or put you down. Please do not consider
positive voices, or neutral voices when completing this questionnaire, only those
that are threatening or put you down.
Please rate the degree to which you agree with each statement, based on your
experience over the past week.

ACTIVELY LISTENING TO NASTY VOICES

A bit Most
Never of the of the All the
time time time

1 I want to keep listening to what the nasty 0 1 2 3

voices have to say.

2 I want to hear what the nasty voices are 0 1 2 3

saying when they start.

3 I listen hard to the nasty voices to make 0 1 2 3

sure I’ve heard what they are saying.

4 I listen out for the nasty voices. 0 1 2 3

3
 PASSIVELY LISTENING TO NASTY VOICES

A bit Most
Never of the of the All the
time time time

5 There’s nothing I can do but listen to what 0 1 2 3

the nasty voices say.

6 When the nasty voices start it’s almost 0 1 2 3

impossible to ignore what they say.

7 I take in every word the nasty voices say. 0 1 2 3

8 I get sucked into the world of the nasty

0 1 2 3
voices.

BELIEVING NASTY VOICES

A bit Most
Never of the of the All the
time time time
0 1 2 3
9 I believe what the nasty voices say.

10 I have a gut feeling that what the nasty 0 1 2 3

voices are saying is true.

11 The nasty voices are right in what they 0 1 2 3

say.

12 I’m convinced what the nasty voices say is 0 1 2 3

true.

4
 DISREGARDING NASTY VOICES

A bit Most
Never of the of the All the
time time time

13 When the nasty voices start, I find a way 0 1 2 3

to ignore them.
0 1 2 3
14 I tune out the nasty voices.

15 I avoid getting sucked into the world of 0 1 2 3

the nasty voices.
0 1 2 3
16 I just don’t care what the nasty voices say.

17 What the nasty voices say doesn’t matter 0 1 2 3

to me.

18 I can brush off all the negative things that

0 1 2 3
the nasty voices say.

5
Listening and believing – Reasons (L&B-R-28)

Name _________________________________________
Date ________________________

Below are a range of statements about why people listen to and believe nasty
voices (voices which threaten you or put you down). Please do not consider
positive voices, or neutral voices when completing this questionnaire, only those
that are threatening or put you down.
Please rate the extent to which each statement describes your experience of
hearing these voices over the past week.

LISTENING TO UNDERSTAND THEM, TO DEAL WITH THE THREAT

Some
Not A bit what Mostly Totally
true true true true true
for me for me for me for me for me

I pay attention to what the nasty voices

say because…

1 I’m trying to figure out why this is

0 1 2 3 4
happening.

2 It might help me work out who the

0 1 2 3 4
voices are.

3 It might help me work out what

0 1 2 3 4
they could do to me.

4 I want to be ready to deal with

0 1 2 3 4
them.

I don’t want to let them win, so I

5 listen to fight them. 0 1 2 3 4

6
 I LISTEN BECAUSE I’M WORN DOWN

Some
Not A bit what Mostly Totally
true true true true true
for me for me for me for me for me

I pay attention to what the nasty voices

say because…

6 I don’t have the confidence to

0 1 2 3 4
ignore the nasty voices.

7 I don’t have the confidence to

0 1 2 3 4
trust my own mind.

8 They’ve worn me down, so I have

0 1 2 3 4
to listen.

9 I feel defeated by them. 0 1 2 3 4

10 I’m so anxious that I can’t do 0 1 2 3 4

anything but listen.

11 I don’t have the energy to do 0 1 2 3 4

anything but listen to them.

7
 I LISTEN TO THE NASTY VOICES BECAUSE I MIGHT LEARN SOMETHING HELPFUL

Some
Not A bit what Mostly Totally
true true true true true
for me for me for me for me for me

I pay attention to what the nasty voices

say because…

12 Listening to the voice will help me

0 1 2 3 4
to learn about myself.

13 The voice knows more than I do

0 1 2 3 4
so I might learn something.

14 Listening will make me smart,

0 1 2 3 4
because the voices are smart.

15 Listening to voices is important to

0 1 2 3 4
my spiritual or cultural beliefs.

8
 I SPEND TIME BY MYSELF SO I HAVE TIME AND SPACE TO LISTEN

Not A bit Some Mostly Totally

true true what true true
for me for me true for me for me
for me

I pay attention to what the nasty voices

say because…

16 I spend time by myself so there’s

0 1 2 3 4
nothing else to listen to.

I spend time by myself so there are

17 0 1 2 3 4
no distractions from what they say.

I spend time by myself so I have

18 0 1 2 3 4
time to listen to them.

9
 THE NASTY VOICES USE STRATEGIES TO CAPTURE MY ATTENTION

Not A bit Some Mostly Totally

true true what true true
for me for me true for me for me
for me

I pay attention to what the nasty voices

say because…

19 They are putting on a

0 1 2 3 4
performance for me.

20 They are whispering (or very

quiet) so I have to listen harder to 0 1 2 3 4
hear what they are saying.

21 They lull me into a false sense of

security by saying nice things, so I
0 1 2 3 4
start to trust them and listen to
what they say.

22 They’re intelligent and trick me 0 1 2 3 4

into listening.

23 They tell a convincing story that 0 1 2 3 4

sucks you in to their world.

10
 THEY ARE JUST LIKE REAL PEOPLE

Not A bit Some Mostly Totally

true true what true true
for me for me true for me for me
for me

I pay attention to what the nasty voices

say because…

24 They are just like real people. 0 1 2 3 4

25 They sound so real. 0 1 2 3 4

26 They’re unpredictable and come

0 1 2 3 4
out of no-where.

I HEAR THE VOICE OF SOMEONE I KNOW

Not A bit Some Mostly Totally

true true what true true
for me for me true for me for me
for me

I pay attention to what the nasty voices

say because…

27 I hear the voice of someone I

know, and I want to work out why 0 1 2 3 4
they are saying horrible things
when they are usually nice.

28 I hear the voice of someone I

know, and I usually believe that 0 1 2 3 4
person so I’m more likely to be
convinced by what they say.

11
Listening and believing – Reasons (L&B-R-16)

Name _________________________________________
Date ________________________
Below are a range of statements about why people listen and believe nasty voices
(voices which threaten you, or put you down). It’s important that you do not
consider positive voices, or neutral voices when completing this questionnaire,
only those that are threatening or put you down.
Please rate the extent to which each statement describes your experience of
hearing these voices over the past week.

Not A bit Somewhat Mostly Totally

true for true for true for me true for true for
me me me me

I pay attention to what the

nasty voices say because...

1 It might help me
0 1 2 3 4
work out who the
voices are.

2 I spend time by
myself so I have 0 1 2 3 4
time to listen to
them.
0 1 2 3 4
3 They sound so real.

4 I don’t have the

confidence to 0 1 2 3 4
ignore the nasty
voices.

5 They tell a
convincing story 0 1 2 3 4
that sucks you in to
their world.

12
 Not A bit Somewhat Mostly Totally
true for true for true for me true for true for
me me me me

6 I’m trying to figure

0 1 2 3 4
out why this is
happening.

7 I’m so anxious that I

0 1 2 3 4
can’t do anything
but listen.
8
It might help me
0 1 2 3 4
work out what they
could do to me.

9 They’ve worn me
0 1 2 3 4
down, so I have to
listen.

10 I don’t have the

0 1 2 3 4
confidence to trust
my own mind.

11 Listening to the
voice will help me 0 1 2 3 4
to learn about
myself.

12 They are just like 0 1 2 3 4

real people.

13 They are whispering

(or very quiet) so I
0 1 2 3 4
have to listen harder
to hear what they
are saying.

14 The voice knows

more than I do so I 0 1 2 3 4
might learn
something.

13
 Not A bit Somewhat Mostly Totally
true for true for true for me true for true for
me me me me

15 I spend time by
myself so there’s 0 1 2 3 4
nothing else to
listen to.

16 I feel defeated by 0 1 2 3 4
them.

14
Listening and believing – Reasons (L&B-R-5)

Name _________________________________________
Date ________________________

Below are a range of statements about why people listen and believe nasty voices
(voices which threaten you, or put you down). It’s important that you do not
consider positive voices, or neutral voices when completing this questionnaire,
only those that are threatening or put you down.
Please rate the extent to which each statement describes your experience of
hearing these voices over the past week.

Not true A bit Somewhat Mostly Totally

for me true for true for true for true for
me me me me

I pay attention to what the

nasty voices say because...

I’m so anxious that I

0 1 2 3 4
can’t do anything but
listen.

I’m trying to figure out 0 1 2 3 4

why this is happening.
0 1 2 3 4
They sound so real.

The voice knows more

0 1 2 3 4
than I do so I might
learn something.

They tell a convincing

0 1 2 3 4
story that sucks you in
to their world.

15