Smartphone Data Helps Measure Verbal Hallucinations

In this study participants used a multi-modal smartphone data collection system to report on their AVH experiences and co-occurring psychological states multiple times daily, over 30 days. At the same time, smartphone sensors recorded their physical activity, geolocation, and calling and texting behavior.

A smartphone data collection method revealed differences between clinical and nonclinical samples of individuals who experience auditory verbal hallucinations, suggesting a new approach to psychosis research. Results from this study were published in the Schizophrenia Bulletin Open.

Earlier studies using the NIMH Research Domain Criteria (RDoC) framework to guide auditory verbal hallucination (AVH) examinations suggests differences between clinical and nonclinical AVH, including perceived controllability, frequency, and valence. Because measuring AVH is so challenging, the researchers developed a smartphone data collection system using behavioral sensing technology and the Ecological Momentary Assessment (EMA) self-reporting methods.

The researchers captured 384 participants’ behavior over 30 days. In addition to prompting participants to complete self-report assessments every day, the technology measured geospatial activity, physical activity, speech frequency and duration, as well as other measures.

Results indicated both the inpatient-level group (ß = .57, SE = .26, Z = 2.19, P < .05, odds ratio = 1.77) and outpatient-level group (ß = .89, SE = .26, Z = 3.44, P < .001, odds ratio = 2.44) were more likely than the no treatment group (intercept = -1.38, SE = .21, Z = -6.69, P < .001, odds ratio = 0.25) to report AVH occurring during EMA reports.

The inpatient-level group rated their AVH experience as significantly more negative than the no treatment group. The inpatient-level group rated their AVH as more negative (ß = .31, Z = 2.97, P < .01), louder (ß = .21, Z = 2.46, P < .05), and more powerful (ß = .32, Z = 3.12, P < .01), among other results.

Limitations include the fact that the study was observational. “It cannot be known whether group differences in AVH experience are the cause of need for treatment, the result of it, or whether a third factor accounts for both,” the researchers stated. Digital traces captured with mobile technology don’t necessarily mean the individual was around actual human speech. Prompts to complete questionnaires could have impacted participants’ thoughts and feelings.

“The present study helped identify several phenomenological and behavioral variables that may determine where one falls on this continuum,” the researchers concluded. “Continued research is needed to translate these findings into clinically useful interventions that may make the difference between episodes that are experienced as debilitating and more successful coping and resilience.”


Ben-Zeev D, Buck B, Chander A, et al. Mobile RDoC: Using smartphones to understand the relationship between auditory verbal hallucinations and need for care. Schizophr Bull Open. Published online November 9, 2020. doi:10.1093/schizbullopen/sgaa060