Measuring the Frequency of Inner-Experience Characteristics by Self-Report: The Nevada Inner Experience Questionnaire

Inner experiences, mental health, and well-being in autistic and non-autistic adults

The nature of autistic adults' everyday inner experiences has been largely unstudied. The purpose of this study was to examine patterns of inner experiences and how they relate to mental health and wellness among autistic and non-autistic adults. Autistic (n = 303) and non-autistic (n = 289) adults (ages 21-82) completed online surveys assessing their anxiety, depression, happiness, life satisfaction, and inner thinking patterns, (inner speaking [i.e., verbal thinking], inner seeing [i.e., visual thinking], unsymbolized thinking, feelings, sensory awareness, self-talk). Group differences in inner thinking were examined using Mann-Whitney U and chi-square tests. Correlations and multiple linear regressions examined associations between inner experiences, mental health, and well-being. Autistic adults had greater use of inner speaking and sensory awareness, compared to non-autistic adults. The most common primary mode of inner experience for both groups was inner speaking, while fewer autistic adults reported that experiencing thoughts as feelings was their primary modality. Autistic adults reported greater use of self-talk for social assessment, self-criticism, and self-management purposes, compared to non-autistic adults. Experiencing thoughts as inner speech and as feelings were associated with anxiety in both groups. Using self-talk for social assessment and self-criticism purposes was correlated with anxiety and depression in both groups, while using self-talk for self-management was associated with depression and anxiety only among autistic adults. The results suggest that autistic and non-autistic adults have similarities in overall patterns of inner thinking, yet autistic adults may be more likely to engage in self-talk as a strategy to manage challenging day-to-day experiences.

Alexithymia, Inner Thinking Patterns, and Perceptions of Mental Health Therapy Strategies Among Autistic Adults

PURPOSE

Autistic adults are at high risk for mental health challenges, yet there has been limited research on mental health interventions for this population. Individual differences in how thoughts and emotions are perceived may directly relate to the success of specific therapy strategies. This study examined whether alexithymia and inner thinking patterns relate to helpfulness and ease of use of mental health therapy strategies among autistic adults.

METHOD

Participants (n = 269 autistic adults, ages 21-77) completed questionnaires assessing alexithymia, inner thinking patterns (i.e., self-talk, verbal thinking, visual thinking), and experiences with mental health therapy strategies. Ordinal logistic regressions were used to examine associations between alexithymia, inner thinking, and perceived helpfulness and ease of use of therapy strategies.

RESULTS

Autistic adults with greater alexithymia found cognitive strategies more difficult to use, while those with greater frequency of self-talk found them easier to use. By contrast, autistic adults with greater visual thinking found guided imagery strategies easier to use. There were no associations between alexithymia or inner thinking and perceived helpfulness or ease of use of behavioral strategies (exposure, behavioral activation), mind-body relaxation strategies (deep breathing, progressive muscle relaxation), or mindfulness meditation.

CONCLUSIONS

The findings suggest that some mental health strategies may be more difficult to implement for some autistic adults, depending on individual thinking profiles. However, alexithymia and inner thinking patterns were unrelated to the perceived helpfulness of mental health strategies. Overall, this highlights the importance of providing individualized supports and accommodations to optimize mental health therapy for autistic adults.

Dynamics of spontaneous thoughts: Exploration, attentional profile and the segmentation of the stream of thoughts

For a long time, clinical knowledge and first-person reports have pointed to individual differences in the dynamics of spontaneous thoughts, in particular in the extreme case of psychiatric conditions (e.g. racing thoughts in Attention Deficit / Hyperactivity Disorder, ADHD; rumination in depression). We used a novel procedure to investigate this individual variability by combining verbal fluency tasks and introspective reports of thought content. Our goal was twofold. First, we tested the hypothesis that a greater segmentation of the stream of thoughts would be associated with trait inattention, in line with subjective reports of ADHD patients. Second, we tested whether the segmentation of the stream of thoughts increased with an increased tendency for exploratory behavior, following recent theoretical claims on the mechanisms underpinning the generation of spontaneous thoughts. Our results support both hypotheses, shedding light on the factors contributing to the individual variability in the dynamics of the stream of thought.

Concurrent Validity and Reliability of Representative Inner Speech Questionnaires

Inner speech is frequently assessed using self-report scales, but their validity is understudied. Uttl et al. (2011) found moderate correlations, perhaps because measures tap into different dimensions of inner speech. We expand on these preliminary results by investigating reliability and concurrent validity of seven inner speech questionnaires in a larger sample. Our results indicate that inner speech questionnaires are reliable but hold moderate concurrent validity, in line with Uttl and colleagues' (2011) results. Specifically, our results suggest that some inner speech scales may capture a general conception of inner speech, while others may assess evaluative components of negative self-talk, self-regulation, and self-reflective processes, but not emotional valence. The results hold implications around further validity investigations of inner speech measures.

Inner speech and the body error theory

Inner speech is commonly understood as the conscious experience of a voice within the mind. One recurrent theme in the scientific literature is that the phenomenon involves a representation of overt speech, for example, a representation of phonetic properties that result from a copy of speech instructions that were ultimately suppressed. I propose a larger picture that involves some embodied objects and their misperception. I call it "the Body Error Theory," or BET for short. BET is a form of illusionism, but the particular version I favor is a cross-modal illusion. Newly described here, my hypothesis is that the experience of inner speech arises from a mix of interoception and audition. Specifically, there is the detection of slight but well-confirmed activities in the speech musculature that occur during inner speech, which helps to transform representations of normal but quiet nonverbal sounds that inevitably occur during inner speech, from breathing to background noise, into a mistaken perception of inner speech. Simply put, activities in the speech musculature mix with sounds to create the appearance of speech sounds, which thus explains the "voice within the mind." I also show how BET's cross-modal system fits with standard information processing accounts for speech monitoring and how it accommodates the central insights of leading theories of inner speech. In addition, I show how BET is supported by data from experience-sampling surveys and how it can be empirically tested against its rivals.

Inner speech in the daily lives of people with aphasia

Introduction

This exploratory, preliminary, feasibility study evaluated the extent to which adults with chronic aphasia (N = 23) report experiencing inner speech in their daily lives by leveraging experience sampling and survey methodology.

Methods

The presence of inner speech was assessed at 30 time-points and themes of inner speech at three time-points, over the course of three weeks. The relationship of inner speech to aphasia severity, demographic information (age, sex, years post-stroke), and insight into language impairment was evaluated.

Results

There was low attrition (<8%) and high compliance (>94%) for the study procedures, and inner speech was experienced in most sampled instances (>78%). The most common themes of inner speech experience across the weeks were 'when remembering', 'to plan', and 'to motivate oneself'. There was no significant relationship identified between inner speech and aphasia severity, insight into language impairment, or demographic information. In conclusion, adults with aphasia tend to report experiencing inner speech often, with some shared themes (e.g., remembering, planning), and use inner speech to explore themes that are uncommon in young adults in other studies (e.g., to talk to themselves about health).

Discussion

High compliance and low attrition suggest design feasibility, and results emphasize the importance of collecting data in age-similar, non-brain-damaged peers as well as in adults with other neurogenic communication disorders to fully understand the experience and use of inner speech in daily life. Clinical implications and future directions are discussed.

Relationships between Self-Talk, Inner Speech, Mind Wandering, Mindfulness, Self-Concept Clarity, and Self-Regulation in University Students

In this study, the researchers explored novel relationships between the self-related processes of self-talk, inner speech, self-concept clarity, mindfulness, mind wandering, and self-regulation. Using self-report questionnaires (n = 227), we found a small positive association between inner speech use and mind wandering, as well as a medium positive association of mindfulness with self-regulation, in accordance with claims made in the literature. We found a medium positive relationship between mindfulness awareness and inner speech responses, potentially because mindfulness awareness represents an active state of self-focus, requiring verbal self-directed probes. Conversely, the correlations between reports of inner speech use and mindfulness acceptance were medium and negatively associated, perhaps because self-acceptance is a less active process that does not require as much self-directed speech as acquiring self-awareness, or perhaps self-acceptance consists of silencing the mind. Furthermore, the mindfulness-acceptance responses were negatively associated with mind wandering but positively correlated with self-concept clarity and self-regulation (all significant and of medium strength). Another noteworthy result was that mind wandering was negatively correlated with self-concept clarity and self-regulation, in accordance with the view that mind wandering represents a self-escape mechanism and thus impedes the transparency of one's self-view and efforts at controlling oneself. This study pieces together what has been presented in the literature, examining variables that are typically studied in isolation. Further, these results have implications for the future study of self-regulation in that self-focused attention, self-acceptance, and self-concept clarity may be mediators on the paths between self-talk or inner speech use and self-regulation.

The Self Course: Lessons Learned from Students' Weekly Questions

In this paper, I tentatively answer 50 questions sampled from a pool of over 10,000 weekly questions formulated by students in a course entitled "The Self". The questions pertain to various key topics related to self-processes, such as self-awareness, self-knowledge, self-regulation, self-talk, self-esteem, and self-regulation. The students' weekly questions and their answers highlight what is currently known about the self. Answers to the student questions also allow for the identification of some recurrent lessons about the self. Some of these lessons include: all self-processes are interconnected (e.g., prospection depends on autobiography), self-terms must be properly defined (e.g., self-rumination and worry are not the same), inner speech plays an important role in self-processes, controversies are numerous (are animals self-aware?), measurement issues abound (e.g., self-recognition as an operationalization of self-awareness), deficits in some self-processes can have devastating effects (e.g., self-regulatory deficits may lead to financial problems), and there are lots of unknowns about the self (e.g., gender differences in Theory-of-Mind).

Self-Consciousness and Self-Awareness: Associations between Stable and Transitory Levels of Evidence

The theory of objective self-awareness predicts the assessment of stable or dispositional self-consciousness and transitory or situational self-awareness. The aim of the present research was to investigate potential associations between patterns of experiential self-description to scores on self-report measures of dispositional self-consciousness. A total of 64 Brazilian volunteers (Mage = 29.7, SD = 8.79, 64.1% female) responded to the Revised Self-Consciousness Scale, the Philadelphia Mindfulness Scale, and the Rumination-Reflection Questionnaire before participating in an experience sampling protocol. The protocol consisted of random daily requests for up to four self-description experiences across seven consecutive days. Participants recorded audio messages on their mobile phones in reply to each request describing their current experience. Reports were analyzed through a reflexive thematic analysis that produced twenty sub-themes accounting for descriptive markers of experience. Based on those descriptive markers, the qualitative data were then transformed into quantitative data for the situational self-awareness indexes. Evidence of association between self-consciousness and self-awareness was stronger for the awareness subscale in a positive correlation with affective situational self-awareness and in a negative correlation with mental representational transitory self-awareness. Although relational evidence has been provided, the data reinforced the theoretical distinction between self-consciousness and self-awareness.

A voice without a mouth no more: The neurobiology of language and consciousness

Most research on the neurobiology of language ignores consciousness and vice versa. Here, language, with an emphasis on inner speech, is hypothesised to generate and sustain self-awareness, i.e., higher-order consciousness. Converging evidence supporting this hypothesis is reviewed. To account for these findings, a 'HOLISTIC' model of neurobiology of language, inner speech, and consciousness is proposed. It involves a 'core' set of inner speech production regions that initiate the experience of feeling and hearing words. These take on affective qualities, deriving from activation of associated sensory, motor, and emotional representations, involving a largely unconscious dynamic 'periphery', distributed throughout the whole brain. Responding to those words forms the basis for sustained network activity, involving 'default mode' activation and prefrontal and thalamic/brainstem selection of contextually relevant responses. Evidence for the model is reviewed, supporting neuroimaging meta-analyses conducted, and comparisons with other theories of consciousness made. The HOLISTIC model constitutes a more parsimonious and complete account of the 'neural correlates of consciousness' that has implications for a mechanistic account of mental health and wellbeing.

The Internal Representations Questionnaire: Measuring modes of thinking

Does the format in which we experience our moment-to-moment thoughts vary from person to person? Many people claim that their thinking takes place in an inner voice and that using language outside of interpersonal communication is a regular experience for them. Other people disagree. We present a novel measure, the Internal Representation Questionnaire (IRQ) designed to assess people's subjective mode of internal representations, and to quantify individual differences in "modes of thinking" along multiple factors in a single questionnaire. Exploratory factor analysis identified four factors: Internal Verbalization, Visual Imagery, Orthographic Imagery, and Representational Manipulation. All four factors were positively correlated with one another, but accounted for unique predictions. We describe the properties of the IRQ and report a test of its ability to predict patterns of interference in a speeded word-picture verification task. Taken together, the results suggest that self-reported differences in how people internally represent their thoughts relates to differences in processing familiar images and written words.