“Dear Edward” (post 1) by Ann Napolitano: Italics and voices in the head

I am so impressed by the clarity of language at the beginning of this novel that I am stopped by a peculiar sentence:

“So much could be solved, she thinks, if we simply held hands with each other” (1, p. 5).

Why have both italics and “she thinks” in the same sentence?

In past posts on other writers’ work, I have made the point that when italics are used instead of saying someone thinks, it is often because it is a voice (from an alternate personality) in the person’s head and not just a thought. So what is going on here?

Perhaps the author is using italics to highlight tear-jerker sentiments in this possibly tear-jerker novel. Or, did the author hear the voice of an alternate personality whose contribution to this novel was to whisper such sentiments to the author while she was writing?

Added Apr. 17: "A new voice entered his head..." (1, p.19).

Most people do not hear voices in their head—which are probably alternate personalities—but the author's casual reference to it suggests that she does have that kind of experience, which is the significant point here, not her use of italics.

1. Ann Napolitano. Dear Edward. New York, Dial Press, 2020/2021.