Abstract
A neuropsychological perspective on auditory verbal hallucinations (AVH) links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream (APS) framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion (TI). In this paper, I propose that an APS framework offers a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI.Electronic supplementary materialThe online version of this article (doi:10.1007/s13164-015-0270-3) contains supplementary material, which is available to authorized users.
Highlights
Auditory verbal hallucinations (AVH) and the experience of thought insertion (TI) are commonly discussed together as characteristic or ‘first-rank’ symptoms (FRS) of schizophrenia (Schneider 1959; see Table 1)
I aim to show that an auditory processing streams (APS) framework may help us to understand the experience of TI as well as AVH, providing a common conceptual framework for both
The evidence presented above suggests that the phenomenological features of both TI and AVH can be connected to dysfunctional activation of auditory processing streams
Summary
Auditory verbal hallucinations (AVH) and the experience of thought insertion (TI) are commonly discussed together as characteristic or ‘first-rank’ symptoms (FRS) of schizophrenia (Schneider 1959; see Table 1). I suggest the APS framework can be united with predictive coding accounts of hallucinations and delusions (Adams et al 2013; Fletcher and Frith 2009), providing the basis for a more integrated model of these symptoms. To illustrate these ideas I begin with a brief description of the similarities and differences in phenomenology and epidemiology of AVH and TI and critique how alternative explanations based on Forward Models fare in accounting for these characteristics. I introduce the APS framework, explore the characteristic features of AVH and TI in terms of the functional division of auditory processing streams, and conclude by outlining the implications and challenges for future research
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