Abstract
Auditory verbal hallucinations (AVHs) are typically associated with schizophrenia but also occur in individuals without any need for care (nonclinical voice hearers [NCVHs]). Cognitive models of AVHs posit potential biases in source monitoring, top-down processes, or a failure to inhibit intrusive memories. However, research across clinical/nonclinical groups is limited, and the extent to which there may be continuity in cognitive mechanism across groups, as predicted by the psychosis-continuum hypothesis, is unclear. We report two studies in which voice hearers with psychosis (n = 31) and NCVH participants reporting regular spiritual voices (n = 26) completed a battery of cognitive tasks. Compared with non-voice-hearing groups (ns = 33 and 28), voice hearers with psychosis showed atypical performance on signal detection, dichotic listening, and memory-inhibition tasks but intact performance on the source-monitoring task. NCVH participants, however, showed only atypical signal detection, which suggests differences between clinical and nonclinical voice hearers potentially related to attentional control and inhibition. These findings suggest that at the level of cognition, continuum models of hallucinations may need to take into account continuity but also discontinuity between clinical and nonclinical groups.
Highlights
Auditory verbal hallucinations (AVHs, or “voices”) are typically associated with schizophrenia or other psychotic disorders (Bauer et al, 2011) but are not specific to any diagnosis (Toh et al, 2015; Waters & Fernyhough, 2017)
Studies have investigated these aspects of cognition in relation to general-population hallucination proneness, to our knowledge, no study has reported on reality monitoring (RM), intentional inhibition, or dichotic listening (DL; assessing both language lateralization and attentional control) in
This study provides evidence for key similarities and differences in the cognitive profiles of voice-hearing psychosis patients and nonclinical voice hearers (NCVHs)
Summary
Auditory verbal hallucinations (AVHs, or “voices”) are typically associated with schizophrenia or other psychotic disorders (Bauer et al, 2011) but are not specific to any diagnosis (Toh et al, 2015; Waters & Fernyhough, 2017). Studies have investigated these aspects of cognition in relation to general-population hallucination proneness, to our knowledge, no study has reported on RM, intentional inhibition, or dichotic listening (DL; assessing both language lateralization and attentional control) in NCVHs or used the most common task linked to topdown processing in hallucinations research (auditory SD) in an NCVH group Research in this area is crucial to untangle when atypical patterns of performance are specific to AVHs broadly, as opposed to psychotic AVHs or psychopathology more broadly.
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