Abstract

Eye movement desensitization and reprocessing (EMDR) therapy targets emotionally disturbing visual memories of traumatic life events, and may be deployed as an efficacious treatment for posttraumatic stress disorder. A key element of EMDR therapy is recalling an emotionally disturbing visual memory while simultaneously performing a dual task. Previous studies have shown that auditory emotional memories may also become less emotional as a consequence of dual tasking. This is potentially beneficial for psychotic patients suffering from disturbing emotional auditory memories of auditory hallucinations. The present study examined whether and to what extent emotionality of auditory hallucination memories could be reduced by dual tasking. The study also assessed whether a modality matching dual task (recall + auditory taxation) could be more effective than a cross modal dual task (recall + visual taxation). Thirty-six patients suffering from auditory hallucinations were asked to recall an emotionally disturbing auditory memory related to an auditory hallucination, to rate emotionality of the memory, and to recall it under three conditions: two active conditions, i.e., visual taxation (making eye-movements) or auditory taxation (counting aloud), and one control condition (staring at a non-moving dot) counterbalanced in order. Patients re-rated emotionality of the memory after each condition. Results show the memory emotionality of auditory hallucinations was reduced and the active conditions showed stronger effects than the control condition. No modality-specific effect was found: the active conditions had an equal effect.

Highlights

  • Auditory hallucinations (AHs) are associated foremost with schizophrenia spectrum disorders [1], they are documented in patients with posttraumatic stress disorder (PTSD; 40%–50%), bipolar I disorder (37%), borderline personality disorder (30%), major depression (10%–23%), obsessive–compulsiveReducing Emotionality of Auditory Hallucination Memories disorder (14%), dementia (14%), and Parkinson disease (10%) [2]

  • Support for model 1 would indicate that the active conditions (AT and VT) would show larger decreases from pre to post than the control condition (CC), indicating support for a general working memory (WM) taxation effect

  • Model 2 [auditory taxation (AT) > VT > CC], which takes general taxation into account besides a modality-specific effect, shows anecdotal support (BF2 = 2.21). (Further elaboration on this model can be found under Modality Specificity.) Analyses in which PTSD patients were compared to non-PTSD patients were not possible, since the subgroup of PTSD patients was too small

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Summary

Introduction

Auditory hallucinations (AHs) are associated foremost with schizophrenia spectrum disorders (approximately 70% of the people with a diagnosis of schizophrenia report AH) [1], they are documented in patients with posttraumatic stress disorder (PTSD; 40%–50%), bipolar I disorder (37%), borderline personality disorder (30%), major depression (10%–23%), obsessive–compulsiveReducing Emotionality of Auditory Hallucination Memories disorder (14%), dementia (14%), and Parkinson disease (10%) [2]. A metaanalysis by Maijer et al [3] reported a mean lifetime prevalence for AHs in the general population of 9.6%. Research on treatment strategies most commonly focusses on auditory verbal hallucinations (AVHs) or hearing voices. Since AHs and AVHs occur mostly in patients with schizophrenia [4, 5], treatment strategies are derived mainly from studies on these patients. The treatment of choice for AHs is antipsychotic medication, which induces a rapid decrease in hallucination severity [6]. In approximately 25 to 30% of the patients, antipsychotic medication is ineffective in the treatment of AHs [8, 9]. Despite the large contribution of antipsychotic medication in the treatment of AHs (and AVHs), development of novel or enhancement of existing treatment strategies is important

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