Strategies of disattention and auditory hallucinations in schizophrenics.

Abstract

Disattentional strategies used by schizophrenics to attenuate auditory stimulation from the environment were proposed as extraordinary conditions of attention which facilitate the misperception of lexical thought as a voice and create an auditory hallucination. Two strategies were studied. The switching strategy involved concentration upon an external visual display to prevent a clearly audible list of words from registering. The holding strategy required mentally repeating a word in the list so as to ignore the words that followed. Process (N = 32) and reactive (N = 32) schizophrenics, 46 of whom had a history of auditory hallucinations, served as subjects. Effectiveness of the two disattentional strategies was tested by subsequent inability of the schizophrenic to recognize words from the taped list. Process schizophrenics with auditory hallucinations were able to use switching effectively but not holding. In contrast, reactive schizophrenics suffering auditory hallucinations successfully used holding but not switching. Both effects were confirmed relative to hallucinating controls given standard memory instructions. Strategy effects were not apparent in nonhallucinating schizophrenics. These results suggest that different disattentional strategies may have been practiced by hallucinating schizophrenics in keeping with their premorbid status and style of attention deployment. A proposal functionally relating disattention to the genesis of auditory hallucinations was suggested.