Features Of Auditory Verbal Hallucinations Research Articles

Phenomenology of auditory verbal hallucination in schizophrenia: An erroneous perception or something else?

This study presents phenomenological features of auditory verbal hallucinations (AVH) in schizophrenia and associated anomalies of experience. The purpose is to compare the lived experience of AVH to the official definition of hallucinations as a perception without object. Furthermore, we wish to explore the clinical and research implication of the phenomenological approach to AVH. Our exposition is based on classic texts on AVH, recent phenomenological studies and our clinical experience. AVH differ on several dimensions from ordinary perception. Only a minority of schizophrenia patients experiences AVH localized externally. Thus, the official definition of hallucinations does not fit the AVH in schizophrenia. AVH are associated with several anomalies of subjective experiences (self-disorders) and the AVH must be considered as a product of self-fragmentation. We discuss the implications with respect to the definition of hallucination, clinical interview, conceptualization of a psychotic state and potential target of pathogenetic research.

Reconciling competing mechanisms posited to underlie auditory verbal hallucinations.

Perception is not the passive registration of incoming sensory data. Rather, it involves some analysis by synthesis, based on past experiences and context. One adaptive consequence of this arrangement is imagination-the ability to richly simulate sensory experiences, interrogate and manipulate those simulations, in service of action and decision making. In this paper, we will discuss one possible cost of this adaptation, namely hallucinations-perceptions without sensory stimulation, which characterize serious mental illnesses like schizophrenia, but which also occur in neurological illnesses, and-crucially for the present piece-are common also in the non-treatment-seeking population. We will draw upon a framework for imagination that distinguishes voluntary from non-voluntary experiences and explore the extent to which the varieties and features of hallucinations map onto this distinction, with a focus on auditory-verbal hallucinations (AVHs)-colloquially, hearing voices. We will propose that sense of agency for the act of imagining is key to meaningfully dissecting different forms and features of AVHs, and we will outline the neural, cognitive and phenomenological sequelae of this sense. We will conclude that a compelling unifying framework for action, perception and belief-predictive processing-can incorporate observations regarding sense of agency, imagination and hallucination. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.

Without insight accompanied with deteriorated brain functional alterations in healthy individuals with auditory verbal hallucinations: a pilot study

Few studies have reported on brain functional differences between healthy individuals with auditory verbal hallucinations (Hi-AVH) with and without insight, so we designed a study to address this knowledge gap. We enrolled 12 Hi-AVH with insight, 15 Hi-AVH without insight, and 15 AVH-free controls (Healthy controls). Global functional connectivity density (gFCD) mapping was used to estimate brain networks. We found that the most common alterations in both Hi-AVH groups were increased gFCD in superior parietal lobule and superior temporal gyrus. We also found that distinct brain functional patterns of Hi-AVH without insight comprised lower gFCD in the frontal lobe oculomotor area, dorsolateral prefrontal cortex, supramarginal gyrus, primary auditory cortex, sensorimotor cortex, ventral anterior, and posterior cingulate Our pilot findings support the hypothesis that abnormal reciprocal action in the circuits for processing perception, memory, language, and attentional control may be pathological features of auditory verbal hallucinations.

Exploring neuroimaging-genetic co-alteration features of auditory verbal hallucinations in different subjects for the establishment of a predictive model.

Exploring neuroimaging-genetic co-alteration features of auditory verbal hallucinations in different subjects for the establishment of a predictive model.

Cerebral blood flow and its connectivity features of auditory verbal hallucinations in schizophrenia: A perfusion study

The goal of the study was to investigate cerebral blood flow (CBF) and its connectivity (an across-subject covariance measure) patterns of schizophrenia (SZ) patients with auditory verbal hallucinations (AVHs). A total of demographically matched 25 SZ patients with AVHs, 25 without AVHs, and 25 healthy controls (HCs) underwent resting state perfusion imaging using a pulsed arterial spin labeling sequence. CBF and its connectivity were analyzed and then CBF topological properties were calculated. AVHs patients exhibited decreased CBF in the bilateral superior and middle frontal gyri and postcentral gyri, and right supplementary motor area compared with SZ patients without AVHs. SZ patients without AVHs showed reduced CBF in the left middle frontal gyrus relative to HCs. Moreover, AVHs groups showed distinct connectivity pattern, an intermediate level between HCs and patients without AVHs in the global efficiency. Our study demonstrates aberrant CBF in the brain regions associated with inner speech monitoring and language processing in SZ patients with AVHs. The complex network measures showed by CBF-derived functional connectivity indicate dysconnectivity between different functional units within the network of AVHs in SZ. Our findings might shed light on the neural underpinnings behind AVHs in this devastating disease at the level of CBF and its connectivity.

Auditory verbal hallucinations in first-episode psychosis: a phenomenological investigation.

BackgroundIn dimensional understanding of psychosis, auditory verbal hallucinations (AVH) are unitary phenomena present on a continuum from non-clinical voice hearing to severe mental illness. There is mixed evidence for this approach and a relative absence of research into subjective experience of AVH in early psychosis.AimsTo conduct primary research into the nature of subjective experience of AVH in first-episode psychosis.MethodA phenomenological study using diary and photo-elicitation qualitative techniques investigating the subjective experience of AVH in 25 young people with first-episode psychosis.ResultsAVH are characterised by: (a) entity, as though from a living being with complex social interchange; and (b) control, exerting authority with ability to influence. AVH are also received with passivity, often accompanied by sensation in other modalities.ConclusionsA modern detailed phenomenological investigation, without presupposition, gives results that echo known descriptive psychopathology. However, novel findings also emerge that may be features of AVH in psychosis not currently captured with standardised measures.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

A Neuropsychological Approach to Auditory Verbal Hallucinations and Thought Insertion - Grounded in Normal Voice Perception.

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.

Characteristics of Auditory Hallucinations and Associated Factors in Older Adults with Schizophrenia

To examine the characteristics of auditory verbal hallucinations and associated factors in older adults with schizophrenia. One hundred ninety-eight persons aged 55 and older living in the community who had developed schizophrenia before age 45 years were assessed for the presence, topography, content, and subjective qualities of auditory hallucinations. George's social antecedent model of psychopathology was used to examine 17 predictor variables of auditory hallucinations. Thirty-two percent experienced auditory verbal hallucinations. More than half heard voices daily, heard good/pleasant voices, or had command hallucinations; 25% obeyed "bad" voices, whereas 87% obeyed "good" voices. There were no significant differences in depression and social functioning between persons judging their voices to be good versus bad. In logistic regression analysis, depressive symptoms, Positive and Negative Syndrome Scale delusion score (>2), and male gender were associated with auditory verbal hallucinations. Older adults with schizophrenia had a lower rate of auditory verbal hallucinations than had been reported previously for younger persons with schizophrenia. For most features of auditory verbal hallucinations, older adults had similar rates to younger persons. However, older adults were more apt to judge their voices as good and more likely to obey the good voices than those voices perceived as bad. From a clinical standpoint, this may be construed as a potentially useful coping strategy. However, subjective judgments about voices did not significantly affect mood or functioning, and the presence of auditory verbal hallucinations was associated with more depressive symptoms.

The Characteristic Features of Auditory Verbal Hallucinations in Clinical and Nonclinical Groups: State-of-the-Art Overview and Future Directions

Despite a growing interest in auditory verbal hallucinations (AVHs) in different clinical and nonclinical groups, the phenomenological characteristics of such experiences have not yet been reviewed and contrasted, limiting our understanding of these phenomena on multiple empirical, theoretical, and clinical levels. We look at some of the most prominent descriptive features of AVHs in schizophrenia (SZ). These are then examined in clinical conditions including substance abuse, Parkinson's disease, epilepsy, dementia, late-onset SZ, mood disorders, borderline personality disorder, hearing impairment, and dissociative disorders. The phenomenological changes linked to AVHs in prepsychotic stages are also outlined, together with a review of AVHs in healthy persons. A discussion of key issues and future research directions concludes the review.