Launay-Slade Hallucination Scale Research Articles

Musical hallucinations, secondary delusions, and lack of insight: results from a cohort study.

Although musical hallucinations do not tend to be accompanied by delusions, occasionally patients persistently accuse others of being responsible for causing the music they perceive, sometimes with severe social consequences such as frequently calling the police or moving house. In this study we seek to broaden our understanding of this rare type of musical hallucination that comes with secondary delusions and lack of insight, and to explore associations, underlying mechanisms, and treatment possibilities. The present study is part of a cohort study on musical hallucinations carried out in the Netherlands from 2010 through 2023. Participants underwent testing with the aid of the MuHa Questionnaire, Launay-Slade Hallucinations Scale (LSHS), Schizotypal Personality Questionnaire (SPQ), Hamilton Depression Rating Scale (HDRS), and Mini Mental State Examination (MMSE). Additionally, they underwent a brain MRI, electroencephalogram, and audiological testing. Five patients out of a group of N = 81 (6%) lacked insight and presented with secondary delusions regarding the perceived music. They were all female, of advanced age, and hearing-impaired, and were diagnosed with cognitive impairment. In three patients (60%), risperidone was started. This had a positive effect on the hallucinations and secondary delusions. The pathophysiological process underlying musical hallucinations is multifactorial in nature. We consider cognitive impairment the most likely contributing factor of the secondary delusions and lack of insight encountered in our patients, and antipsychotics the most beneficial treatment. On the basis of these small numbers, no definite conclusions can be drawn, so further research is needed to elucidate the underlying mechanisms and to develop evidence-based treatment methods for people experiencing this rare and debilitating combination of symptoms. Since the black box warning of risperidone cautions against the use of this drug in elderly persons with dementia, a proper comparison with the efficacy and safety of other antipsychotics for this group is paramount.

Measuring imagery strength in schizophrenia: no evidence of enhanced mental imagery priming.

Recent research shows ambivalent results regarding the relationship between mental imagery and schizophrenia. The role of voluntary visual imagery in schizophrenic hallucinations remains unclear. The aim of the study was to investigate the association between visual imagery, schizophrenia, and the occurrence of schizophrenic hallucinations using an objective visual imagery task. The sample consisted of 16 participants with schizophrenia (59.1% female; MAge =45.55) and 44 participants without schizophrenia (62.5% female; MAge =43.94). Visual imagery was measured using the Vividness of Visual Imagery Questionnaire (VVIQ) as well as the well-validated Binocular Rivalry Task (BRT). Occurrences of hallucinations were assessed using the Launay-Slade Hallucination Scale. Participants with schizophrenia showed more hallucinatory experiences but did not score higher on either the VVIQ or the BRT than participants without schizophrenia. A correlation between the VVIQ and the BRT was found, validating the measurement of visual imagery and enabling the interpretation that visual imagery vividness is not enhanced in people with schizophrenia. The association between mental imagery vividness and schizophrenia found in previous studies may be based on other facets of mental imagery than visual imagery.

Hypersensitivity to passive voice hearing in hallucination proneness.

Voices are a complex and rich acoustic signal processed in an extensive cortical brain network. Specialized regions within this network support voice perception and production and may be differentially affected in pathological voice processing. For example, the experience of hallucinating voices has been linked to hyperactivity in temporal and extra-temporal voice areas, possibly extending into regions associated with vocalization. Predominant self-monitoring hypotheses ascribe a primary role of voice production regions to auditory verbal hallucinations (AVH). Alternative postulations view a generalized perceptual salience bias as causal to AVH. These theories are not mutually exclusive as both ascribe the emergence and phenomenology of AVH to unbalanced top-down and bottom-up signal processing. The focus of the current study was to investigate the neurocognitive mechanisms underlying predisposition brain states for emergent hallucinations, detached from the effects of inner speech. Using the temporal voice area (TVA) localizer task, we explored putative hypersalient responses to passively presented sounds in relation to hallucination proneness (HP). Furthermore, to avoid confounds commonly found in in clinical samples, we employed the Launay-Slade Hallucination Scale (LSHS) for the quantification of HP levels in healthy people across an experiential continuum spanning the general population. We report increased activation in the right posterior superior temporal gyrus (pSTG) during the perception of voice features that positively correlates with increased HP scores. In line with prior results, we propose that this right-lateralized pSTG activation might indicate early hypersensitivity to acoustic features coding speaker identity that extends beyond own voice production to perception in healthy participants prone to experience AVH.

Launay–Slade Hallucination Scale-Extended: simplifying its interpretation

ABSTRACT Background The Launay–Slade Hallucination Scale – Extended (LSHS-E) is one of the most used self-reported questionnaires to explore the multidimensionality of hallucinatory-like experiences (HLEs). This scale is defined as a 5-level Likert scale, which goes from 0-“certainly does not apply to me” to 4-“certainly applies to me.” Like any Likert scale, the LSHS-E scale assumes that the ordinal categories are equally spaced among them, which might not be true, giving rise to possible issues in offering a valid interpretation of the responses. Method This study introduces a parametric model: the ordered stereotype model. This model determines the uneven spacing among ordinal responses, dictated by the studied data. Results This work shows that the ordinal categories of the LSHS-E scale are determined both by unequal spacing and by the spacing among the last three adjacent categories, which makes them indistinguishable. Subsequent analysis showed good internal reliability, and also a four-factor structure was maintained. Discussion The current study’s findings suggest that people who suffer from HLEs might not easily disclose their experiences and so give neutral responses for fear of being stigmatized. Further, neutral responses might identify people at risk of psychosis, and individuals during the prodromal stage may not be aware of their transient or fleeting HLEs. Future research should determine the distance among the categories on a Likert scale as a first step before analyzing and understanding the data.

Varieties of Inner Speech and Creative Potential

Inner speaking, the covert talking that goes on inside a person's mind, can shape creative thought. How the phenomenological properties and quality of inner speaking correlate with a person's creative potential, however, is an open scientific problem. To explore this, participants ( n = 267) filled in the revised Varieties of Inner Speech Questionnaire and the revised Launay Slade Hallucination Scale (auditory subscale), and performed three tests of creative potential: one divergent (Alternative Uses Test) and two convergent thinking tests (Compound Remote Associates Test, short Hagen Matrices Test). The results showed that a tendency to engage in condensed and evaluative/ critical inner speaking negatively correlated with convergent thinking ability; and the results pointed toward a potential negative correlation of auditory hallucination proneness with divergent and convergent thinking ability. No evidence was found for a correlation of the dialogicality, imagining of others’ voices, or positive/regulatory aspect of the participants day-to-day inner speech, with creative potential. Herewith, the presented study contributes novel insight into the relationship between the varieties of inner speech and creative potential.

Factor analysis of the revised Launay-Slade hallucination scale (LSHS-R) in the Russian-speaking environment

Factor analysis of the revised Launay-Slade hallucination scale (LSHS-R) in the Russian-speaking environment

Measurement practices in hallucinations research

ABSTRACT Introduction: In several sub-fields of psychology, there has been a renewed focus on measurement practices. As far as we are aware, this has been absent in hallucinations research. Thus, we investigated (a) cross-study variation in how hallucinatory experiences are measured and (b) the reliability of measurements obtained using two tasks that are widely employed in hallucinations research. Method: In Study 1, we investigated to what extent there was variation in how the Launay-Slade Hallucination Scale (LSHS) has been used across 100 studies. In Study 2, we investigated the reliability of the measurements obtained through source monitoring and signal detection tasks, using data from four recent publications. Materials/data are available at doi: 10.17605/osf.io/d3gnk/. Results: In Study 1, we found substantial variation in how hallucinatory experiences were assessed using the LSHS and that descriptions of the LSHS were often incomplete in important ways. In Study 2, we reported a range of reliability estimates for the measurements obtained using source monitoring and signal discrimination tasks. Some measurements obtained using source monitoring tasks had unacceptably low levels of reliability. Conclusions: Our findings suggest that suboptimal measurement practices are common in hallucinations research and we suggest steps researchers could take to improve measurement practices.

The perceived salience of vocal emotions is dampened in non-clinical auditory verbal hallucinations

ABSTRACT Introduction: Auditory verbal hallucinations (AVH) are a cardinal symptom of schizophrenia but are also reported in the general population without need for psychiatric care. Previous evidence suggests that AVH may reflect an imbalance of prior expectation and sensory information, and that altered salience processing is characteristic of both psychotic and non-clinical voice hearers. However, it remains to be shown how such an imbalance affects the categorisation of vocal emotions in perceptual ambiguity. Methods: Neutral and emotional nonverbal vocalisations were morphed along two continua differing in valence (anger; pleasure), each including 11 morphing steps at intervals of 10%. College students (N = 234) differing in AVH proneness (measured with the Launay-Slade Hallucination Scale) evaluated the emotional quality of the vocalisations. Results: Increased AVH proneness was associated with more frequent categorisation of ambiguous vocalisations as ‘neutral’, irrespective of valence. Similarly, the perceptual boundary for emotional classification was shifted by AVH proneness: participants needed more emotional information to categorise a voice as emotional. Conclusions: These findings suggest that emotional salience in vocalisations is dampened as a function of increased AVH proneness. This could be related to changes in the acoustic representations of emotions or reflect top-down expectations of less salient information in the social environment.

Cognitive and phenomenological characteristics of hallucination-proneness across the lifespan

ABSTRACT Introduction The impact of age on hallucination-proneness within healthy adult cohorts and its relation to underlying cognitive mechanisms is underexplored. Based on previously researched trends in relation to cognitive ageing, we hypothesised that older and younger adults, when compared to a middle adult age group, would show differential relations between hallucination-proneness and cognitive performance. Methods A mixed methods, between-groups study was conducted with 30 young adults, 26 older adults, and 27 from a “middle adulthood” group. Participants completed a source memory task, jumbled speech task, Launay-Slade hallucination scale, unusual experiences schedule, and control measures of delusion-proneness and attitudes to mental health. Results Compared to older age-groups, younger participants demonstrated better scores on the source memory task, and reported hearing more words in jumbled speech. Additionally, younger cohorts rated higher on hallucination-proneness and disclosed more unusual experiences on a customised schedule designed to gather further qualitative data. Jumbled speech scores positively correlated with hallucination-proneness scores, particularly for the “middle” age group. Source memory performance unexpectedly correlated positively with hallucination-proneness, although this may be the product of age differences in task performance. Conclusions Age differences in hallucination-proneness are evident on self-report and cognitive measures. Implications are discussed for potentially non-overlapping cognitive mechanisms underlying hallucination-proneness in non-clinical groups.

Internet-based self-help for psychosis: Findings from a randomized controlled trial.

Cognitive-behavioral therapy (CBT) for psychosis is recommended in many national guidelines, but dissemination into routine health care remains poor. This study tests whether an 8-week, CBT-oriented, Internet-based intervention (IBI) for people with psychosis is feasible, effective, and safe compared to care as usual. A sample of 101 people diagnosed with schizophrenia-spectrum disorders (age: M = 40.0, SD = 9.60; sex: 58% female) was randomly assigned to either an IBI for psychosis or a wait-list control condition. The primary outcome was a composite score of the positive factor of the Positive and Negative Syndrome Scale, the Launay Slade Hallucination Scale, and the paranoia checklist (clinicaltrials.gov, NCT02974400). The composite score of psychotic symptom severity decreased more in the IBI condition than in the wait-list condition, reflected in the significant interaction of Time × Condition, F(1, 87.28) = 4.04, p = .047, dbetween = 0.24, 95% CI [-0.15, 0.63]. In the combined sample of participants who received immediate or delayed access to the intervention, the outcome improved further during the 6-month follow up period with a significant main effect of time, F(1, 69.35) = 9.59, p = .003, d = -0.37, 95% CI [-0.66, -0.07]. Participants were satisfied with the intervention (89%), and many used the intervention as defined per protocol (52%; at least four completed modules). Adverse events were infrequent (4.9%). Internet-based, CBT-oriented interventions provide an add-on effect to care as usual and have the potential to narrow the psychological treatment gap in psychosis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Role for Positive Schizotypy and Hallucination Proneness in Semantic Processing.

Semantic processing underpins the organization of verbal information for both storage and retrieval. Deficits in semantic processing are associated with both the risk for and symptoms presented in schizophrenia. However, studies are mixed and could reflect the confounding effects of medication and symptom heterogeneity. Therefore, we considered whether two risk phenotypes, positive schizotypy and hallucinatory predisposition, present in the general population were associated with differential responding profiles for a semantic processing task. One hundred and eighty-three participants completed the Schizotypal Personality Questionnaire, Launay-Slade Hallucination Scale, National Adult Reading Test, a handedness measure, and a computerized semantic relatedness judgment task. Pairs of words were related through their dominant or subordinate meanings, or unrelated. Participants were divided into four groups using a mean split on cognitive-perceptual (positive) schizotypy and hallucination proneness. Significant differences between groups were found for reaction time on the semantic relatedness task, with the high cognitive-perceptual schizotypy groups responding significantly slower to all word pairs compared to their low scoring counterparts. There was some evidence that high hallucination proneness was associated with significantly faster reaction times which may reflect disinhibitive processes, however additional support is required. The results suggest that these two components of psychosis risk are associated with different patterns of responding to semantic processing. More diffuse activation of semantic information appeared to be associated with positive schizotypy, while those predisposed to hallucinations appeared to respond quicker. These results have significant implications in the re-conceptualization of hallucination proneness as distinct from positive schizotypy. Additional research is required to investigate the association between psychotic-like experiences separate from personality variables such as positive schizotypy and semantic processing.

Validation of the Launay-Slade Hallucination Scale among Indian Healthy Adults.

Psychotic Like Experiences (PLEs) have been reported in several cultures. The 16 item Launay-Slade Hallucination Scale-Extended (LSHS-E) measures hallucination like experiences (HLEs) in the general population. This study investigated the psychometric properties and the factor structure of LSHS-E Hindi among healthy adults of Delhi. LSHS-E was translated from English to Hindi and then back to English. It was administered as a paper pencil questionnaire to 182 adults from the general population. Reliability of LSHS-E Hindi was measured using Cronbach's alpha and factor structure was established using confirmatory factor analysis (CFA). It was tested against the Community Assessment of Psychic Experiences (CAPE-42) for convergent and divergent validity. Latent Class Analysis (LCA) was performed to identify subgroups with different endorsement of HLEs. Among 182, 18 participants reporting mental and neurological disorders were excluded. LSHS-E Hindi had good reliability (0.85; 95% CI: 0.82 to 0.88). CFA of Hindi LSHS-E revealed the a priori four-factor solution to be best, namely: 'intrusive thoughts', 'vivid daydreams', 'multisensory HLEs', 'auditory and visual HLEs'. LSHS-E Hindi showed stronger correlation with positive domain of CAPE than with negative and depression domains. LCA revealed three classes: low, intermediate and high endorsement of HLEs. Participants with highest endorsement of HLEs were less educated and had highest endorsement on all CAPE dimensions. LSHS-E Hindi has good psychometric properties and can be used to study HLEs in Indians. The four-factor structure model depicts the multidimensionality of HLEs, with 'intrusive thoughts' being the most commonly reported HLE in the sample. LCA supports the continuum hypothesis of HLEs.

M53. EMOTIONAL SELF-VOICE PROCESSING AND ITS RELATIONSHIP WITH HALLUCINATORY PRONENESS

BackgroundSensory brain areas typically reduce their activity when we speak, allowing us to differentiate our own from someone else’s speech. Similarly, the amplitude of the N100 component of the EEG event-related potential in response to own speech is smaller than for passive listening to own or someone else’s speech. This amplitude suppression effect seems to be altered in voice hearers, which in turn could result in source misattribution (e.g., self-produced voice attributed to an external source). Emotion in speech can have a comparable effect, altering not only self-voice processing but also differentiation of the quality of auditory hallucinations in clinical and non-clinical voice hearers. For example, unlike in non-clinical voice hearers, auditory hallucinations in clinical voice hearers are usually derogatory in content and negatively affect daily functioning. Recent research strongly suggests that clinical and non-clinical voice hearers lie on a continuum ranging from low to high hallucinatory proneness. Based on this notion, the present study used EEG to investigate the effects of manipulations of self-voice quality in self-generated and passively listened-to self-voice as a function of hallucinatory proneness (HP) in healthy young adults. This is the first EEG study that examined the interplay of sensory suppression, emotion, and HP in a non-clinical population.MethodsParticipants varying in HP (according to the Launay Slade Hallucination Scale) participated in a standardized button-press task to elicit their own voice (compared to passively listening to it) in which the self-voice changed stepwise from fully neutral to fully emotional. The experimental task comprised three conditions: motor-to-auditory (MA), where the button-press generated the voice, auditory only (AO), where the voice was presented without the button press, and motor only (MO-a control condition to remove the motor related artifacts from the MA condition), where the button press did not generate the voice. Neutral and angry self-voice (single syllable ‘ah’ and ‘oh’ vocalizations of 500 ms duration) were recorded for each participant before the EEG acquisition. These voices were morphed to generate a neutral to angry continuum consisting of five stimuli ranging from fully neutral to fully angry: 100% neutral, 60-40% neutral-angry, 50-50% neutral-angry and 40–60% neutral-angry and 100% angry.ResultsPreliminary results with 17 participants show a significant effect of emotional self-voice quality on N1 suppression effect, with a larger suppression effect for the 100% angry as compared to 100% neutral self-voice. On the other hand, 60-40% neutral-angry, 50-50% neutral-angry and 40–60% neutral-angry self-voice show an enhancement effect. Furthermore, the results show a significant interaction of HP and voice quality on N1 suppression effect such that high HP showed no N1 suppression effect for the 100% neutral self-voice and an enhanced N1 effect when emotional quality of the self-voice increased.DiscussionThese data suggest that participants perceive the manipulations in the self-voice quality such that they recognize their own fully neutral and angry voice depicted by N100 suppression effect. Similarly, an N100 enhancement effect for 50-50% neutral-angry voice suggest that it is perceived as the most uncertain or peculiar of all the stimuli. Further, low and high HP show difference in N100 suppression effect for different voices, suggesting that HP may alter self-voice processing and these alterations are enhanced for emotional self-voice. This further supports the fact that abnormal perceptual experiences in voice hearers are higher when auditory hallucinations are emotional in nature.

M247. PAST AND ANTICIPATED HUMILIATION MAY CONTRIBUTE TO ANXIETY AND PRONENESS TO PSYCHOSIS EXPERIENCES IN A COMMUNITY SAMPLE

BackgroundChildhood adversity is a risk factor for psychosis. Bullying, abuse, neglect and family conflict can cause biological (e.g. stress hyper-reactivity) and psychological (e.g. negative beliefs about self and perceived threat from others) changes that may lead to psychopathology in adulthood. Past and anticipated humiliation is associated with proneness to persecutory ideation in non-clinical samples. However, whether this is associated with proneness to other positive psychosis symptoms is unclear. This study measured how humiliation is related to hallucination-like experiences (HLE) and intrusive thinking assessed via the Launay-Slade Hallucination Scale Extended and disorganisation assessed via the Schizotypal Personality Questionnaire-Brief Revised, and if increased anxiety mediates this relationship.MethodsThis cross-sectional study recruited a community sample of 92 adults (62% female; Mean [SD] age = 27.3 [10.8]) who completed measures of past/anticipated humiliation, risky family environment, family socioeconomic status, state anxiety and proneness to positive psychotic 1 2020 Congress of the Schizophrenia International Research Society symptoms. Serial mediation tested for direct and indirect relationships among study variables.ResultsWorse past and anticipated humiliation, risky family environments and state anxiety correlated with more severe intrusive thoughts, multisensory HLEs and disorganisation (r range 0.23–0.54). Serial mediation showed that of the historical factors, only past humiliation predicted anticipated humiliation (p < 0.001), which in turn was the only unique predictor of state anxiety (p = 0.004). The relationship then differed for proneness to different positive psychosis symptoms. Only state anxiety was a unique predictor of audio-visual HLEs (p = .03) and intrusive thoughts (p = .01), whereas both past humiliation and anxiety predicted disorganisation and multisensory HLEs (both p < .03).DiscussionAnxious anticipation about potential harm in interpersonal interactions, likely caused by cumulative past humiliation, may increase proneness to positive psychosis experiences through increased difficulty controlling negative emotions and the frequency and content of worrying thoughts and memories.

M52. VOICES IN THE HEAD: AUDITORY VERBAL HALLUCINATIONS (AVH) IN HEALTHY INDIVIDUALS

BackgroundAuditory verbal hallucinations (AVH) are conscious sensory experiences occurring in the absence of external stimulation. AVH are experienced by 75% of individuals diagnosed with schizophrenia and can manifest in other neuropsychiatric disorders. However, AVH are also reported amongst healthy individuals. This implies that hearing voices is not necessarily linked to psychopathology. Amongst voice hearers, the likelihood of AVH seems to reflect individual differences in hallucination proneness (HP). The HP construct allows placing individuals on a psychosis continuum ranging from non-clinical to clinical experiences. Clinical voice hearers tend to misattribute internal events to external sources (externalization bias). Specifically, they seem to experience altered sensory feedback in response to self-initiated stimuli: Although more predictable, clinical voice hearers show similar, neurophysiological responses in reaction to self-initiated vs. externally presented stimuli. EEG studies suggest that this aberrance of prediction is associated with diminished N1-suppression effects that are observed in healthy individuals in response to self-initiated stimuli. Accordingly, clinical voice hearers may have problems differentiating between self-initiated and externally generated speech, potentially leading to externalization of their own speech. In line with this proposal, the current study focusses on non-clinical aspects of the psychosis continuum in healthy voice hearers and controls. This approach avoids confounding factors (medication, disease onset/duration etc.) that typically impede comparisons of clinical and non-clinical voice hearers. By utilizing insights on prediction from the forward model concept within the auditory-sensory domain, we want to investigate how N1-amplitudes in reaction to one’s own or someone else’s voice are modulated as a function of HP. Next to ascertaining the mechanism behind AVH, this research could give direction to identifying risk factors that potentiate the emergence of first-incidence psychosis.MethodsHP was assessed by means of the Launay-Slade Hallucination Scale. Each participant’s voice was recorded prior to EEG data acquisition (monosyllabic utterances, “ah” & “oh”, duration = 500 ms). Voice stimuli were morphed with an anchor voice, so that voice identity could be alternated from self- to other-voice (0%, 40%, 50%, 60%, 100%). To contrast neurophysiological responses between self- vs. externally generated voice stimuli, a well-established motor-to-auditory paradigm was used: In a motor-to-auditory condition (MAC) participants were prompted to press a button, thereby eliciting a voice stimulus (self-initiation). In an auditory-only condition (AOC), participants were prompted to passively listen to the voice stimulus (external generation). The motor-only condition (MOC), in which participants executed the button press only, served as a control condition to correct for motor activity in MAC.ResultsData from 38 participants replicate the classical N1-suppression effects for self-initiated vs. externally generated self-voice stimuli. This pattern of suppression is also visible for other-voice stimuli. Furthermore, current findings seem to replicate reversed N1-suppression for self-voice in individuals with high HP.DiscussionPreliminary findings suggest that HP modulates voice identity processing. More specifically, HP determines how voice stimuli are processed within the internal and external domain. Particularly, individuals with high HP show a reversal of N1-suppression for self-voice stimuli, which corroborates the external biasing hypothesis.

The Impact of Childhood Trauma, Hallucinations, and Emotional Reactivity on Delusional Ideation

Abstract Background A large body of evidence has demonstrated that childhood trauma increases the risk for developing a psychotic disorder. However, the path by which psychotic symptoms develop following trauma is still debated. Emotional reactivity, a tendency to experience more intense and enduring emotional responses, and hallucinations are sequelae of childhood trauma that may predict the emergence of delusional ideation. This study aimed to examine evidence for this hypothesis in a college student sample. Methods Self-report measures were used to cross-sectionally assess childhood trauma (Childhood Trauma Questionnaire), delusional ideation (Peters et al Delusions Inventory), hallucinations (Launay-Slade Hallucinations Scale), and emotional reactivity (Emotion Reactivity Scale) in 1703 US college students. Results Hallucinations and emotional reactivity fully mediated the relationship between childhood trauma and delusional ideation, after controlling for covariates (gender, age, levels of current stress, stressful life events, and resilience). Discussion These results suggest that hallucinations and emotional reactivity associated with childhood trauma may represent quantifiable targets for early intervention.

A look into hallucinations: the relationship between visual imagery and hallucinations in Alzheimer's disease

ABSTRACTIntroduction: We investigated the relationship between visual hallucinations and vividness of visual imagery in patients with Alzheimer's disease (AD).Method: We recruited 28 patients with AD and 30 healthy control participants, matched for age and education. We evaluated proneness towards hallucinations with the Launay–Slade Hallucinations Scale, which includes items assessing visual and auditory hallucinations. We also evaluated vividness of visual imagery with the Vividness of Visual Imagery Questionnaire on which participants had to imagine four images (i.e., imagining the face of a friend, the rising sun, a familiar shop-front, and a country scene) and report the vividness of the images they generated.Results: Analysis demonstrated significant positive correlations between visual hallucinations and vividness of visual imagery in AD patients, however, no significant correlations were observed between auditory hallucinations and vividness of visual imagery in these participants. No significant correlations were observed between hallucinations and vividness of visual imagery in healthy control participants, probably due to the lack of hallucinations in these participants.Discussion: These results demonstrate a selective relationship between the occurrence of visual (but not auditory) hallucinations and the ability to generate vivid visual images in AD.

Self-voice perception and its relationship with hallucination predisposition

ABSTRACTIntroduction: Auditory verbal hallucinations (AVH) are a core symptom of psychotic disorders such as schizophrenia but are also reported in 10–15% of the general population. Impairments in self-voice recognition are frequently reported in schizophrenia and associated with the severity of AVH, particularly when the self-voice has a negative quality. However, whether self-voice processing is also affected in nonclinical voice hearers remains to be specified.Methods: Thirty-five nonclinical participants varying in hallucination predisposition based on the Launay-Slade Hallucination Scale, listened to prerecorded words and vocalisations differing in identity (self/other) and emotional quality. In Experiment 1, participants indicated whether words were spoken in their own voice, another voice, or whether they were unsure (recognition task). They were also asked whether pairs of words/vocalisations were uttered by the same or by a different speaker (discrimination task). In Experiment 2, participants judged the emotional quality of the words/vocalisations.Results: In Experiment 1, hallucination predisposition affected voice discrimination and recognition, irrespective of stimulus valence. Hallucination predisposition did not affect the evaluation of the emotional valence of words/vocalisations (Experiment 2).Conclusions: These findings suggest that nonclinical participants with high HP experience altered voice identity processing, whereas HP does not affect the perception of vocal emotion. Specific alterations in self-voice perception in clinical and nonclinical voice hearers may establish a core feature of the psychosis continuum.

Psychosocial characteristics differentiate non-distressing and distressing voices in 10,346 adolescents

Adolescents hearing non-existent voices may be at risk for psychosis, but the prevalence of voice-hearing (VH) in the general population complicates clinical interpretations. Differentiating between VH with and without distress may aid treatment decisions in psychosis services, but understanding the differences between these two phenomena as they present in the normal adolescent population is necessary to validate this differentiation. The present study compared VH with and without distress in 10,346 adolescents in relation to clinical characteristics, known risk factors, predictors and psychosocial moderators of psychosis. A population-based cohort of Norwegian 16–19 years old adolescents completed a comprehensive web-based questionnaire, including two questions from the extended Launay-Slade Hallucinations Scale: (1) I often hear a voice speaking my thoughts aloud and (2) I have been troubled by hearing voices in my head. Adolescents reporting no VH, non-distressing VH or distressing VH were compared on 14 psychosocial and clinical variables. A multinomial regression model showed that non-disturbing voices were predicted by better school grades, social dysfunction, distractibility, affective symptoms and experience of trauma, while the disturbing voices were predicted by the experience of bullying and trauma, perceived negative self-worth and self-efficacy, less family support, dysregulation of activation, distractibility, self-harm and anxiety. Hearing voices without distress versus being distressed by the voices is related to different constellations of psychosocial variables, suggesting that they represent two separate groups of adolescents. The findings validate the emphasis on distress in clinical practice.

Voice-selective prediction alterations in nonclinical voice hearers

Auditory verbal hallucinations (AVH) are a cardinal symptom of psychosis but also occur in 6–13% of the general population. Voice perception is thought to engage an internal forward model that generates predictions, preparing the auditory cortex for upcoming sensory feedback. Impaired processing of sensory feedback in vocalization seems to underlie the experience of AVH in psychosis, but whether this is the case in nonclinical voice hearers remains unclear. The current study used electroencephalography (EEG) to investigate whether and how hallucination predisposition (HP) modulates the internal forward model in response to self-initiated tones and self-voices. Participants varying in HP (based on the Launay-Slade Hallucination Scale) listened to self-generated and externally generated tones or self-voices. HP did not affect responses to self vs. externally generated tones. However, HP altered the processing of the self-generated voice: increased HP was associated with increased pre-stimulus alpha power and increased N1 response to the self-generated voice. HP did not affect the P2 response to voices. These findings confirm that both prediction and comparison of predicted and perceived feedback to a self-generated voice are altered in individuals with AVH predisposition. Specific alterations in the processing of self-generated vocalizations may establish a core feature of the psychosis continuum.