The effects of varying auditory input on schizophrenic hallucinations (original) (raw)
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The behavioral treatment of auditory hallucinatory responding of a schizophrenic patient
Journal of Behavior Therapy and Experimental Psychiatry, 1996
This study assessed the efficacy of a behaviorally based treatment package to decrease the frequency of verbal responding to auditory hallucinations and to increase attention to important external stimuli, rather than to the hallucinations. The subject, a 49-year-old male, with a 20-year history of auditory hallucinatory responding (AHR), laughing and talking to himself, was seen in an outpatient clinic. Observations were made during management skill training, given usually twice a week. Observation sessions were divided into 15minute intervals. The intervention package included reinforcement in the form of praise, pats on the back, and token reinforcement contingent on the absence of auditory hallucinations. Cancellation tests were given to measure his ability to attend to external tasks. Using an ABCAD design, it was seen that the data indicated that the intervention resulted in both a sharp decrease in auditory hallucinations and an increase in the subject's ability to attend to external tasks.
Auditory processing and hallucinations in schizophrenia
Schizophrenia Research, 2013
The aim of this study was to investigate whether deficits in auditory processing are associated with auditory hallucinations in patients with schizophrenia. It was hypothesised that individuals with a diagnosis of schizophrenia would demonstrate deficits in processing the spectral and temporal aspects of sound and that such deficits would be more pronounced in patients with a history of auditory hallucinations (hallucinators) than those without such a history (non-hallucinators). A community sample meeting clinical criteria for schizophrenia or schizoaffective disorder (19 hallucinators, 15 non-hallucinators) and a matched healthy control group (n = 17) completed a broad range of auditory processing tasks involving pitch discrimination of modulated (temporal) and unmodulated (spectral) pure tones, auditory streaming and affective prosodic identification, as well as measures assessing current psychiatric symptoms. In all experimental tasks patients were impaired compared to controls. Specifically hallucinators performed worse than non-hallucinators and controls for pitch discrimination of unmodulated tones and auditory streaming, and both hallucinators and non-hallucinators performed significantly worse than controls for discrimination of modulated tones and affective prosody. These findings suggest that impaired temporal processing may contribute to general difficulties identifying affective speech prosody in patients with schizophrenia, while spectral processing deficits may specifically compromise melodic streaming in hallucinators, which combined with deficits in temporal processing, contribute to the experience of auditory hallucinations.
Managing schizophrenic patients with verbal auditory hallucination: Who else do we need in the team?
A multi-disciplinary approach is paramount in schizophrenia research because the disorder itself and its symptoms are heterogenous. As verbal auditory hallucination is the commonest yet poorly understood symptom in patients with schizophrenia, studies have focussed on the symptom in order to understand schizophrenia better. This paper highlights on significant audiological findings in auditory hallucination research. Interestingly, the vast amount of empirical data on auditory pathways in schizophrenia patients have moved our traditional beliefs on the symptom towards more scientific reasoning. Unfortunately, the contribution from audiologists who are specialized in managing auditory disorders is very limited in this research field. It is a hope that their involvement in the multi-discplinary team will strengthen and more importantly help in exploring new research ideas in this challenging research field.
A Pilot Study of Exposure Control of Chronic Auditory Hallucinations in Schizophrenia
British Journal of Psychiatry, 1995
BackgroundMany patients complain less of their auditory hallucinations per se than of lack of control of the experiences. There is reason to believe that a non-distraction (exposure) approach could help patients gain more control over persistent auditory hallucinations and teach them that their experience is a form of thinking and has no external source. This study is a pilot test of that idea.MethodFive DSM–III–R schizophrenic outpatients with medication-resistant auditory hallucinations improved with a mean of 31 hour-long sessions over 3 months of therapist-guided exposure to their hallucinations and situations likely to evoke them.ResultsImprovement was greatest in patients' anxiety and sense of control over their hallucinations, less in social use of leisure and hallucinating time.ConclusionsThese mildly encouraging pilot results warrant a controlled study of exposure for drug-resistant chronic auditory hallucinations and other psychotic experiences which are associated wit...
Objective: Research concerning the subjective sensory qualities of auditory hallucinations (AH) in people diagnosed with schizophrenia is scarce. Our goal was to investigate the “auditoriness” of AH and their overlap with symptoms grounded in alterations of thought rather than perception. Method: We undertook a detailed analysis of phenomenological interviews with 80 schizophrenia-spectrum voice-hearers. Results: We coded the dominant voice patterns of our subjects and found that only a minority (17.5%) reported a dominant pattern of AH which were experienced as literally auditory. Of dominant AH patterns, 11.3% were instead described as only quasi- or partially auditory, 28.8% as involving a combination of distinctly auditory and thought-like voices, and 15% as unambiguously thought-like. In addition, 5% reported exclusively simple, short-duration AH (e.g. hearing a single word), 12.5% the misperception of actual speech or sounds, and 10% predominantly multisensory voices. We also found substantial overlap between voices and symptoms traditionally considered abnormalities of thought rather than sensation. Conclusion: We believe these findings challenge common assumptions about AH in people diagnosed with schizophrenia, draw attention to potentially important but under-recognized characteristics of voices, and suggest a need for greater recognition of the heterogeneity of voices and the potential clinical as well as theoretical risks of conceptual over-simplification.
Fourteen of 1 8 hallucinating schizophrenic patients reported that the voices they heard went away when they undertook a maneuver that precluded subvocalization. The same applied to 1 8 of 21 normal subjects who hallucinated under the influence of hypnotic suggestion. Control maneuvers had no such effect. The authors suggest that auditory hallucinations may be projections of schizophrenic patients’ verbal thoughts, subvocalized due to deficient cerebral cortical inhibition.
Schizophrenia Bulletin
A comprehensive understanding of the phenomenology of auditory hallucinations (AHs) is essential for developing accurate models of their causes. Yet, only 1 detailed study of the phenomenology of AHs with a sample size of N ≥ 100 has been published. The potential for overreliance on these findings, coupled with a lack of phenomenological research into many aspects of AHs relevant to contemporary neurocognitive models and the proposed (but largely untested) existence of AH subtypes, necessitates further research in this area. We undertook the most comprehensive phenomenological study of AHs to date in a psychiatric population (N = 199; 81% people diagnosed with schizophrenia), using a structured interview schedule. Previous phenomenological findings were only partially replicated. New findings included that 39% of participants reported that their voices seemed in some way to be replays of memories of previous conversations they had experienced; 45% reported that the general theme or content of what the voices said was always the same; and 55% said new voices had the same content/theme as previous voices. Cluster analysis, by variable, suggested the existence of 4 AH subtypes. We propose that there are likely to be different neurocognitive processes underpinning these experiences, necessitating revised AH models.
Auditory hallucinations and subvocal speech in schizophrenic patients
The American journal of psychiatry, 1987
Fourteen of 18 hallucinating schizophrenic patients reported that the voices they heard went away when they undertook a maneuver that precluded subvocalization. The same applied to 18 of 21 normal subjects who hallucinated under the influence of hypnotic suggestion. Control maneuvers had no such effect. The authors suggest that auditory hallucinations may be projections of schizophrenic patients' verbal thoughts, subvocalized due to deficient cerebral cortical inhibition.
More on the Mechanisms of Auditory Verbal Hallucinations
Continues to press the case on the standard self-monitoring account of AVH in schizophrenia, particularly those that focus on inner speech. Focuses on the explanatory framework that guides work in this area including issues about describing the phenomenology of AVH, the validity of introspective reports, and the mechanisms and principles needed to tie brain to behavior. Again, it is argued that while dominant, the inner speech model is perhaps the least plausible of the models under consideration.