A Preliminary Investigation into the Existence of a Hypervigilance Subtype of Auditory Hallucination in People with Psychosis

Garwood, Lucy; Dodgson, Guy; Bruce, Vicki; McCarthy-Jones, Simon

doi:10.1017/s1352465813000714

Cited by 26 publications

(24 citation statements)

References 23 publications

(38 reference statements)

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“…52 This study also found evidence for another AVH subtype, characterized as occurring in a quiet environment when voice hearers’ attention was internally focused. These AVH could contrastingly be conceived of as having their basis in memories or misattributed inner speech, raising the possibility of subtyping at this level.…”

Section: Subtyping By Cognitive Processessupporting

confidence: 61%

Better Than Mermaids and Stray Dogs? Subtyping Auditory Verbal Hallucinations and Its Implications for Research and Practice

McCarthy-Jones

Thomas

Strauss

et al. 2014

Schizophrenia Bulletin

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108

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The phenomenological diversity of auditory verbal hallucinations (AVH) is not currently accounted for by any model based around a single mechanism. This has led to the proposal that there may be distinct AVH subtypes, which each possess unique (as well as shared) underpinning mechanisms. This could have important implications both for research design and clinical interventions because different subtypes may be responsive to different types of treatment. This article explores how AVH subtypes may be identified at the levels of phenomenology, cognition, neurology, etiology, treatment response, diagnosis, and voice hearer’s own interpretations. Five subtypes are proposed; hypervigilance, autobiographical memory (subdivided into dissociative and nondissociative), inner speech (subdivided into obsessional, own thought, and novel), epileptic and deafferentation. We suggest other facets of AVH, including negative content and form (eg, commands), may be best treated as dimensional constructs that vary across subtypes. After considering the limitations and challenges of AVH subtyping, we highlight future research directions, including the need for a subtype assessment tool.

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Section: Subtyping By Cognitive Processessupporting

confidence: 61%

Better Than Mermaids and Stray Dogs? Subtyping Auditory Verbal Hallucinations and Its Implications for Research and Practice

McCarthy-Jones

Thomas

Strauss

et al. 2014

Schizophrenia Bulletin

Self Cite

108

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“…In relation to hyperarousal, a hypervigilance subtype of voice hearing has been previously proposed (McCarthy-Jones et al, 2012, 2014; Garwood et al, 2015) and within this model is viewed as linked to the sensitization of the sympathetic nervous system following childhood victimization. Understandable hypervigilance to danger may result in a reduced threshold for threat detection in environmental noise (e.g., perceiving background sounds of people talking or traffic as a sign of danger), leading to intrusions of anomalous experiences.…”

Section: A Model Of Posttraumatic Stress In Psychosismentioning

confidence: 99%

Pathways from Trauma to Psychotic Experiences: A Theoretically Informed Model of Posttraumatic Stress in Psychosis

2017

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In recent years, empirical data and theoretical accounts relating to the relationship between childhood victimization and psychotic experiences have accumulated. Much of this work has focused on co-occurring Posttraumatic Stress Disorder or putative causal mechanisms in isolation from each other. The complexity of posttraumatic stress reactions experienced in psychosis remains poorly understood. This paper therefore attempts to synthesize the current evidence base into a theoretically informed, multifactorial model of posttraumatic stress in psychosis. Three trauma-related vulnerability factors are proposed to give rise to intrusions and to affect how people appraise and cope with them. First, understandable attempts to survive trauma become habitual ways of regulating emotion, manifesting in cognitive-affective, behavioral and interpersonal responses. Second, event memories, consisting of perceptual and episodic representations, are impacted by emotion experienced during trauma. Third, personal semantic memory, specifically appraisals of the self and others, are shaped by event memories. It is proposed these vulnerability factors have the potential to lead to two types of intrusions. The first type is anomalous experiences arising from emotion regulation and/or the generation of novel images derived from trauma memory. The second type is trauma memory intrusions reflecting, to varying degrees, the retrieval of perceptual, episodic and personal semantic representations. It is speculated trauma memory intrusions may be experienced on a continuum from contextualized to fragmented, depending on memory encoding and retrieval. Personal semantic memory will then impact on how intrusions are appraised, with habitual emotion regulation strategies influencing people’s coping responses to these. Three vignettes are outlined to illustrate how the model accounts for different pathways between victimization and psychosis, and implications for therapy are considered. The model is the first to propose how emotion regulation and autobiographical memory may lead to a range of intrusive experiences in psychosis, and therefore attempts to explain the different phenomenological associations observed between trauma and intrusions. However, it includes a number of novel hypotheses that require empirical testing, which may lead to further refinement. It is anticipated the model will assist research and practice, in the hope of supporting people to manage the impact of victimization on their lives.

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“…The aim was to lay bare the essence of an experience and make it intelligible to others. In light of this first‐person orientation, phenomenology can be viewed as the foundational science for psychopathology , yet relatively few papers publish primary evidence on the phenomenology of AVH experience (See Table S1).…”

Section: Phenomenological Enquirymentioning

confidence: 99%

Understanding auditory verbal hallucinations: a systematic review of current evidence

Upthegrove

Broome

Caldwell

et al. 2015

Acta Psychiatr Scand

108

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There has been a large growth in research on AVHs in recent decades dominated by neurobiological and neuroimaging studies. Future research should include focus on phenomenological aspects and AVHs change over the course of developing illness. Integration between branches of enquiry is needed, and the risk is that without this, models are proposed and investigated that bear scant relevance to the symptom itself.

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A Preliminary Investigation into the Existence of a Hypervigilance Subtype of Auditory Hallucination in People with Psychosis

Abstract: The results offered tentative support for the existence of an HV-AH subcategorization and justifies future research in larger samples. Potential implications for models of AHs are also considered.

Cited by 26 publications

References 23 publications

Better Than Mermaids and Stray Dogs? Subtyping Auditory Verbal Hallucinations and Its Implications for Research and Practice

Better Than Mermaids and Stray Dogs? Subtyping Auditory Verbal Hallucinations and Its Implications for Research and Practice

Pathways from Trauma to Psychotic Experiences: A Theoretically Informed Model of Posttraumatic Stress in Psychosis

Understanding auditory verbal hallucinations: a systematic review of current evidence

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