Auditory verbal hallucinations result from combinatoric associations of multiple neural events

Abstract

While Auditory Verbal Hallucinations (AVH) refer to specific experiences shared by all subjects who have AVH—the perception of auditory speech without corresponding external stimuli, the characteristics of these experiences differ from one subject to another. These characteristics include aspects such as the location of AVH (inside or outside the head), the linguistic complexity of AVH (hearing words, sentences, or conversations), the range of content of AVH (repetitive or systematized content), and many other variables. In another word, AVH are phenomenologically heterogeneous experiences. After decades of research focused on a few explanatory mechanisms for AVH, it is apparent that none of these mechanisms alone explains the wide phenomenological range of AVH experiences. To date, our phenomenological understanding of AVH remains largely disjointed from our understanding of the mechanisms of AVH. For a cohesive understanding of AVH, I review the phenomenology and the cognitive and neural basis of AVH. This review indicates that the phenomenology of AVH is not a pointless curiosity. How a subject describes his AVH experiences could inform about the neural events that resulted in AVH. I suggest that a subject-specific combinatoric associations of different neural events result in AVH experiences phenomenologically diverse across subjects.

Tailoring Cognitive Behavioral Therapy to Subtypes of Voice-Hearing

“…While there are reasons to believe that adopting the approach described here will lead to the development of more effective psychological interventions for voice-hearing, there are also a number of reasons to be cautious. First, there is a relatively long history of approaches that involve subtyping of hallucinatory experiences being of little practical use in terms of developing better interventions (Stephane, 2013 ). For example, Jaspers ( 1962 ) distinguished “true” AVH, which are heard in external space, from pseudohallucinations, which are heard in internal space (i.e., from inside the head), and suggested that the latter are a more benign form of AVH.…”

Alcohol withdrawal hallucinations in the general population, an epidemiological study

“…lack of insight") or without associated psychotic symptoms. It appears that, just like hallucinations could occur through a combination of mechanisms (Stephane, 2013), alcohol can cause hallucinations through multiple routes.…”

Current perspectives on the mechanisms of auditory hallucinations: introduction to the special research topic

“…deLeede-Smith and Barkus adopt a developmental perspective, charting how the features of AH emerge and persist across the lifespan, and suggest that mechanisms maintaining AH differ across these populations, whilst Badcock and Chhabra ( 2013 ) provide an extensive and reflective review of the literature on the perception of voice identity, which points to subtle biases across different levels of voice identity. Rounding out this set of articles, Stephane ( 2013 ) emphasizes the heterogeneity of AH from one voice hearer to the next, and persuasively argues that whilst hallucinatory experiences are unique to each individual they are not random collections of features. Instead, Stephane suggests, they arise from a limited number of dimensions of phenomenological AH space—each linked to a separate neural basis.…”