Evaluation of inner–outer space distinction and verbal hallucinations in schizophrenia

Stephane, Massoud; Kuskowski, Michael A.; McClannahan, Kate; Surerus, Christa; Nelson, Katie

doi:10.1080/13546801003619884

Cited by 19 publications

(15 citation statements)

References 14 publications

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“…Based on the phenomenological structure of AVH (Stephane et al, 2003), Larøi and Woodward have suggested that AVH could result from combinatoric abnormalities in inner space-outer space and self-other distinctions, where either can be present or absent (Larøi and Woodward, 2007). We have investigated these capacities in the same subjects and with similar experimental designs and found, as has been previously reported, that hallucinating schizophrenia patients showed other- and outer space-misattributions (Stephane et al, 2010a,c). More importantly, we found that inner space-outer space and self-other distinction capacities are independent (Stephane et al, in preparation), which mirrors nicely the different “where” and “what” pathways for speech processing (Badcock, 2010).…”

Section: Combinatorics: Resolving the Phenomenological Puzzlementioning

confidence: 53%

“…However, this apparent disorder in the spatial localization of inner speech received much less attention than self-other misattribution of inner speech. Nonetheless, The literature shows that three studies have examined this aspect of inner speech and all reported tendency of schizophrenia patients to confuse speech experienced in inner space with speech experienced in outer space (Harvey, 1985; Franck et al, 2000; Badcock, 2010; Stephane et al, 2010a). …”

Section: Cognitive Models Of Brain Activity Associated With Avhmentioning

confidence: 99%

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Auditory verbal hallucinations result from combinatoric associations of multiple neural events

Stephane¹

2013

Front. Hum. Neurosci.

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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.

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Section: Combinatorics: Resolving the Phenomenological Puzzlementioning

confidence: 53%

Section: Cognitive Models Of Brain Activity Associated With Avhmentioning

confidence: 99%

Auditory verbal hallucinations result from combinatoric associations of multiple neural events

Stephane¹

2013

Front. Hum. Neurosci.

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“…From the perspective of inner speech generation disorder, these aspects of AVH experiences point to agency and spatial externalizations of inner verbal thoughts at a cognitive level. Consistently, neuropsychiatric research has shown evidence for both types of externalizations (9, 10).…”

Section: Introductionmentioning

confidence: 60%

“…In the former, subjects distinguished between speech delivered via headphones simulating IS perception and that simulating ES perception (20). In the latter, subjects distinguished between sentences they silently read (experienced in IS) and sentences they read aloud (experienced in ES) (10, 21, 22). All speech generation studies (10, 21, 22), unlike that of speech perception (20), reported IS/ES distinction impairment.…”

Section: Introductionmentioning

confidence: 99%

The Self, Agency and Spatial Externalizations of Inner Verbal Thoughts, and Auditory Verbal Hallucinations

Stephane

2019

Front. Psychiatry

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Aim: Auditory Verbal Hallucinations (AVH) are experienced as the “voices” of others (O-AVH) or self (S-AVH) in internal space/inside the head (IS-AVH) or external space (ES-AVH), and are considered to result from agency and spatial externalizations of inner speech. Both types of externalizations are conflated, and the relationship between these externalizations and AVH experiences is unclear. In this paper, I investigate the relationship between cognitive agency and spatial externalizations and between these externalizations and the types of AVH experience. Method: Twenty-five patients with history of AVH and 24 matched healthy controls performed agency and spatial distinction tasks: distinction between self-generated (read) (S) sentences and other-generated (O) sentences, and between sentences read silently (experienced in internal space, IS) and sentences read aloud (experienced in external space, ES). Regression analyses between misattribution biases (S-O vs. IS-ES, and O-S vs. ES-IS) were obtained. t tests were used to compare misattribution biases between AVH subtypes (S-AVH vs. O-AVH, and IS-AVH vs. ES-AVH). Results: Regressions suggest that agency distinction is independent from spatial distinction in both groups. O-AVH and S-AVH subgroups differed only with respect to S-O bias, and IS-AVH and ES-AVH subgroups differed only with respect to IS-ES bias. Conclusion: These results suggest that agency and spatial externalizations of inner speech are independent at phenomenological and cognitive and levels; and that these externalizations are co-related across levels. I discuss the implications of these findings in the wider context of research on AVH and on the experience of self.

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“…Daalman et al (2011) found no differences between patient vs. nonpatient voice hearers in perceived location, supporting the idea that externality does not indicate greater severity of illness. Stephane et al (2010) found that schizophrenia patients with only internal hallucinations performed more poorly than those with only external hallucinations on an internal “say/think” source memory task, suggesting that internal hallucinators may be less able to discriminate between internal versus externalized stimuli, a deficit posited to be central to psychosis (Docherty, 2012a; Ferchiou et al, 2010; Johnson, 2006). Nayani and David (1996) found that internal verbal hallucinations consisted of longer word sequences than external ones, which led them to posit that internal voices might be more complex, and hence a more established and incorporated psychotic phenomenon that develops over time with illness progression.…”

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confidence: 99%

Internal versus external auditory hallucinations in schizophrenia: symptom and course correlates

Docherty

Dinzeo

McCleery³

et al. 2014

Cognitive Neuropsychiatry

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Introduction The auditory hallucinations associated with schizophrenia are phenomenologically diverse. “External” hallucinations classically have been considered to reflect more severe psychopathology than “internal” hallucinations, but empirical support has been equivocal. Methods We examined associations of “internal” v. “external” hallucinations with (a) other characteristics of the hallucinations, (b) severity of other symptoms, and (c) course of illness variables, in a sample of 97 stable outpatients with schizophrenia or schizoaffective disorder who experienced auditory hallucinations. Results Patients with internal hallucinations did not differ from those with external hallucinations on severity of other symptoms. However, they reported their hallucinations to be more emotionally negative, distressing, and long-lasting, less controllable, and less likely to remit over time. They also were more likely to experience voices commenting, conversing, or commanding. However, they also were more likely to have insight into the self-generated nature of their voices. Patients with internal hallucinations were not older, but had a later age of illness onset. Conclusions Differences in characteristics of auditory hallucinations are associated with differences in other characteristics of the disorder, and hence may be relevant to identifying subgroups of patients that are more homogeneous with respect to their underlying disease processes.

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Evaluation of inner–outer space distinction and verbal hallucinations in schizophrenia

Cited by 19 publications

References 14 publications

Auditory verbal hallucinations result from combinatoric associations of multiple neural events

Auditory verbal hallucinations result from combinatoric associations of multiple neural events

The Self, Agency and Spatial Externalizations of Inner Verbal Thoughts, and Auditory Verbal Hallucinations

Internal versus external auditory hallucinations in schizophrenia: symptom and course correlates

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