Impaired recognition of self-expressed thought in patients with auditory hallucinations.

Abstract

This study tested the hypothesis that psychiatric patients with a history of auditory hallucinations would show impaired recognition of their own thoughts relative to nonhallucinating patients. The reasoning underlying this proposal was that given the need to discriminate between one's own lexical thought and a voice from another source, the person less familiar with the properties of his or her thinking would more likely mislabel the source. Twelve hallucinators and eight nonhallucinators were asked to identify lexical, semantic, and syntactic properties of their own thoughts expressed a week earlier, and, as hypothesized, hallucinators were less capable of doing so. Control measures of verbal memory, opinion stability, and communication skill showed no differences between these groups. Analysis of process and reactive premorbid status revealed possible links of impaired thought recognition to excessive internal and external deployment of attention.Hallucinations, at least those not associated with any obvious disruption of central nervous system functioning, are among the more mystifying examples of serious psychological disturbance. There is general consensus that auditory and visual hallucinations are misrepresentations of the person's own thoughts in lexical (word) or image form so that they are treated as having external reference (i.e., as a perception; Horowitz, 1975). However, as is often true when solid empirical evidence is lacking, a large number of reasons have been proposed to explain why a gross misattribution occurs.Psychodynamic theorists have offered a range of speculations about the basis for hallucinations that frequently emphasize the adaptive qualities of the experience (Bender, 1970;Sherman & Beverly, 1924). Psychoanalytic thinkers have proposed hallucinations to be direct or symbolic repetitions of psychic trauma (Breuer & Freud, 1895) or regressions to a lower level of thought (from The author would like to express his appreciation to P. M. Temples and his staff at the Georgia Mental Health Institute for their generous cooperation with this investigation.Requests for reprints should be sent to

Influence of metacognitive variables and thought suppression on number of thoughts, discomfort they produce and number and quality of auditory illusions

“…There are diverse theoretical positions in relation to hallucinations, but all maintain that such experiences are actually private events attributed to an external source (Bentall, 1990;Bentall, Haddock, & Slade, 1994;Frith, 1995;Helbrun, 1980;Morrison, Haddock, & Tarrier, 1995). Based on this assumption, Bentall (1990) has stressed the importance of skill in judging the source of a perceived event for understanding hallucinatory phenomena, which is been called "reality discrimination".…”

Affective reactions to auditory hallucinations in psychotic, evangelical and control groups

“…Psychologists have long regarded hallucinations as indicators of serious psychological disturbance (e.g. Esquirol, 1832;Heilbrun, 1980;Jaspers, 1911;Schneider, 1959). However, humankind has been familiar with hallucinatory experiences for even longer, at least since biblical times (Preuss, 1975).…”

Cognitive-Behavioral Therapy

“…Heilbrun found that 12 psychiatric patients with a history of hallucinations turned out to be insuffi ciently capable of identifying the words, meaning, and grammatical style of their own spoken sentences following a 1-week lapse of time, as compared to eight nonhallucinating psychiatric patients. Incidentally, the two groups did not differ with regard to their ability to remember verbal material, the stability of their opinions, or the level of their communication skills (Heilbrun 1980 ) . A meta-analysis of 23 studies carried out over the past 30 years confi rmed that individuals diagnosed with schizophrenia who are prone to hallucinations tend to attribute self-generated thoughts and utterances to other people (Waters and Badcock 2010 ) .…”