The feeling, embodiment and emotion of hallucinations in first episode psychosis: A prospective phenomenological visual-ecological study using novel multimodal unusual sensory experience (MUSE) maps

Abstract

Background: Research and practice typically focus upon unimodal hallucinations, especially auditory verbal hallucinations. Contemporary research has however indicated that voice-hearing may co-occur within a broader milieu of feelings, and multimodal hallucinations may be more common than previously thought. Methods: An observational design asked participants to prospectively document the feeling and modality of hallucinations for one week prior to an interview. Novel visual diary methods involving drawing, writing and body-mapping generated 42 MUSE maps (multimodal unusual sensory experience), analysed with a participatory qualitative method. Twelve people took part: all experiencing hallucinations daily, accessing early intervention in psychosis services, given psychotic-spectrum diagnoses, and living in the community. The study took place during a seven-month period in 2018 at Leicestershire and Rutland's Psychosis Intervention and Early Recovery service (UK). Findings: All documented hallucinations co-occurred with bodily feelings. Feelings were localised to specific body areas, generalised across the body and extended beyond the body into peripersonal space. Co-occurring emotional feelings most commonly related to confusion, fear and frustration. Interpretation: Hallucinations were characterised by numerous feelings arising at once, often including multimodal, emotional, and embodied features. Within this study, the immediate feeling of hallucination experiences were readily communicated through prospective, visual, and ecological information gathering methods and particularly those which offer multiple modes of communication (e.g. body-map, visual, written, oral). Uptake of visual, ecological and prospective methods may enhance understandings of lived experiences of hallucinations. Funding: University of Leicester.

Amygdala subdivisions exhibit aberrant whole-brain functional connectivity in relation to stress intolerance and psychotic symptoms in 22q11.2DS

“…Consequently, sensorimotor dysfunction likely contributes to both affective and psychotic psychopathology (102). Our results regarding CMA to somatosensory dysconnectivity in patients with PS (+) and ITS(+) is in line with evidence showing heightened affective appraisal of sensory stimuli in psychosis (103) and suggests that sensory experiences manifest along the pathway between affective and psychotic symptoms. Overall, our results regarding contribution of CMA dysconnectivity to both PS and ITS, hint toward a key role of the CMA as a neurobiological substrate of affective pathway to psychosis.…”

New Directions for Symptoms and Diagnosis in Schizophrenia

“…Regarding accompanying symptoms, all types of hallucinations seem to be associated with other clinical features. Thus, the study of Melvin et al [57] reported clusters of emotional feelings associated with hallucinations which by order of frequency could be described as fear and anxiety; despair and powerlessness; abused and threat; frustration and anger; loneliness; stress and distress and worry. The same research highlighted co-occurring bodily feelings such as tension, pressure, agitation, chills, heaviness, and dizziness, across hallucination types identifiable, localized, specific, and communicable.…”