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Towards a cognitive model of hallucinations in the course of alcohol dependence? A source monitoring-based pilot study

Published online by Cambridge University Press:  27 March 2014

Ł. Gawęda ,
J. Mikuła ,
W. Szelenbaum  and
A. Kokoszka
Ł. Gawęda*
Affiliation:
II Department of Psychiatry, Medical University of Warsaw, Poland
J. Mikuła
Affiliation:
Day Clinic for Alcohol-Dependent Patients, Mazowiecki Brodnowski Hospital, Warsaw, Poland
W. Szelenbaum
Affiliation:
University of Social Sciences and Humanities, Warsaw, Poland
A. Kokoszka
Affiliation:
II Department of Psychiatry, Medical University of Warsaw, Poland University of Social Sciences and Humanities, Warsaw, Poland
*
* Address for correspondence: Ł. Gawęda, Ph.D., II Department of Psychiatry, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland. (Email: [email protected])
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Abstract

Background

We investigated whether source-monitoring deficits (here a discrimination between imagined and performed actions) underlie hallucinations among patients with a history of hallucinations in the course of their alcohol dependence.

Method

We assessed 29 patients with alcohol dependence who had no history of hallucinations during their course of alcoholism and 29 patients with a history of at least one episode of hallucinations of any modality during their course of alcohol dependency. The control group consisted of 24 healthy participants. Participants were assessed with an action memory task. Simple actions were presented to the participants verbally or non-verbally. Some actions were performed physically and others were imagined. In the recognition phase, participants were asked whether the action was presented verbally or non-verbally (action presentation type discrimination) and whether the action was performed or imagined (self-monitoring). A confidence score related to self-monitoring responses was also obtained.

Results

Alcoholics with a history of hallucinations misremembered imagined actions as perceived ones more frequently than patients without hallucinations, but not the reverse. Only patients with a history of hallucinations committed more errors of this type than healthy subjects. There were no group differences regarding discrimination between an action presentation type. Both clinical groups committed errors with a higher degree of confidence than healthy subjects.

Conclusions

Our results tentatively suggest that a specific type of source-monitoring deficit (i.e. confusing imagery with reality) may be involved in the hallucinations in patients with alcohol dependence. The findings are discussed in the light of a transdiagnostic approach to hallucinations.

Keywords

Alcohol dependencealcoholicscognitive confidencehallucinationsself-monitoringsource-monitoring
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 13 , October 2014 , pp. 2763 - 2773
Copyright
Copyright © Cambridge University Press 2014 

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