Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-27T16:40:02.676Z Has data issue: false hasContentIssue false

Do Thoughts Have Sound? Differences between Thoughts and Auditory Hallucinations in Schizophrenia

Published online by Cambridge University Press:  07 May 2014

Carlos Cuevas-Yust*
Affiliation:
Hospital Universitario Virgen del Rocío (Spain)
*
*Correspondence concerning this article should be addressed to Carlos Cuevas-Yust. Unidad de Gestión Clínica - Salud Mental Virgen del Rocío/IBIS/Hospital Universitario Virgen del Rocío (Servicio Andaluz de Salud). Sevilla (Spain). E-mail: [email protected]

Abstract

Cognitive theories about auditory hallucinations maintain that inner speech is erroneously interpreted as coming from an external source. Few first-hand accounts of patients’ experiences have been made, so there is limited knowledge of the process through which patients distinguish their auditory verbal hallucinations (AVHs) from ordinary thoughts. 89 individuals diagnosed with schizophrenia, some experiencing acute hallucinatory symptomatology (Sz-AVHs) and some who were not (Sz-noAVHs), were assessed along with 48 individuals from the general population using the Auditory Hallucinations Assessment Questionnaire (AHAQ; Cuevas-Yust, Rodríguez Martín, Ductor Recuerda, Salas Azcona, & León Gómez, 2006). The Schz-AVHs group reported hearing ordinary thoughts at the same volume as their auditory hallucinations (p = .53) and spoken words (p = .89). In contrast, the Sz-noAVHs and general population samples reported hearing spoken words louder than their own thoughts (p = .002; p = .04). In comparison to these last two groups, the Sz-AVHs group described the sound of their thoughts as louder. These findings are consistent with the cognitive hypothesis of auditory verbal hallucinations. Confusion identifying the source of auditory hallucinations could be due, in part, to “hearing” one’s thoughts at the same volume as auditory hallucinations and spoken words.

Type
Research Article
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, P., Larøi, F., McGuirea, P. K., & Aleman, A. (2008). The hallucinating brain: A review of structural and functional neuroimaging studies of hallucinations. Neuroscience and Biobehavioral Reviews, 32, 175191. http://dx.doi.org/10.1016/j.neubiorev.2007.07.012 Google Scholar
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (DSM-IV TR) (4 th Ed., Text Revision). Washington DC: Author.Google Scholar
Bentall, R. P. (1990). The illusions of reality: A review and integration of psychological research on hallucination. Psychological Bulletin, 107, 8295. http://dx.doi.org/10.1037//0033-2909.107.1.82 Google Scholar
Bentall, R. P. (1996). La investigación psicológica sobre las alucinaciones y los delirios: Psicopatología y aplicaciones para las estrategias de tratamiento [Psychological research on hallucinations and delusions: Psychopathology and therapeutic applications]. In Aldaz, J. A. & Vázquez, C. (comps.), Esquizofrenia: Fundamentos psicológicos y psiquiátricos de la rehabilitación [Psychological and psychiatric fundamentals of rehabilitation] (pp. 89108). Madrid, Spain: Siglo Veintiuno de España Editores.Google Scholar
Birchwood, M., Smith, J., Cochrane, R., Wetton, S., & Copestake, S. (1990). The social functioning scale: The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. British Journal of Psychiatry, 157, 853859. http://dx.doi.org/10.1192/bjp.157.6.853 Google Scholar
Cuevas-Yust, C., Rodríguez-Martín, B., Ductor-Recuerda, M. J., Salas Azcona, R., & León Gómez, M. (2006). Is volume a relevant factor for distinguishing thoughts from auditory hallucinations? Acta Psychiatrica Scandinavica, 431, 3940.Google Scholar
Festinger, L. (1957). A theory of cognitive dissonance. Stanford, CA: Stanford University Press.Google Scholar
Frith, C. D. (1992). The cognitive neuropsychology of schizophrenia. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Garret, M., & Silva, R. (2003). Auditory hallucinations, source monitoring, and the belief that “voices” are real. Schizophrenia Bulletin, 29, 445457. http://dx.doi.org/10.1093/oxfordjournals.schbul.a007018 Google Scholar
Hoffman, R. E., Varanko, M., Gilmore, J., & Kishara, L. (2008). Experiential features used by patients with schizophrenia to differentiate ‘voices’ from ordinary verbal thought. Psychological Medicine, 38, 11671176. http://dx.doi.org/10.1017/S0033291707002395 Google Scholar
Ingram, R. E. (1990). Self-focused attention in clinical disorders: Review and conceptual model. Psychological Bulletin, 107, 156176. http://dx.doi.org/10.1037//0033-2909.107.2.156 CrossRefGoogle ScholarPubMed
Johns, L. C., & van Os, J. (2001). The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21, 11251141. http://dx.doi.org/10.1016/S0272-7358(01)00103-9 CrossRefGoogle ScholarPubMed
Junginger, J., & Frame, C. L. (1985). Self-report of the frequency and phenomenology of verbal hallucinations. The Journal of Nervous and Mental Disease, 173, 149155. http://dx.doi.org/10.1097/00005053-198503000-00003 Google Scholar
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261276. http://dx.doi.org/10.1093/schbul/13.2.261 Google Scholar
Langdon, R., Jones, S. R., Connaughton, E., & Fernyhough, C. (2009). The phenomenology of inner speech: Comparison of schizophrenic patients with auditory verbal hallucinations and healthy controls. Psychological Medicine, 39, 655663. http://dx.doi.org/10.1017/S0033291708003978 CrossRefGoogle ScholarPubMed
Larøi, F., de Haan, S., Jones, S., & Raballo, A. (2010). Auditory verbal hallucinations: Dialoguing between the cognitive sciences and phenomenology. Phenomenology and the Cognitive Sciences, 9, 225240. http://dx.doi.org/10.1007/s11097-010-9156-0 Google Scholar
Moliner, M. (1987). Diccionario de uso del español [Spanish use dictionary]. Madrid, Spain: Editorial Gredos.Google Scholar
Moritz, S., & Larøi, F. (2008). Differences and similarities in the sensory and cognitive signatures of voice-hearing, intrusions and thoughts. Schizophrenia Research, 102, 96107. http://dx.doi.org/10.1016/j.schres.2008.04.007 CrossRefGoogle ScholarPubMed
Morrison, A. P., & Haddock, G. (1997). Self-focused attention in schizophrenic patients and normal subjects: A comparative study. Personality and Individual Differences, 23, 937941. http://dx.doi.org/10.1016/S0191-8869(97)00130-X Google Scholar
Morrison, A. P., Haddock, G., & Tarrier, N. (1995). Intrusive thoughts and auditory hallucinations: A cognitive approach. Behavioural and Cognitive Therapy, 23, 265280.http://dx.doi.org/10.1017/S1352465800015873 Google Scholar
Pérez-Álvarez, M., & García-Montes, J. M. (2006). Entendimiento filosófico de la esquizofrenia [Philosophical understanding of schizophrenia]. Apuntes de Psicología, 24, 1129.Google Scholar
Perona-Garcelán, S., Cuevas-Yust, C., García-Montes, J., Pérez-Álvarez, M., Ductor-Recuerda, M. J., Salas-Azcona, R., … Rodriguez Martin, B. (2008). Relationship between self-focused attention and dissociation in patients with and without auditory hallucinations. The Journal of Nervous and Mental Disease, 196, 190197. http://dx.doi.org/10.1097/NMD.0b013e318165c7c1 Google Scholar
Stanghellini, G., & Cutter, J. (2003). Auditory verbal hallucinations-breaking the silence of inner dialogue. Psychopathology, 36, 120128. http://dx.doi.org/10.1159/000071256 Google Scholar
Stanghellini, G., Langer, A. I., Ambrosini, A., & Cangas, A. J. (2012). Quality of hallucinatory experiences: Differences between a clinical and a non-clinical sample. World Psychiatry, 11, 110113. http://dx.doi.org/10.1016/j.wpsyc.2012.05.007 Google Scholar
Seal, M. L., Aleman, A., & McGuire, P. K. (2004). Compelling imagery, unanticipated speech and deceptive memory: Neurocognitive models of auditory verbal hallucinations in schizophrenia. Cognitive Neuropsychiatry, 9, 4372. http://dx.doi.org/10.1080/13546800344000156 Google Scholar
Strauss, J. S. (1989). Subjective experiences of schizophrenia: Toward a new dynamic psychiatry-II. Schizophrenia Bulletin, 15, 179187. http://dx.doi.org/10.1093/schbul/15.2.179 CrossRefGoogle Scholar
Wang, L., Metzak, P. D., & Woodward, T. D. (2011). Aberrant connectivity during self-other source monitoring in schizophrenia. Schizophrenia Research, 125, 136142. http://dx.doi.org/10.1016/j.schres.2010.11.012 Google Scholar
Waters, F., Allen, P., Aleman, A., Fernyhough, C., Woodward, T. S., Badcock, J. C., … Larøi, , , F. (2012). Auditory hallucinations in schizophrenia and nonschizophrenia populations: A review and integrated model of cognitive mechanisms. Schizophrenia Bulletin, 38, 683693. http://dx.doi.org/10.1093/schbul/sbs045 Google Scholar
Wells, A. (2007). The attention training technique: Theory, effects, and a metacognitive hypothesis on auditory hallucinations. Cognitive and Behavioral Practice, 14, 134138. http://dx.doi.org/10.1016/j.cbpra.2006.01.010 Google Scholar
Wells, A., & Matthews, G. (1994). Attention and emotion. Hove, UK: Erlbaum.Google Scholar