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Rajanthiran L, Curtis G, Ayalde J, Orr K, Melvill-Smith P, Banerjee A, Schenk M, Wearne D. 'Is hearing believing?': A study of voices and beliefs in psychosis and trauma. Australas Psychiatry 2022; 30:547-551. [PMID: 35968743 DOI: 10.1177/10398562221106064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study compared voice characteristics and beliefs in participants diagnosed with post-traumatic stress disorder (PTSD) with dissociation, schizophrenia (SCZ) and both diagnoses of SCZ and PTSD. The relationship between dissociation and voice beliefs was also assessed. METHOD We identified 56 participants meeting the diagnostic criteria for PTSD with dissociation, SCZ or both diagnoses (PTSD + SCZ) who also experienced auditory hallucinations. Measures included PTSD Symptoms Scales Interview (PSSI-5), Psychotic Symptoms Rating Scale (PSYRAT), Clinician Administered Dissociative States Scale (CADSS), Beliefs about Voices Questionnaire (BAVQ) and Positive and Negative Syndrome Scale (PANSS). RESULTS Beliefs about voices were similar across diagnostic groups. Participants with SCZ were more likely to attribute their voices to an external origin, and participants with dual diagnosis were less able to control their voices. The PTSD-only group scored higher in dissociation scores than either the SCZ-only or dual diagnosis group. Malevolent voice appraisals correlated with dissociation scores only in the dual diagnosis group. CONCLUSIONS This research supports the hypothesis that voice beliefs are similar across diagnoses of PTSD and SCZ. However, differences in voice characteristics, emotional responses and relationship to dissociation may need to be considered in the psychological management of voices.
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Affiliation(s)
| | - Guy Curtis
- School of Psychology, UWA, Perth, Western Australia
| | | | - Kenneth Orr
- 103905Marian Center, Perth, Western Australia
| | | | - Amit Banerjee
- Headspace Youth Early Psychosis Program, Perth, Western Australia
| | - Meta Schenk
- 103905Marian Center, Perth, Western Australia
| | - Deborah Wearne
- School of Medicine, University of Western Australia (UWA), Perth, Western Australia
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López-Silva P, Cavieres Á, Humpston C. The phenomenology of auditory verbal hallucinations in schizophrenia and the challenge from pseudohallucinations. Front Psychiatry 2022; 13:826654. [PMID: 36051554 PMCID: PMC9424625 DOI: 10.3389/fpsyt.2022.826654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
In trying to make sense of the extensive phenomenological variation of first-personal reports on auditory verbal hallucinations, the concept of pseudohallucination is originally introduced to designate any hallucinatory-like phenomena not exhibiting some of the paradigmatic features of "genuine" hallucinations. After its introduction, Karl Jaspers locates the notion of pseudohallucinations into the auditory domain, appealing to a distinction between hallucinatory voices heard within the subjective inner space (pseudohallucination) and voices heard in the outer external space (real hallucinations) with differences in their sensory richness. Jaspers' characterization of the term has been the target of a number of phenomenological, conceptual and empirically-based criticisms. From this latter point of view, it has been claimed that the concept cannot capture distinct phenomena at the neurobiological level. Over the last years, the notion of pseudohallucination seems to be falling into disuse as no major diagnostic system seems to refer to it. In this paper, we propose that even if the concept of pseudohallucination is not helpful to differentiate distinct phenomena at the neurobiological level, the inner/outer distinction highlighted by Jaspers' characterization of the term still remains an open explanatory challenge for dominant theories about the neurocognitive origin of auditory verbal hallucinations. We call this, "the challenge from pseudohallucinations". After exploring this issue in detail, we propose some phenomenological, conceptual, and empirical paths for future research that might help to build up a more contextualized and dynamic view of auditory verbal hallucinatory phenomena.
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Affiliation(s)
- Pablo López-Silva
- School of Psychology, Faculty of Social Sciences, Universidad de Valparaíso, Valparaíso, Chile.,Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Álvaro Cavieres
- Department of Psychiatry, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - Clara Humpston
- School of Psychology, University of York, York, United Kingdom.,School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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Truong TPA, Applewhite B, Heiderscheit A, Himmerich H. A Systematic Review of Scientific Studies and Case Reports on Music and Obsessive-Compulsive Disorder. Int J Environ Res Public Health 2021; 18:11799. [PMID: 34831558 PMCID: PMC8618048 DOI: 10.3390/ijerph182211799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a severe psychiatric disorder, which can be associated with music-related symptoms. Music may also be used as an adjunct treatment for OCD. Following the PRISMA guidelines, we performed a systematic literature review exploring the relationship between music and OCD by using three online databases: PubMed, the Web of Science, and PsycINFO. The search terms were "obsessive compulsive disorder", "OCD", "music", and "music therapy". A total of 27 articles were utilised (n = 650 patients/study participants) and grouped into three categories. The first category comprised case reports of patients with musical obsessions in patients with OCD. Most patients were treated with selective serotonin reuptake inhibitors (SSRIs) or a combination of an SSRI and another pharmacological or a non-pharmacological treatment, with variable success. Studies on the music perception of people with OCD or obsessive-compulsive personality traits represented the second category. People with OCD or obsessive-compulsive personality traits seem to be more sensitive to tense music and were found to have an increased desire for harmony in music. Three small studies on music therapy in people with OCD constituted the third category. These studies suggest that patients with OCD might benefit from music therapy, which includes listening to music.
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Affiliation(s)
- Thanh Phuong Anh Truong
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London SE5 8AF, UK; (T.P.A.T.); (B.A.)
- Mental Health Studies Program, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Briana Applewhite
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London SE5 8AF, UK; (T.P.A.T.); (B.A.)
| | - Annie Heiderscheit
- Department of Music Therapy, Augsburg University, Minneapolis, MN 55454, USA;
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London SE5 8AF, UK; (T.P.A.T.); (B.A.)
- South London and Maudsley NHS Foundation Trust (SLaM), London SE5 8AZ, UK
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Wearne D, Curtis G, Choy W, Magtengaard R, Samuel M, Melvill-Smith P. Trauma-intrusive hallucinations and the dissociative state. BJPsych Open 2018; 4:385-388. [PMID: 30202600 PMCID: PMC6127963 DOI: 10.1192/bjo.2018.52] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/26/2018] [Accepted: 08/05/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Research has supported a model of dissociation mediating the experience of hearing voices in traumatised individuals. AIMS To further understand this model by examining subtypes of the dissociative experience involved in trauma-intrusive hallucinations. METHOD The study involved four hospitals, 11 psychiatrists and 69 participants assessed using the Psychotic Symptoms Rating scale, the PTSD Symptoms Scale Interview and the Dissociative Subtype of PTSD Score. RESULTS In total, 59% (n = 41) of the participants heard voices and they were compared with the 41% (n = 28) who did not. The severity of PTSD symptoms did not predict experience of hearing voices. Regression analysis indicated that two scales of dissociation (derealisation/depersonalisation and loss of awareness) were equally good predictors of the extent of hearing voices. Adding other possible predictors (age of trauma <18, sexual violence) was relevant but did not enhance the prediction. CONCLUSIONS This research supports the proposal that trauma-intrusive voices are mediated by symptoms of dissociation. The supported model describes general, rather than trauma specific, symptoms of dissociation mediating the experience of hearing voices. The concept of anchoring is discussed and suggests a potential treatment strategy, which could be useful in the clinical management of hearing voices. DECLARATION OF INTEREST None.
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Affiliation(s)
- Deborah Wearne
- Consultant Psychiatrist and Clinical Senior Lecturer, University of Western Australia, Australia
| | - Guy Curtis
- Head of Discipline and Deputy Dean - Psychology, School of Psychology and Exercise Science, Murdoch University, Australia
| | - Winston Choy
- Consultant Psychiatrist and Clinical Senior Lecturer, University of Western Australia, Bentley Mental Health Service, Australia
| | | | - Mathew Samuel
- Consultant Psychiatrist, Hollywood Hospital, Australia
| | - Peter Melvill-Smith
- Consultant Psychiatrist and Clinical Senior Lecturer, University of Western Australia, Joondalup Mental Health Service, Australia
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Abstract
Prior to the seventeenth century, the experiences we now name hallucinations were valued within a cultural context, they could bring meaning to the subject or the world. From mid-seventeenth to eighteenth centuries, they acquire a medical quality in mental and organic illnesses. However, the term was only fully integrated in psychiatry by Esquirol in the eighteenth-nineteenth centuries. By then, a controversy begins on whether hallucinations have a perceptual or intellectual origin. Esquirol favors the intellectual origin, describing them as an involuntary exercise of memory and imagination. By the twentieth century, some authors maintain that hallucinations are a form of delusion (Ey), while others describe them as a change in perception (Jaspers, Fish). More integrated perspectives like those proposed by Alonso Fernandez and Luque, highlights the heterogeneity of hallucinations and the multiplicity of their types and causes. The terms pseudohallucination, illusion, and hallucinosis are grafted into the concept of hallucination. Since its introduction the term pseudohallucination has been used with different meanings. The major characteristics that we found associated with pseudohallucinations were "lack of objectivity" and "presence of insight" (differing from hallucinations). Illusions are unanimously taken as distortions of real objects. Hallucinosis, first described in the context of alcohol consumption, is generally considered egodystonic, in which insight is preserved. These and other controversial aspects regarding the evolution of the term hallucination and all its derivative concepts are discussed in this paper.
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Affiliation(s)
- Diogo Telles-Correia
- Clinica Universitaria de Psiquiatria e Psicologia, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Abstract
OBJECTIVE This paper firstly explores the historical concept of pseudohallucinations and their phenomenology. It then examines the experience of hallucinosis in two subject groups, one with post-traumatic stress disorder with dissociative symptoms and the second with schizophrenia. METHOD The two groups were assessed using the Psychotic Symptoms Rating Scale with a view to identifying differences in the hallucinatory and delusional experience. RESULTS There was no significant difference between the groups in loudness, control, position, duration, or frequency of the voices. Delusions and negative content differed significantly, however. CONCLUSIONS Researchers have started to describe pseudohallucinations along a continuum. We build on this dimensional approach and suggest a collaborative nomenclature for subtyping.
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Affiliation(s)
- Deborah Wearne
- Consultant Psychiatrist, Maia House, Midland, WA, Australia
| | - Amanda Genetti
- Clinical Psychologist, Maia House, Midland, WA, Australia
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Affiliation(s)
- Sabrina Kastaun
- Heart & Brain Research Group, Justus-Liebig-University Giessen and Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Sa-Ra Lie
- Heart & Brain Research Group, Justus-Liebig-University Giessen and Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; Department of Surgery
| | - Mesut Yeniguen
- Heart & Brain Research Group, Justus-Liebig-University Giessen and Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; Neurology, Buergerhospital, Friedberg, Germany
| | - Markus Schoenburg
- Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; Heart & Brain Research Group, Justus-Liebig-University Giessen and Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Tibo Gerriets
- Heart & Brain Research Group, Justus-Liebig-University Giessen and Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; Neurology, Buergerhospital, Friedberg, Germany; Department of Neurology, Justus-Liebig-University, Giessen, Germany
| | - Martin Juenemann
- Heart & Brain Research Group, Justus-Liebig-University Giessen and Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; Neurology, Buergerhospital, Friedberg, Germany.
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