Better Than Mermaids and Stray Dogs? Subtyping Auditory Verbal Hallucinations and Its Implications for Research and Practice

Overview

Journal Schizophr Bull

Publisher Oxford University Press

Specialty Psychiatry

Date 2014 Jun 18

PMID 24936087

Citations 44

Authors

Simon McCarthy-Jones

Neil Thomas

Clara Strauss

Guy Dodgson

Nev Jones

Angela Woods

Chris R Brewin

Mark Hayward

Massoud Stephane

Jack Barton

David Kingdon

Iris E Sommer

Affiliations

Soon will be listed here.

Abstract

The phenomenological diversity of auditory verbal hallucinations (AVH) is not currently accounted for by any model based around a single mechanism. This has led to the proposal that there may be distinct AVH subtypes, which each possess unique (as well as shared) underpinning mechanisms. This could have important implications both for research design and clinical interventions because different subtypes may be responsive to different types of treatment. This article explores how AVH subtypes may be identified at the levels of phenomenology, cognition, neurology, etiology, treatment response, diagnosis, and voice hearer's own interpretations. Five subtypes are proposed; hypervigilance, autobiographical memory (subdivided into dissociative and nondissociative), inner speech (subdivided into obsessional, own thought, and novel), epileptic and deafferentation. We suggest other facets of AVH, including negative content and form (eg, commands), may be best treated as dimensional constructs that vary across subtypes. After considering the limitations and challenges of AVH subtyping, we highlight future research directions, including the need for a subtype assessment tool.

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