1
|
Szymanek P, Homan M, van Elk M, Hohol M. Effects of expectations and sensory unreliability on voice detection - A preregistered study. Conscious Cogn 2024; 123:103718. [PMID: 38880020 DOI: 10.1016/j.concog.2024.103718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024]
Abstract
The phenomenon of "hearing voices" can be found not only in psychotic disorders, but also in the general population, with individuals across cultures reporting auditory perceptions of supernatural beings. In our preregistered study, we investigated a possible mechanism of such experiences, grounded in the predictive processing model of agency detection. We predicted that in a signal detection task, expecting less or more voices than actually present would drive the response bias toward a more conservative and liberal response strategy, respectively. Moreover, we hypothesized that including sensory noise would enhance these expectancy effects. In line with our predictions, the findings show that detection of voices relies on expectations and that this effect is especially pronounced in the case of unreliable sensory data. As such, the study contributes to our understanding of the predictive processes in hearing and the building blocks of voice hearing experiences.
Collapse
Affiliation(s)
- Piotr Szymanek
- Doctoral School in the Social Sciences, Jagiellonian University in Krakow, Poland; Mathematical Cognition and Learning Lab, Copernicus Center for Interdisciplinary Studies, Jagiellonian University in Krakow, Poland.
| | - Marek Homan
- Mathematical Cognition and Learning Lab, Copernicus Center for Interdisciplinary Studies, Jagiellonian University in Krakow, Poland
| | - Michiel van Elk
- Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Mateusz Hohol
- Mathematical Cognition and Learning Lab, Copernicus Center for Interdisciplinary Studies, Jagiellonian University in Krakow, Poland
| |
Collapse
|
2
|
Orepic P, Bernasconi F, Faggella M, Faivre N, Blanke O. Robotically-induced auditory-verbal hallucinations: combining self-monitoring and strong perceptual priors. Psychol Med 2024; 54:569-581. [PMID: 37779256 DOI: 10.1017/s0033291723002222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
BACKGROUND Inducing hallucinations under controlled experimental conditions in non-hallucinating individuals represents a novel research avenue oriented toward understanding complex hallucinatory phenomena, avoiding confounds observed in patients. Auditory-verbal hallucinations (AVH) are one of the most common and distressing psychotic symptoms, whose etiology remains largely unknown. Two prominent accounts portray AVH either as a deficit in auditory-verbal self-monitoring, or as a result of overly strong perceptual priors. METHODS In order to test both theoretical models and evaluate their potential integration, we developed a robotic procedure able to induce self-monitoring perturbations (consisting of sensorimotor conflicts between poking movements and corresponding tactile feedback) and a perceptual prior associated with otherness sensations (i.e. feeling the presence of a non-existing another person). RESULTS Here, in two independent studies, we show that this robotic procedure led to AVH-like phenomena in healthy individuals, quantified as an increase in false alarm rate in a voice detection task. Robotically-induced AVH-like sensations were further associated with delusional ideation and to both AVH accounts. Specifically, a condition with stronger sensorimotor conflicts induced more AVH-like sensations (self-monitoring), while, in the otherness-related experimental condition, there were more AVH-like sensations when participants were detecting other-voice stimuli, compared to detecting self-voice stimuli (strong-priors). CONCLUSIONS By demonstrating an experimental procedure able to induce AVH-like sensations in non-hallucinating individuals, we shed new light on AVH phenomenology, thereby integrating self-monitoring and strong-priors accounts.
Collapse
Affiliation(s)
- Pavo Orepic
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Melissa Faggella
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Nathan Faivre
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
3
|
Majeed R. Gunning for affective realism: Emotion, perception and police shooting errors. PHILOSOPHICAL PSYCHOLOGY 2023. [DOI: 10.1080/09515089.2023.2188890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Affiliation(s)
- Raamy Majeed
- Lecturer in Philosophy, Department of Philosophy, University of Manchester, Manchester, UK
| |
Collapse
|
4
|
Anticevic A, Halassa MM. The thalamus in psychosis spectrum disorder. Front Neurosci 2023; 17:1163600. [PMID: 37123374 PMCID: PMC10133512 DOI: 10.3389/fnins.2023.1163600] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Psychosis spectrum disorder (PSD) affects 1% of the world population and results in a lifetime of chronic disability, causing devastating personal and economic consequences. Developing new treatments for PSD remains a challenge, particularly those that target its core cognitive deficits. A key barrier to progress is the tenuous link between the basic neurobiological understanding of PSD and its clinical phenomenology. In this perspective, we focus on a key opportunity that combines innovations in non-invasive human neuroimaging with basic insights into thalamic regulation of functional cortical connectivity. The thalamus is an evolutionary conserved region that forms forebrain-wide functional loops critical for the transmission of external inputs as well as the construction and update of internal models. We discuss our perspective across four lines of evidence: First, we articulate how PSD symptomatology may arise from a faulty network organization at the macroscopic circuit level with the thalamus playing a central coordinating role. Second, we discuss how recent animal work has mechanistically clarified the properties of thalamic circuits relevant to regulating cortical dynamics and cognitive function more generally. Third, we present human neuroimaging evidence in support of thalamic alterations in PSD, and propose that a similar "thalamocortical dysconnectivity" seen in pharmacological imaging (under ketamine, LSD and THC) in healthy individuals may link this circuit phenotype to the common set of symptoms in idiopathic and drug-induced psychosis. Lastly, we synthesize animal and human work, and lay out a translational path for biomarker and therapeutic development.
Collapse
Affiliation(s)
- Alan Anticevic
- School of Medicine, Yale University, New Haven, CT, United States
- *Correspondence: Alan Anticevic,
| | - Michael M. Halassa
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, United States
- Michael M. Halassa,
| |
Collapse
|
5
|
Patel S. Towards a conative account of mental imagery. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2148521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Shivam Patel
- Department of Philosophy, Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
6
|
Sheldon AD, Kafadar E, Fisher V, Greenwald MS, Aitken F, Negreira AM, Woods SW, Powers AR. Perceptual pathways to hallucinogenesis. Schizophr Res 2022; 245:77-89. [PMID: 35216865 PMCID: PMC9232894 DOI: 10.1016/j.schres.2022.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/22/2022]
Abstract
Recent advances in computational psychiatry have provided unique insights into the neural and cognitive underpinnings of psychotic symptoms. In particular, a host of new data has demonstrated the utility of computational frameworks for understanding how hallucinations might arise from alterations in typical perceptual processing. Of particular promise are models based in Bayesian inference that link hallucinatory perceptual experiences to latent states that may drive them. In this piece, we move beyond these findings to ask: how and why do these latent states arise, and how might we take advantage of heterogeneity in that process to develop precision approaches to the treatment of hallucinations? We leverage specific models of Bayesian inference to discuss components that might lead to the development of hallucinations. Using the unifying power of our model, we attempt to place disparate findings in the study of psychotic symptoms within a common framework. Finally, we suggest directions for future elaboration of these models in the service of a more refined psychiatric nosology based on predictable, testable, and ultimately treatable information processing derangements.
Collapse
Affiliation(s)
- Andrew D Sheldon
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Eren Kafadar
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Victoria Fisher
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Maximillian S Greenwald
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Fraser Aitken
- School of Biomedical and Imaging Sciences, Kings College, London, UK
| | | | - Scott W Woods
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Albert R Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America.
| |
Collapse
|
7
|
Fountas Z, Sylaidi A, Nikiforou K, Seth AK, Shanahan M, Roseboom W. A Predictive Processing Model of Episodic Memory and Time Perception. Neural Comput 2022; 34:1501-1544. [PMID: 35671462 DOI: 10.1162/neco_a_01514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/06/2022] [Indexed: 11/04/2022]
Abstract
Human perception and experience of time are strongly influenced by ongoing stimulation, memory of past experiences, and required task context. When paying attention to time, time experience seems to expand; when distracted, it seems to contract. When considering time based on memory, the experience may be different than what is in the moment, exemplified by sayings like "time flies when you're having fun." Experience of time also depends on the content of perceptual experience-rapidly changing or complex perceptual scenes seem longer in duration than less dynamic ones. The complexity of interactions among attention, memory, and perceptual stimulation is a likely reason that an overarching theory of time perception has been difficult to achieve. Here, we introduce a model of perceptual processing and episodic memory that makes use of hierarchical predictive coding, short-term plasticity, spatiotemporal attention, and episodic memory formation and recall, and apply this model to the problem of human time perception. In an experiment with approximately 13,000 human participants, we investigated the effects of memory, cognitive load, and stimulus content on duration reports of dynamic natural scenes up to about 1 minute long. Using our model to generate duration estimates, we compared human and model performance. Model-based estimates replicated key qualitative biases, including differences by cognitive load (attention), scene type (stimulation), and whether the judgment was made based on current or remembered experience (memory). Our work provides a comprehensive model of human time perception and a foundation for exploring the computational basis of episodic memory within a hierarchical predictive coding framework.
Collapse
Affiliation(s)
- Zafeirios Fountas
- Emotech Labs, London, N1 7EU U.K.,Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London WC1N 3AR, U.K.
| | | | | | - Anil K Seth
- Department of Informatics and Sackler Centre for Consciousness Science, University of Sussex, Brighton, BN1 9RH, U.K.,Canadian Institute for Advanced Research Program on Brain, Mind, and Consciousness, Toronto, ON M5G 1M1, Canada
| | - Murray Shanahan
- Department of Computing, Imperial College London, London, SW7 2RH, U.K.
| | - Warrick Roseboom
- Department of Informatics and Sackler Centre for Consciousness Science, University of Sussex, Brighton BN1 9RH, U.K.
| |
Collapse
|
8
|
Rappe S, Wilkinson S. Counterfactual cognition and psychosis: adding complexity to predictive processing accounts. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2054789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sofiia Rappe
- Faculty of Philosophy, Ludwig-Maximilians-Universität München, München, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität München, München, Germany
| | - Sam Wilkinson
- Department of Sociology, Philosophy, and Anthropology, University of Exeter, Exeter, UK
| |
Collapse
|
9
|
Wilkinson S, Green H, Hare S, Houlders J, Humpston C, Alderson-Day B. Thinking about hallucinations: why philosophy matters. Cogn Neuropsychiatry 2022; 27:219-235. [PMID: 34874242 PMCID: PMC9006978 DOI: 10.1080/13546805.2021.2007067] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: Hallucinations research is increasingly incorporating philosophy or the work of philosophically trained individuals. We present three different ways in which this is successfully implemented to the enhancement of knowledge and understanding of hallucinations and related phenomena.Method: We review contributions from phenomenology, philosophy of cognitive science, and philosophy of science and psychiatry.Results: We demonstrate that these areas of philosophy make significant contributions to hallucinations research. Phenomenology gives us a sophisticated and critical understanding of the lived experience of hallucinations. Philosophy of cognitive science enables big-picture theorising and synthesis of ideas, as well as a critical engagement with new paradigms. Philosophy of science and psychiatry raises valuable and theoretically informed questions about diagnosis and categorisation.Conclusions: These contributions reflect both the methodological variety within philosophy and its relevance to the hallucinations researcher.
Collapse
Affiliation(s)
- Sam Wilkinson
- Sociology, Philosophy and Anthropology, University of Exeter, Exeter, UK, Sam Wilkinson
| | - Huw Green
- Neuropsychology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Stephanie Hare
- Neuroimaging, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Clara Humpston
- School of Psychology, University of Birmingham Institute for Mental Health, Birmingham, UK
| | | |
Collapse
|
10
|
Alderson-Day B, Moffatt J, Lima CF, Krishnan S, Fernyhough C, Scott SK, Denton S, Leong IYT, Oncel AD, Wu YL, Gurbuz Z, Evans S. Susceptibility to auditory hallucinations is associated with spontaneous but not directed modulation of top-down expectations for speech. Neurosci Conscious 2022; 2022:niac002. [PMID: 35145758 PMCID: PMC8824703 DOI: 10.1093/nc/niac002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022] Open
Abstract
Auditory verbal hallucinations (AVHs)-or hearing voices-occur in clinical and non-clinical populations, but their mechanisms remain unclear. Predictive processing models of psychosis have proposed that hallucinations arise from an over-weighting of prior expectations in perception. It is unknown, however, whether this reflects (i) a sensitivity to explicit modulation of prior knowledge or (ii) a pre-existing tendency to spontaneously use such knowledge in ambiguous contexts. Four experiments were conducted to examine this question in healthy participants listening to ambiguous speech stimuli. In experiments 1a (n = 60) and 1b (n = 60), participants discriminated intelligible and unintelligible sine-wave speech before and after exposure to the original language templates (i.e. a modulation of expectation). No relationship was observed between top-down modulation and two common measures of hallucination-proneness. Experiment 2 (n = 99) confirmed this pattern with a different stimulus-sine-vocoded speech (SVS)-that was designed to minimize ceiling effects in discrimination and more closely model previous top-down effects reported in psychosis. In Experiment 3 (n = 134), participants were exposed to SVS without prior knowledge that it contained speech (i.e. naïve listening). AVH-proneness significantly predicted both pre-exposure identification of speech and successful recall for words hidden in SVS, indicating that participants could actually decode the hidden signal spontaneously. Altogether, these findings support a pre-existing tendency to spontaneously draw upon prior knowledge in healthy people prone to AVH, rather than a sensitivity to temporary modulations of expectation. We propose a model of clinical and non-clinical hallucinations, across auditory and visual modalities, with testable predictions for future research.
Collapse
Affiliation(s)
| | - Jamie Moffatt
- Department of Psychology, Durham University, Durham, UK
- Department of Psychology, University of Sussex, Brighton, UK
| | - César F Lima
- Centro de Investigação e Intervenção Social, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Saloni Krishnan
- Department of Psychology, Royal Holloway, University of London, London, UK
| | | | - Sophie K Scott
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Sophie Denton
- Department of Psychology, Durham University, Durham, UK
| | | | - Alena D Oncel
- Department of Psychology, Durham University, Durham, UK
| | - Yu-Lin Wu
- Department of Psychology, Durham University, Durham, UK
| | - Zehra Gurbuz
- Department of Psychology, Durham University, Durham, UK
| | - Samuel Evans
- Department of Psychology, University of Westminster, London, UK
| |
Collapse
|
11
|
Büttiker P, Weissenberger S, Ptacek R, Stefano GB. Interoception, Trait Anxiety, and the Gut Microbiome: A Cognitive and Physiological Model. Med Sci Monit 2021; 27:e931962. [PMID: 33945520 PMCID: PMC8106255 DOI: 10.12659/msm.931962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Trait anxiety is characterized as a constant and often subliminal state that persists during daily life. Interoception is the perception of internal states and sensations, including from the autonomic nervous system. This review aims to develop a predictive model to explain the emergence, manifestations, and maintenance of trait anxiety. The model begins with the assumption that anxiety states arise from active interoceptive inference. The subsequent activation of autonomic responses results from aversive sensory encounters. A cognitive model is proposed for trait anxiety that includes the aversive sensory components from interoception, exteroception, and proprioception. A further component of the hypothesis is that repeated exposure to subliminal anxiety-evoking sensory elements can lead to an overgeneralization of this response to other inputs that are generally non-aversive. Increased uncertainty may result when predicting the sensory environment, resulting in arbitrary interoceptive anxiety responses that may be due to unjustifiable causes. Arbitrary successful or unsuccessful matching of predictions and responses reduces the individual’s confidence to maintain the anxiety trait. In this review, the application of the proposed model is illustrated using gut microbial dysbiosis or imbalance of the gut microbiome.
Collapse
Affiliation(s)
- Pascal Büttiker
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Simon Weissenberger
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Radek Ptacek
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - George B Stefano
- Center for Cognitive and Molecular Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| |
Collapse
|
12
|
Zhuo C, Cheng L, Li G, Xu Y, Jing R, Li S, Zhang L, Lin X, Zhou C. COMT-Val158Met polymorphism modulates antipsychotic effects on auditory verbal hallucinations and temporal lobe gray matter volumes in healthy individuals-symptom relief accompanied by worrisome volume reductions. Brain Imaging Behav 2021; 14:1373-1381. [PMID: 30712251 PMCID: PMC7572342 DOI: 10.1007/s11682-019-00043-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Investigation of auditory verbal hallucinations (AVHs) in schizophrenics is complicated by psychiatric symptoms. Investigating healthy individuals with AVHs (H-AVHs) can obviate such confounding factors. The objective of this study was to explore the effects of antipsychotic treatment on AVHs and gray matter volumes (GMVs) in H-AVH subjects and whether such are effects are influenced by COMT-Val158Met genotype. Magnetic resonance imaging (MRI) and genotyping studies were completed for 42 H-AVH subjects and 42 well-matched healthy controls (HCs). COMT-Met/Met homozygotes (158th codon) were identified as COMT-Met genotype; COMT-Met/Val heterozygotes and COMT-Val/Val homozygotes were identified as COMT-Val genotype. Data were compared across groups (H-AVH vs. HC, and between genotypes) with two-sample t-tests. The H-AVH COMT-Met group showed a stronger response to antipsychotic treatment than the H-AVH COMT-Val group (p < 0.001). Both H-AVH genotype groups exhibited temporal lobe GMV reductions after treatment, and relative to their respective genotype-matched HC groups. Antipsychotic treatment effects in H-AVH subjects were influenced by COMT-Val158Met genotype and associated with widespread GMV reductions. These findings provide clues for further exploration of treatment targets for AVHs. Treatment associated GMV reductions, however, raise concerns about use of antipsychotics in H-AVH subjects.
Collapse
Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Morbidity Laboratory (PNGC-Lab), Tianjin Mental Health Center, Mental Health Teaching Hospital, Nankai University Affiliated Anding Hospital, Tianjin Medical University, Tianjin, 300222, China. .,Department of Psychiatry, Institute of Mental Healthy, Genetic Lab, Jining Medical University, Jining, 272191, China. .,Department of Psychiatry, College of Basic Medical Research, Tianjin Medical University, Tianjin, 300000, China. .,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China. .,Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China. .,Department of Psychiatry, Shanxi Medical University, Taiyuan, 030000, China.
| | - Langlang Cheng
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Gongying Li
- Department of Psychiatry, Institute of Mental Healthy, Genetic Lab, Jining Medical University, Jining, 272191, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China.,Department of Psychiatry, Shanxi Medical University, Taiyuan, 030000, China
| | - Rixing Jing
- Department of Pattern Recognition, China National Key Laboratory, Institute of Automation, Chinese Academy of Sciences, Beijing, 100191, China.,Department of Pattern Recognition, University of Chinese Academy of Sciences, Beijing, 100191, China
| | - Shen Li
- Department of Psychiatry, College of Basic Medical Research, Tianjin Medical University, Tianjin, 300000, China
| | - Li Zhang
- GHM Institute of CNS Regeneration, Jinan University, Guangzhou, 510632, Guangdong Province, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
| |
Collapse
|
13
|
Fazekas P. Hallucinations as intensified forms of mind-wandering. Philos Trans R Soc Lond B Biol Sci 2020; 376:20190700. [PMID: 33308066 DOI: 10.1098/rstb.2019.0700] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This paper argues for a novel way of thinking about hallucinations as intensified forms of mind-wandering. Starting from the observation that hallucinations are associated with hyperactive sensory areas underlying the content of hallucinatory experiences and a confusion with regard to the reality of the source of these experiences, the paper first reviews the different factors that might contribute to the impairment of reality monitoring. The paper then focuses on the sensory characteristics determining the vividness of an experience, reviews their relationship to the sensory hyperactivity observed in hallucinations, and investigates under what circumstances they can drive reality judgements. Finally, based on these considerations, the paper presents its main proposal according to which hallucinations are intensified forms of mind-wandering that are amplified along their sensory characteristics, and sketches a possible model of what factors might determine if an internally and involuntarily generated perceptual representation is experienced as a hallucination or as an instance of mind-wandering. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.
Collapse
Affiliation(s)
- Peter Fazekas
- Centre for Philosophical Psychology, Universiteit Antwerpen, Antwerpen, Belgium.,Cognitive Neuroscience Research Unit, Centre of Functionally Integrative Neuroscience, Aarhus Universitet, Aarhus, Denmark
| |
Collapse
|
14
|
Langland-Hassan P. Inner speech. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2020; 12:e1544. [PMID: 32949083 DOI: 10.1002/wcs.1544] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/25/2020] [Accepted: 08/13/2020] [Indexed: 11/07/2022]
Abstract
Inner speech travels under many aliases: the inner voice, verbal thought, thinking in words, internal verbalization, "talking in your head," the "little voice in the head," and so on. It is both a familiar element of first-person experience and a psychological phenomenon whose complex cognitive components and distributed neural bases are increasingly well understood. There is evidence that inner speech plays a variety of cognitive roles, from enabling abstract thought, to supporting metacognition, memory, and executive function. One active area of controversy concerns the relation of inner speech to auditory verbal hallucinations (AVHs) in schizophrenia, with a common proposal being that sufferers of AVH misidentify their own inner speech as being generated by someone else. Recently, researchers have used artificial intelligence to translate the neural and neuromuscular signatures of inner speech into corresponding outer speech signals, laying the groundwork for a variety of new applications and interventions. This article is categorized under: Philosophy > Foundations of Cognitive Science Linguistics > Language in Mind and Brain Philosophy > Consciousness Philosophy > Psychological Capacities.
Collapse
|
15
|
Abstract
As all human activities, verbal communication is fraught with errors. It is estimated that humans produce around 16,000 words per day, but the word that is selected for production is not always correct and neither is the articulation always flawless. However, to facilitate communication, it is important to limit the number of errors. This is accomplished via the verbal monitoring mechanism. A body of research over the last century has uncovered a number of properties of the mechanisms at work during verbal monitoring. Over a dozen routes for verbal monitoring have been postulated. However, to date a complete account of verbal monitoring does not exist. In the current paper we first outline the properties of verbal monitoring that have been empirically demonstrated. This is followed by a discussion of current verbal monitoring models: the perceptual loop theory, conflict monitoring, the hierarchical state feedback control model, and the forward model theory. Each of these models is evaluated given empirical findings and theoretical considerations. We then outline lacunae of current theories, which we address with a proposal for a new model of verbal monitoring for production and perception, based on conflict monitoring models. Additionally, this novel model suggests a mechanism of how a detected error leads to a correction. The error resolution mechanism proposed in our new model is then tested in a computational model. Finally, we outline the advances and predictions of the model.
Collapse
|
16
|
|
17
|
Affiliation(s)
- Jan Koenderink
- University of Leuven (KU Leuven), Belgium; Justus Liebig University Giessen, Germany; University of California at Berkeley, CA, USA; Utrecht University, the Netherlands
| |
Collapse
|
18
|
Zhuo C, Xu Y, Zhang L, Jing R, Zhou C. The Effect of Dopamine Antagonist Treatment on Auditory Verbal Hallucinations in Healthy Individuals Is Clearly Influenced by COMT Genotype and Accompanied by Corresponding Brain Structural and Functional Alterations: An Artificially Controlled Pilot Study. Front Genet 2019; 10:92. [PMID: 30894870 PMCID: PMC6414462 DOI: 10.3389/fgene.2019.00092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/29/2019] [Indexed: 11/29/2022] Open
Abstract
Few studies have been conducted to explore the influence of the catechol-o-methyltransferase (COMT) genotype on the severity of and treatment efficacy on auditory verbal hallucination (AVH) symptoms in healthy individuals with AVHs (Hi-AVHs). We hypothesized that the efficacy of dopamine antagonist treatment on AVHs in Hi-AVHs may be influenced by their COMT genotype and may be accompanied by corresponding brain alterations. To preliminarily investigate and test our hypothesis in an artificially controlled pilot study, we enrolled 42 Hi-AVHs as subjects and used magnetic resonance imaging and genetic methods to explore the basis brain features to investigate whether the efficacy of dopamine antagonist treatment on AVHs in Hi-AVH subjects was influenced by their COMT genotype or not. We found that COMT-met genotype subjects’ treatment response was better than that of COMT-val subjects. Although COMT-met genotype subjects demonstrated an increase in global functional connectivity density (gFCD) but no difference on gray matter volume (GMV) compared to COMT-val genotype subjects at baseline, notably, we found that both groups demonstrated gFCD and GMV reduction after treatment, but the reduction was more widespread in COMT-met genotype subjects than in COMT-val genotype subjects. This is the first study to report that Hi-AVH subjects’ baseline brain functional features are influenced by their COMT genotypes and that the COMT-met genotype subjects exhibit better responses to dopamine antagonists but have more widespread GMV and gFCD reduction than subjects with the COMT-val genotype. Despite several limitations, these findings may provide auxiliary information to further explain the mechanisms of AVHs and provide a clue for scholars to further explore specific treatment targets for AVHs in Hi-AVH subjects or in schizophrenia patients.
Collapse
Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, College of Basic Medical Science, Tianjin Medical University, Tianjin, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Psychiatry, Institute of Mental Health, Jining Medical University, Jining, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Li Zhang
- GHM Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Rixing Jing
- Department of Pattern Recognition, China National Key Laboratory, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Department of Pattern Recognition, University of Chinese Academy of Sciences, Beijing, China
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
19
|
Bansal S, Ford JM, Spering M. The function and failure of sensory predictions. Ann N Y Acad Sci 2018; 1426:199-220. [PMID: 29683518 DOI: 10.1111/nyas.13686] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/26/2018] [Accepted: 02/27/2018] [Indexed: 01/24/2023]
Abstract
Humans and other primates are equipped with neural mechanisms that allow them to automatically make predictions about future events, facilitating processing of expected sensations and actions. Prediction-driven control and monitoring of perceptual and motor acts are vital to normal cognitive functioning. This review provides an overview of corollary discharge mechanisms involved in predictions across sensory modalities and discusses consequences of predictive coding for cognition and behavior. Converging evidence now links impairments in corollary discharge mechanisms to neuropsychiatric symptoms such as hallucinations and delusions. We review studies supporting a prediction-failure hypothesis of perceptual and cognitive disturbances. We also outline neural correlates underlying prediction function and failure, highlighting similarities across the visual, auditory, and somatosensory systems. In linking basic psychophysical and psychophysiological evidence of visual, auditory, and somatosensory prediction failures to neuropsychiatric symptoms, our review furthers our understanding of disease mechanisms.
Collapse
Affiliation(s)
- Sonia Bansal
- Maryland Psychiatric Research Center, University of Maryland, Catonsville, Maryland
| | - Judith M Ford
- University of California and Veterans Affairs Medical Center, San Francisco, California
| | - Miriam Spering
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
20
|
Lu Y, Marshall C, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Bearden CE, Mathalon D, Addington J. Perceptual abnormalities in clinical high risk youth and the role of trauma, cannabis use and anxiety. Psychiatry Res 2017; 258:462-468. [PMID: 28886901 PMCID: PMC5915322 DOI: 10.1016/j.psychres.2017.08.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/12/2017] [Accepted: 08/18/2017] [Indexed: 12/21/2022]
Abstract
Recent research suggests that perceptual abnormalities are a group of diverse experiences, which have been associated with trauma, cannabis use, and anxiety. Of the attenuated psychotic symptoms that are present in youth at clinical high risk (CHR) of psychosis, perceptual abnormalities tend to be one of the most frequently endorsed symptoms. However, very few studies have explored perceptual abnormalities and their relationships with the above environmental and affective factors in a CHR sample. Four hundred and forty-one CHR individuals who met criteria for attenuated psychotic symptom syndrome (APSS) determined by the Structured Interview for Psychosis-risk Syndromes (SIPS) were assessed on the content of their perceptual abnormalities, early traumatic experience, cannabis use and self-reported anxiety. Logistic regression analyses suggested that both simple auditory and simple visual perceptual abnormalities were more likely to be reported by CHR who had early traumatic experiences, who are current cannabis users, and who have higher levels of anxiety. Multiple regression analysis revealed that only trauma and anxiety were independent predictors of both simple auditory and simple visual perceptual abnormalities. It is possible that examining subtypes of perceptual abnormalities in CHR leads to an improved understanding of the prevalence of such symptoms.
Collapse
Affiliation(s)
- Yun Lu
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Marshall
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Carrie E Bearden
- Department of Psychiatry & Biobehavioral Sciences and Psychology University of California at Los Angeles, Los Angeles, CA, USA
| | - Daniel Mathalon
- Department of Psychiatry, University of California at San Francisco and SFVA Medical Center, San Francisco, CA, USA
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
| |
Collapse
|
21
|
El Haj M, Roche J, Jardri R, Kapogiannis D, Gallouj K, Antoine P. Clinical and neurocognitive aspects of hallucinations in Alzheimer's disease. Neurosci Biobehav Rev 2017; 83:713-720. [PMID: 28235545 PMCID: PMC5565710 DOI: 10.1016/j.neubiorev.2017.02.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 01/14/2023]
Abstract
Due to their prevalence, hallucinations are considered as one of the most frequent psychotic symptoms in Alzheimer's disease (AD). These psychotic manifestations reduce patients' well-being, increase the burden of caregivers, contribute to early institutionalization, and are related with the course of cognitive decline in AD. Considering their consequences, we provide a comprehensive account of the current state of knowledge about the prevalence and characteristics of hallucinations in AD. We propose a comprehensive and testable theoretical model about hallucinations in AD: the ALZHA (ALZheimer and HAllucinations) model. In this model, neurological, genetic, cognitive, affective, and iatrogenic factors associated with hallucinations in AD are highlighted. According to the ALZHA model, hallucinations in AD first involve trait markers (i.e., cognitive deficits, neurological deficits, genetic predisposition and/or sensory deficits) to which state markers that may trigger these experiences are added (e.g., psychological distress and/or iatrogenic factors). Finally, we provide recommendations for assessment and management of these psychotic manifestations in AD, with the aim to benefit patients, caregivers, and health professionals.
Collapse
Affiliation(s)
- Mohamad El Haj
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
| | - Jean Roche
- CHU de Lille, Unité de Psychogériatrie, Pôle de gérontologie, 59037 Lille, France
| | - Renaud Jardri
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | | | - Karim Gallouj
- Department of Geriatrics, Tourcoing Hospital, France
| | - Pascal Antoine
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| |
Collapse
|
22
|
Wilkinson S, Dodgson G, Meares K. Predictive Processing and the Varieties of Psychological Trauma. Front Psychol 2017; 8:1840. [PMID: 29089916 PMCID: PMC5651022 DOI: 10.3389/fpsyg.2017.01840] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/03/2017] [Indexed: 11/13/2022] Open
Abstract
A recently popular framework in the cognitive sciences takes the human nervous system to be a hierarchically arranged Bayesian prediction machine. In this paper, we examine psychological trauma through the lens of this framework. We suggest that this can help us to understand the nature of trauma, and the different effects that different kinds of trauma can have. We end by exploring synergies between our approach and current theories of PTSD, and gesture toward future directions.
Collapse
Affiliation(s)
- Sam Wilkinson
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Guy Dodgson
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Kevin Meares
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
23
|
Humpston CS, Evans LH, Teufel C, Ihssen N, Linden DE. Evidence of absence: no relationship between behaviourally measured prediction error response and schizotypy. Cogn Neuropsychiatry 2017; 22:373-390. [PMID: 28697644 PMCID: PMC5646181 DOI: 10.1080/13546805.2017.1348289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The predictive processing framework has attracted much interest in the field of schizophrenia research in recent years, with an increasing number of studies also carried out in healthy individuals with nonclinical psychosis-like experiences. The current research adopted a continuum approach to psychosis and aimed to investigate different types of prediction error responses in relation to psychometrically defined schizotypy. METHODS One hundred and two healthy volunteers underwent a battery of behavioural tasks including (a) a force-matching task, (b) a Kamin blocking task, and (c) a reversal learning task together with three questionnaires measuring domains of schizotypy from different approaches. RESULTS Neither frequentist nor Bayesian statistical methods supported the notion that alterations in prediction error responses were related to schizotypal traits in any of the three tasks. CONCLUSIONS These null results suggest that deficits in predictive processing associated with clinical states of psychosis are not always present in healthy individuals with schizotypal traits.
Collapse
Affiliation(s)
- Clara S. Humpston
- CUBRIC, School of Psychology, Cardiff University, Cardiff, UK, Clara S. Humpston
| | - Lisa H. Evans
- CUBRIC, School of Psychology, Cardiff University, Cardiff, UK
| | | | - Niklas Ihssen
- Department of Psychology, Durham University, Durham, UK
| | - David E. J. Linden
- CUBRIC, School of Psychology, Cardiff University, Cardiff, UK,School of Medicine, Cardiff University, Cardiff, UK
| |
Collapse
|
24
|
Abstract
In 2007, we proposed an explanation of delusion formation as aberrant prediction error-driven associative learning. Further, we argued that the NMDA receptor antagonist ketamine provided a good model for this process. Subsequently, we validated the model in patients with psychosis, relating aberrant prediction error signals to delusion severity. During the ensuing period, we have developed these ideas, drawing on the simple principle that brains build a model of the world and refine it by minimising prediction errors, as well as using it to guide perceptual inferences. While previously we focused on the prediction error signal per se, an updated view takes into account its precision, as well as the precision of prior expectations. With this expanded perspective, we see several possible routes to psychotic symptoms - which may explain the heterogeneity of psychotic illness, as well as the fact that other drugs, with different pharmacological actions, can produce psychotomimetic effects. In this article, we review the basic principles of this model and highlight specific ways in which prediction errors can be perturbed, in particular considering the reliability and uncertainty of predictions. The expanded model explains hallucinations as perturbations of the uncertainty mediated balance between expectation and prediction error. Here, expectations dominate and create perceptions by suppressing or ignoring actual inputs. Negative symptoms may arise due to poor reliability of predictions in service of action. By mapping from biology to belief and perception, the account proffers new explanations of psychosis. However, challenges remain. We attempt to address some of these concerns and suggest future directions, incorporating other symptoms into the model, building towards better understanding of psychosis.
Collapse
Affiliation(s)
| | | | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge, Cambridge, UK .,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
25
|
Toh WL, Castle DJ, Thomas N, Badcock JC, Rossell SL. Auditory verbal hallucinations (AVHs) and related psychotic phenomena in mood disorders: analysis of the 2010 Survey of High Impact Psychosis (SHIP) data. Psychiatry Res 2016; 243:238-45. [PMID: 27419653 DOI: 10.1016/j.psychres.2016.06.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/08/2016] [Accepted: 06/21/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) are known to occur in mood disorders, but there has been scant research in the area. This paper aimed to explore the presence of hallucinations, and AVHs in particular, across affective disorders (with non-affective disorders serving as clinical reference groups). Specific attention was given to i) running commentary, ii) voices conversing, and iii) negative voices. A secondary aim was to examine patterns of associated delusional themes. METHOD Participants were 1550 Australians, aged 18-64 years, assigned to one of four groups on the basis of diagnosis: i) bipolar disorder (BD), ii) depressive psychosis (DP), iii) schizophrenia (SCZ), and iv) schizoaffective disorder (SAD). Relevant data collected from the 2010 Australian Survey of High Impact Psychosis (SHIP) was analysed. RESULTS Current prevalence of hallucinations was such that BD<DP; severity of hallucinations, and AVHs in particular, was in the order BD=DP<SAD=SCZ. These results were statistically significant. Negative voices, and concomitantly, persecutory delusions, were prominent across all clinical groups. DISCUSSION Future research should examine age of AVH onset as well as other forms of AVHs, whilst taking into account participants' specific mood states.
Collapse
Affiliation(s)
- Wei Lin Toh
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University School of Psychology and Psychiatry, Melbourne, VIC, Australia.
| | - David J Castle
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, VIC, Australia
| | - Neil Thomas
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University School of Psychology and Psychiatry, Melbourne, VIC, Australia
| | - Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry (CCRN), Royal Perth Hospital, University of Western Australia, WA, Australia
| | - Susan L Rossell
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University School of Psychology and Psychiatry, Melbourne, VIC, Australia; Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia
| |
Collapse
|
26
|
Jardri R, Hugdahl K, Hughes M, Brunelin J, Waters F, Alderson-Day B, Smailes D, Sterzer P, Corlett PR, Leptourgos P, Debbané M, Cachia A, Denève S. Are Hallucinations Due to an Imbalance Between Excitatory and Inhibitory Influences on the Brain? Schizophr Bull 2016; 42:1124-34. [PMID: 27261492 PMCID: PMC4988749 DOI: 10.1093/schbul/sbw075] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This review from the International Consortium on Hallucinations Research intends to question the pertinence of the excitatory-to-inhibitory (E/I) imbalance hypothesis as a model for hallucinations. A large number of studies suggest that subtle impairments of the E/I balance are involved in neurological and psychiatric conditions, such as schizophrenia. Emerging evidence also points to a role of the E/I balance in maintaining stable perceptual representations, suggesting it may be a plausible model for hallucinations. In support, hallucinations have been linked to inhibitory deficits as shown with impairment of gamma-aminobutyric acid transmission, N-methyl-d-aspartate receptor plasticity, reductions in gamma-frequency oscillations, hyperactivity in sensory cortices, and cognitive inhibition deficits. However, the mechanisms by which E/I dysfunctions at the cellular level might relate to clinical symptoms and cognitive deficits remain unclear. Given recent data advances in the field of clinical neuroscience, it is now possible to conduct a synthesis of available data specifically related to hallucinations. These findings are integrated with the latest computational frameworks of hallucinations, and recommendations for future research are provided.
Collapse
Affiliation(s)
- Renaud Jardri
- Univ Lille, CNRS UMR 9193, SCALab (psyCHIC Team) & CHU Lille, Psychiatry Department (CURE), Lille, France;
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen; Department of Radiology, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Matthew Hughes
- Brain & Psychological Sciences Centre, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Jérôme Brunelin
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Université Laval, Québec City, Québec, Canada; Université Lyon 1, INSERM U1028 & CNRS 5292, Lyon Neuroscience Research Centre (ΨR2 Team), Centre Hospitalier Le Vinatier, Lyon, France
| | - Flavie Waters
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, and Clinical Research Centre, Graylands Health Campus, North Metropolitan Area Health Service Mental Health, Perth, Western Australia, Australia
| | | | - Dave Smailes
- School of Health and Social Sciences, Leeds Trinity University, Leeds, UK
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universtätsmedizin Berlin, Berlin, Germany
| | - Philip R Corlett
- Department of Psychiatry, Yale University, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT
| | - Pantelis Leptourgos
- Group for Neural Theory, INSERM U960, Institute of Cognitive Studies, École Normale Supérieure, Paris, France
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Arnaud Cachia
- Laboratoire de Psychologie du Développement et de l'Éducation de l'Enfant, UMR 8240, CNRS & Université Paris-Descartes (Sorbonne-Paris-Cité), Paris, France
| | - Sophie Denève
- Group for Neural Theory, INSERM U960, Institute of Cognitive Studies, École Normale Supérieure, Paris, France
| |
Collapse
|
27
|
Gallimore AR, Strassman RJ. A Model for the Application of Target-Controlled Intravenous Infusion for a Prolonged Immersive DMT Psychedelic Experience. Front Pharmacol 2016; 7:211. [PMID: 27471468 PMCID: PMC4944667 DOI: 10.3389/fphar.2016.00211] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/30/2016] [Indexed: 01/22/2023] Open
Abstract
The state of consciousness induced by N,N-dimethyltryptamine (DMT) is one of the most extraordinary of any naturally-occurring psychedelic substance. Users consistently report the complete replacement of normal subjective experience with a novel "alternate universe," often densely populated with a variety of strange objects and other highly complex visual content, including what appear to be sentient "beings." The phenomenology of the DMT state is of great interest to psychology and calls for rigorous academic enquiry. The extremely short duration of DMT effects-less than 20 min-militates against single dose administration as the ideal model for such enquiry. Using pharmacokinetic modeling and DMT blood sampling data, we demonstrate that the unique pharmacological characteristics of DMT, which also include a rapid onset and lack of acute tolerance to its subjective effects, make it amenable to administration by target-controlled intravenous infusion. This is a technology developed to maintain a stable brain concentration of anesthetic drugs during surgery. Simulations of our model demonstrate that this approach will allow research subjects to be induced into a stable and prolonged DMT experience, making it possible to carefully observe its psychological contents, and provide more extensive accounts for subsequent analyses. This model would also be valuable in performing functional neuroimaging, where subjects are required to remain under the influence of the drug for extended periods. Finally, target-controlled intravenous infusion of DMT may aid the development of unique psychotherapeutic applications of this psychedelic agent.
Collapse
Affiliation(s)
- Andrew R. Gallimore
- Computational Neuroscience Unit, Okinawa Institute of Science and Technology Graduate UniversityOkinawa, Japan
| | - Rick J. Strassman
- Department of Psychiatry, University of New Mexico School of MedicineAlbuquerque, NM, USA
| |
Collapse
|
28
|
Moseley P, Alderson-Day B, Ellison A, Jardri R, Fernyhough C. Non-invasive Brain Stimulation and Auditory Verbal Hallucinations: New Techniques and Future Directions. Front Neurosci 2016; 9:515. [PMID: 26834541 PMCID: PMC4717303 DOI: 10.3389/fnins.2015.00515] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/22/2015] [Indexed: 12/11/2022] Open
Abstract
Auditory verbal hallucinations (AVHs) are the experience of hearing a voice in the absence of any speaker. Results from recent attempts to treat AVHs with neurostimulation (rTMS or tDCS) to the left temporoparietal junction have not been conclusive, but suggest that it may be a promising treatment option for some individuals. Some evidence suggests that the therapeutic effect of neurostimulation on AVHs may result from modulation of cortical areas involved in the ability to monitor the source of self-generated information. Here, we provide a brief overview of cognitive models and neurostimulation paradigms associated with treatment of AVHs, and discuss techniques that could be explored in the future to improve the efficacy of treatment, including alternating current and random noise stimulation. Technical issues surrounding the use of neurostimulation as a treatment option are discussed (including methods to localize the targeted cortical area, and the state-dependent effects of brain stimulation), as are issues surrounding the acceptability of neurostimulation for adolescent populations and individuals who experience qualitatively different types of AVH.
Collapse
Affiliation(s)
- Peter Moseley
- School of Psychology, University of Central Lancashire Preston, UK
| | - Ben Alderson-Day
- Science Laboratories, Department of Psychology, Durham University Durham, UK
| | - Amanda Ellison
- Science Laboratories, Department of Psychology, Durham University Durham, UK
| | - Renaud Jardri
- Centre National de la Recherche Scientifique UMR-9193, SCA-Lab & CHU Lille, Fontan Hospital, CURE Platform, Lille University Lille, France
| | - Charles Fernyhough
- Science Laboratories, Department of Psychology, Durham University Durham, UK
| |
Collapse
|
29
|
Alderson-Day B, Fernyhough C. Auditory verbal hallucinations: Social, but how? JOURNAL OF CONSCIOUSNESS STUDIES : CONTROVERSIES IN SCIENCE & THE HUMANITIES 2016; 23:163-194. [PMID: 29238264 PMCID: PMC5724750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Auditory verbal hallucinations (AVH) are experiences of hearing voices in the absence of an external speaker. Standard explanatory models propose that AVH arise from misattributed verbal cognitions (i.e. inner speech), but provide little account of how heard voices often have a distinct persona and agency. Here we review the argument that AVH have important social and agent-like properties and consider how different neurocognitive approaches to AVH can account for these elements, focusing on inner speech, memory, and predictive processing. We then evaluate the possible role of separate social-cognitive processes in the development of AVH, before outlining three ways in which speech and language processes already involve socially important information, such as cues to interact with others. We propose that when these are taken into account, the social characteristics of AVH can be explained without an appeal to separate social-cognitive systems.
Collapse
|
30
|
Fovet T, Orlov N, Dyck M, Allen P, Mathiak K, Jardri R. Translating Neurocognitive Models of Auditory-Verbal Hallucinations into Therapy: Using Real-time fMRI-Neurofeedback to Treat Voices. Front Psychiatry 2016; 7:103. [PMID: 27445865 PMCID: PMC4921472 DOI: 10.3389/fpsyt.2016.00103] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/31/2016] [Indexed: 12/31/2022] Open
Abstract
Auditory-verbal hallucinations (AVHs) are frequent and disabling symptoms, which can be refractory to conventional psychopharmacological treatment in more than 25% of the cases. Recent advances in brain imaging allow for a better understanding of the neural underpinnings of AVHs. These findings strengthened transdiagnostic neurocognitive models that characterize these frequent and disabling experiences. At the same time, technical improvements in real-time functional magnetic resonance imaging (fMRI) enabled the development of innovative and non-invasive methods with the potential to relieve psychiatric symptoms, such as fMRI-based neurofeedback (fMRI-NF). During fMRI-NF, brain activity is measured and fed back in real time to the participant in order to help subjects to progressively achieve voluntary control over their own neural activity. Precisely defining the target brain area/network(s) appears critical in fMRI-NF protocols. After reviewing the available neurocognitive models for AVHs, we elaborate on how recent findings in the field may help to develop strong a priori strategies for fMRI-NF target localization. The first approach relies on imaging-based "trait markers" (i.e., persistent traits or vulnerability markers that can also be detected in the presymptomatic and remitted phases of AVHs). The goal of such strategies is to target areas that show aberrant activations during AVHs or are known to be involved in compensatory activation (or resilience processes). Brain regions, from which the NF signal is derived, can be based on structural MRI and neurocognitive knowledge, or functional MRI information collected during specific cognitive tasks. Because hallucinations are acute and intrusive symptoms, a second strategy focuses more on "state markers." In this case, the signal of interest relies on fMRI capture of the neural networks exhibiting increased activity during AVHs occurrences, by means of multivariate pattern recognition methods. The fine-grained activity patterns concomitant to hallucinations can then be fed back to the patients for therapeutic purpose. Considering the potential cost necessary to implement fMRI-NF, proof-of-concept studies are urgently required to define the optimal strategy for application in patients with AVHs. This technique has the potential to establish a new brain imaging-guided psychotherapy for patients that do not respond to conventional treatments and take functional neuroimaging to therapeutic applications.
Collapse
Affiliation(s)
- Thomas Fovet
- Univ Lille, CNRS, UMR-9193, psyCHIC team & CHU Lille, Psychiatry Dpt (CURE), Fontan Hospital , Lille , France
| | - Natasza Orlov
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London , London , UK
| | - Miriam Dyck
- Department of Psychiatry, Psychotherapy and Psychosomatics, JARA-Brain, RWTH Aachen University , Aachen , Germany
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK; Department of Psychology, University of Roehampton, London, UK
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, JARA-Brain, RWTH Aachen University , Aachen , Germany
| | - Renaud Jardri
- Univ Lille, CNRS, UMR-9193, psyCHIC team & CHU Lille, Psychiatry Dpt (CURE), Fontan Hospital , Lille , France
| |
Collapse
|
31
|
Abstract
In this introduction we present the orthodox account of auditory verbal hallucinations (AVHs), a number of worries for this account, and some potential responses open to its proponents. With some problems still remaining, we then introduce the problems presented by the phenomenon of thought insertion, in particular the question of how different it is supposed to be from AVHs. We then mention two ways in which theorists have adopted different approaches to voices and thoughts in psychosis, and then present the motivation and composition of this special issue.
Collapse
Affiliation(s)
- Sam Wilkinson
- Department of Philosophy, University of Durham, Durham, UK
| | | |
Collapse
|
32
|
Badcock JC. A Neuropsychological Approach to Auditory Verbal Hallucinations and Thought Insertion - Grounded in Normal Voice Perception. ACTA ACUST UNITED AC 2015; 7:631-652. [PMID: 27617046 PMCID: PMC4995233 DOI: 10.1007/s13164-015-0270-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A neuropsychological perspective on auditory verbal hallucinations (AVH) links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream (APS) framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion (TI). In this paper, I propose that an APS framework offers a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI.
Collapse
Affiliation(s)
- Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, 6009 Western Australia
| |
Collapse
|
33
|
Wilkinson S. Forward models and passive psychotic symptoms. Front Hum Neurosci 2015; 9:22. [PMID: 25688201 PMCID: PMC4310322 DOI: 10.3389/fnhum.2015.00022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/11/2015] [Indexed: 11/13/2022] Open
|