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Bell A, Toh WL, Allen P, Cella M, Jardri R, Larøi F, Moseley P, Rossell SL. Examining the relationships between cognition and auditory hallucinations: A systematic review. Aust N Z J Psychiatry 2024; 58:467-497. [PMID: 38470085 PMCID: PMC11128145 DOI: 10.1177/00048674241235849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
OBJECTIVE Auditory hallucinations (hearing voices) have been associated with a range of altered cognitive functions, pertaining to signal detection, source-monitoring, memory, inhibition and language processes. Yet, empirical results are inconsistent. Despite this, several theoretical models of auditory hallucinations persist, alongside increasing emphasis on the utility of a multidimensional framework. Thus, clarification of current evidence across the broad scope of proposed mechanisms is warranted. METHOD A systematic search of the Web of Science, PubMed and Scopus databases was conducted. Records were screened to confirm the use of an objective behavioural cognitive task, and valid measurement of hallucinations specific to the auditory modality. RESULTS Auditory hallucinations were primarily associated with difficulties in perceptual decision-making (i.e. reduced sensitivity/accuracy for signal-noise discrimination; liberal responding to ambiguity), source-monitoring (i.e. self-other and temporal context confusion), working memory and language function (i.e. reduced verbal fluency). Mixed or limited support was observed for perceptual feature discrimination, imagery vividness/illusion susceptibility, source-monitoring for stimulus form and spatial context, recognition and recall memory, executive functions (e.g. attention, inhibition), emotion processing and language comprehension/hemispheric organisation. CONCLUSIONS Findings were considered within predictive coding and self-monitoring frameworks. Of concern was the portion of studies which - despite offering auditory-hallucination-specific aims and inferences - employed modality-general measures, and/or diagnostic-based contrasts with psychologically healthy individuals. This review highlights disparities within the literature between theoretical conceptualisations of auditory hallucinations and the body of rigorous empirical evidence supporting such inferences. Future cognitive investigations, beyond the schizophrenia-spectrum, which explicitly define and measure the timeframe and sensory modality of hallucinations, are recommended.
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Affiliation(s)
- Adrienne Bell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Wei Lin Toh
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
- Department of Psychology, Alfred Health, Melbourne, VIC, Australia
| | - Paul Allen
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Matteo Cella
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Renaud Jardri
- University of Lille, INSERM U-1172, Plasticity and Subjectivity Team, Lille Neuroscience and Cognition Research Centre, Fontan Hospital, CHU Lille, Lille, France
| | - Frank Larøi
- Department of Psychology, University of Oslo, Oslo, Norway
- Psychology and Neuroscience of Cognition Research Unit, University of Liege, Liege, Belgium
| | - Peter Moseley
- Department of Psychology, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Susan L Rossell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
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Bere MJ, Rossell SL, Tan EJ, Carruthers SP, Gurvich C, Neill E, Sumner PJ, Van Rheenen TE, Toh WL. Exploring the cognitive profiles related to unimodal auditory versus multisensory hallucinations in schizophrenia-spectrum disorders. Cogn Neuropsychiatry 2024; 29:55-71. [PMID: 38345024 DOI: 10.1080/13546805.2024.2314941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/12/2023] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Hallucinations can be experienced across multiple sensory modalities, but psychiatric studies investigating the cognitive mechanisms of hallucinations have been somewhat restricted to the auditory domain. This study explored the cognitive profiles of individuals experiencing multisensory hallucinations (MH) in schizophrenia-spectrum disorders (SSD) and compared these to those experiencing unimodal auditory hallucinations (AH) or no hallucinations (NH). METHODS Participants included SSD patients (n = 119) stratified by current hallucination status (NH, AH, MH) and nonclinical controls (NCs; n = 113). Group performance was compared across several cognitive domains: speed of processing, attention, working memory, verbal learning, visual learning, reasoning and problem-solving, social cognition, and inhibition. RESULTS The clinical groups performed worse than NCs but differences between the clinical groups were not evident across most cognitive domains. Exploratory analyses revealed that the MH group was more impaired on the visual learning task compared to the NH (but not AH) group. CONCLUSIONS Preliminary results suggest that impaired visual learning may be related to MH. This could be attributed to the presence of visual hallucinations (VH), or greater psychopathology, in this group. However, replication is needed, as well as the investigation of other potential cognitive mechanisms of MH.
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Affiliation(s)
- Mikaela J Bere
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Susan L Rossell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Eric J Tan
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
- Memory Ageing & Cognition Centre, National University Health System, Singapore, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sean P Carruthers
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Caroline Gurvich
- Department of Psychiatry, Monash University & Alfred Hospital, Melbourne, Australia
| | - Erica Neill
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Philip J Sumner
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Wei Lin Toh
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
- Department of Psychology, Alfred Hospital, Melbourne, Australia
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3
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Heim S, Polyak S, Hußmann K. Mimicking effects of auditory verbal hallucinations on language production at the level of words, sentences and stories. Front Psychol 2022; 13:1017865. [DOI: 10.3389/fpsyg.2022.1017865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Schizophrenia is characterised foremost by hallucinations, delusions and disorganised speech. Deficits in the internal speech monitor may contribute to the development of auditory-verbal hallucinations. This study investigates potential effects in the opposite direction: could the presence of auditory-verbal hallucinations have an effect on speech production? To this end, a recent mimicking/simulation approach was adopted for 40 healthy participants who perceived either white noise or hallucination-like speech recordings during different language production tasks with increasing demands: picture naming, verbal fluency with and without category switch, sentence production, and discourse. In line with reports about real schizophrenia cases in the literature, mimicking auditory-verbal hallucinations affected verbal fluency (switch condition) and sentence production (duration) in a different way than mere noise. These effects were not correlated, suggesting that hallucinations may even affect different levels of linguistic complexity in different ways. Anyway, in both cases (mimicked), auditory hallucination appear to contribute to the emergence of disordered speech. The mimicking/simulation paradigm may in future help to identify and disentangle the various factors contributing to disorganised speech in schizophrenia. They may also support the development and implementation of new protocols, e.g., in speech and language therapy in persons with schizophrenia in order to improve their communication skills despite the presence of auditory-verbal hallucinations.
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Implications for Early Diagnosis and Treatment in Schizophrenia Due to Correlation between Auditory Perceptual Deficits and Cognitive Impairment. J Clin Med 2021; 10:jcm10194557. [PMID: 34640571 PMCID: PMC8509531 DOI: 10.3390/jcm10194557] [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] [Received: 09/02/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
It is indicated that auditory perception deficits are present in schizophrenia and related to formal thought disorder. The purpose of the present study was to investigate the association of auditory deficits with cognitive impairment in schizophrenia. An experimental group of 50 schizophrenia patients completed a battery of auditory processing evaluation and a neuropsychological battery of tests. Correlations between neuropsychological battery scores and auditory processing scores were examined. Cognitive impairment was correlated with auditory processing deficits in schizophrenia patients. All neuropsychological test scores were significantly correlated with at least one auditory processing test score. Our findings support the coexistence of auditory processing disorder, severe cognitive impairment, and formal thought disorder in a subgroup of schizophrenia patients. This may have important implications in schizophrenia research, as well as in early diagnosis and nonpharmacological treatment of the disorder.
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Moschopoulos N, Nimatoudis I, Kaprinis S, Sidiras C, Iliadou V. Auditory processing disorder may be present in schizophrenia and it is highly correlated with formal thought disorder. Psychiatry Res 2020; 291:113222. [PMID: 32562936 DOI: 10.1016/j.psychres.2020.113222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 12/17/2022]
Abstract
The present study investigates the presence of Auditory Processing Disorder (APD) in schizophrenia and its association with symptomatology, especially Formal Thought Disorder (FTD). 50 patients with schizophrenia and 25 matched healthy controls completed a battery of three auditory processing tests. Positive and Negative Syndrome Scale (PANSS) and Thought, Language and Communication (TLC) scale were used to assess clinical symptoms. The patient group was divided into two subgroups, according to FTD severity. Auditory processing performance of the control group and the patient group was evaluated. Correlations between auditory processing scores and TLC scores, as well as auditory processing scores and PANSS scores were examined. Most of the patients, especially those with FTD, had auditory deficits that can be classified as APD. Patients showed impaired performance compared to controls in all tests. Total severity and specific factors of FTD, as well as other clinical symptoms and symptom categories were correlated with auditory processing performance. We provided evidence that APD may be present in schizophrenia and that FTD, as well as other clinical symptoms are associated with auditory processing deficits. There are important clinical implications for non-pharmacological interventions and early diagnosis of schizophrenia.
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Affiliation(s)
- Nikolaos Moschopoulos
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Ioannis Nimatoudis
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stergios Kaprinis
- 2nd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Sidiras
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Iliadou
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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6
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Toh WL, Tan EJ, Neill E, Van Rheenen TE, Gurvich C, Sumner PJ, Carruthers SP, Thomas EHX, Rossell SL. Identifying the cognitive underpinnings of voice-hearing by comparing never, past and current voice-hearers. Acta Psychiatr Scand 2020; 141:553-562. [PMID: 32144760 DOI: 10.1111/acps.13169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/12/2020] [Accepted: 03/01/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The current study aimed to compare specific cognitive profiles corresponding to auditory verbal hallucinations (AVH) status and elucidate which pattern of cognitive deficits may predict voice-hearing status. METHOD Clinical participants with schizophrenia spectrum disorders were partitioned into: (i) current voice-hearers (n = 46), (ii) past voice-hearers (n = 37) and (iii) never voice-hearers (n = 40), and compared with 319 non-clinical controls. Cognitive assessment employed the MATRICS Consensus Cognitive Battery (MCCB), supplemented by the Delis-Kaplan Executive Function System (D-KEFS) Colour-Word Interference Test (Stroop) as a robust measure of executive function. RESULTS On the Visual Learning domain, current and past voice-hearers had significantly poorer performance relative to never voice-hearers, who in turn had significantly poorer performance than non-clinical controls. Current and never voice-hearers had significantly poorer performance on the Social Cognition domain relative to non-clinical controls. Current voice-hearers also had significantly poorer performance on the Inhibition domain relative to non-clinical controls. Binary logistic regression revealed that Visual Learning was the only significant cognitive predictor of AVH presence. CONCLUSION Visual learning, and potentially inhibition, may be viable therapeutic targets when addressing cognitive mechanisms associated with AVHs. Future research should focus on investigating additional cognitive mechanisms, employing diverse voice-hearing populations and embarking on related longitudinal studies.
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Affiliation(s)
- W L Toh
- Faculty of Health, Arts & Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Vic., Australia
| | - E J Tan
- Faculty of Health, Arts & Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Vic., Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Vic., Australia
| | - E Neill
- Faculty of Health, Arts & Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Vic., Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Vic., Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Vic., Australia
| | - T E Van Rheenen
- Faculty of Health, Arts & Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Vic., Australia.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Vic., Australia
| | - C Gurvich
- Alfred Hospital & Central Clinical School, Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Vic., Australia
| | - P J Sumner
- Faculty of Health, Arts & Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Vic., Australia
| | - S P Carruthers
- Faculty of Health, Arts & Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Vic., Australia
| | - E H X Thomas
- Alfred Hospital & Central Clinical School, Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Vic., Australia
| | - S L Rossell
- Faculty of Health, Arts & Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Vic., Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Vic., Australia
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Cella M, Bodnar M, Lepage M, Malla A, Joober R, Iyer S, Wykes T, Preti A. Investigating subjective cognitive complaints in psychosis: Introducing the brief scale to Investigate cognition in schizophrenia (SSTICS-Brief). Cogn Neuropsychiatry 2020; 25:190-200. [PMID: 32028842 DOI: 10.1080/13546805.2020.1722084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Cognitive difficulties are a core deficit for people with schizophrenia and are generally assessed with neuropsychological tests. Self-report assessments are also useful in understanding difficulties from the service user's perspective. This study aims to introduce and test the shorter version of the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) to improve its acceptability and comprehensibility.Methods: In consultation with service users and clinicians, we identified items from the original 21-item SSTICS that were found difficult and these were excluded. The reduced scale was explored with Confirmatory Factor Analysis (CFA) in two independent samples in the UK and Canada. Convergent validity with symptoms and IQ was assessed and compared between the original and the reduced scale.Results: Six-hundred and seven people with schizophrenia and first-episode psychosis took part in this study. Seven items were removed to produce the SSTICS-Brief. This had good reliability and the CFA confirmed a unidimensional structure. Convergent validity with symptoms and IQ were optimal between the long and short versions.Conclusions: The SSTICS-B has better acceptability than its longer form and could be administered in less time. The resulting measure is likely to be a valuable short self-assessment of cognitive complaints for people with schizophrenia.
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Affiliation(s)
- Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Michael Bodnar
- The Royal Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Ashok Malla
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Srividya Iyer
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Til Wykes
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Antonio Preti
- Center for Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
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8
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Moschopoulos NP, Nimatoudis I, Kaprinis S, Iliadou V. Behavioral assessment of auditory processing deficits in schizophrenia: Literature review and suggestions for future research. Scand J Psychol 2018; 60:116-127. [DOI: 10.1111/sjop.12514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Nikolaos P. Moschopoulos
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Ioannis Nimatoudis
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Stergios Kaprinis
- 2nd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Vasiliki Iliadou
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
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9
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Aase I, Kompus K, Gisselgård J, Joa I, Johannessen JO, Brønnick K. Language Lateralization and Auditory Attention Impairment in Young Adults at Ultra-High Risk for Psychosis: A Dichotic Listening Study. Front Psychol 2018; 9:608. [PMID: 29755393 PMCID: PMC5934990 DOI: 10.3389/fpsyg.2018.00608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/10/2018] [Indexed: 12/11/2022] Open
Abstract
Objectives: Impaired attention and language functions are common in psychosis, but have been less explored in subjects with ultra-high risk for psychosis (UHR). The aim of the study was to investigate differences in language lateralization and auditory attention in UHR subjects compared to healthy controls with a dichotic listening paradigm. In addition, symptoms from The Structural Interview for Prodromal Syndromes (SIPS) were explored in relation to performance on dichotic listening. Methods: The UHR subjects (n = 46, female = 28, mean age = 17.9) were compared to a group of healthy controls (n = 40, female = 20, mean age = 16.8). A split-plot repeated measures analysis of covariance was conducted with group as between-subjects factor and attention conditions (non-forced, forced-right, forced-left) and side (right ear, left ear) as repeated measures factors (2×3×2 design) using gender, age and handedness as covariates. SIPS symptoms were subjected to Spearman’s r correlations with laterality indexes and attentional gain in each ear. Results: There was a statistically significant three-way interaction of group (UHR, healthy controls) × forced condition (non-forced, forced-right, forced-left) × side (right ear, left ear), p = 0.048. The effect was due to an interaction between group × side in the forced-left condition. There were no significant differences between UHR subjects and healthy controls in the non-forced condition. Right ear gain correlated with “Perceptual abnormalities/Hallucinations” (P4), r = 0.486, p = 0.001. Conclusion: UHR subjects demonstrated impairment in top-down attentional mechanisms, but showed no language lateralization abnormalities. Impairment in top-down attentional mechanisms are frequently reported from dichotic listening studies in patients with schizophrenia. Higher levels of perceptual abnormalities and hallucinatory experiences were associated with enhanced report from the right ear in the forced-right condition.
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Affiliation(s)
- Ingvild Aase
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
| | - Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jens Gisselgård
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway
| | - Inge Joa
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
| | - Jan O Johannessen
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Brønnick
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
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Spagna A, He G, Jin S, Gao L, Mackie MA, Tian Y, Wang K, Fan J. Deficit of supramodal executive control of attention in schizophrenia. J Psychiatr Res 2018; 97:22-29. [PMID: 29172174 DOI: 10.1016/j.jpsychires.2017.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/21/2017] [Accepted: 11/02/2017] [Indexed: 01/30/2023]
Abstract
Although a deficit in executive control of attention is one of the hallmarks in schizophrenia that has significant impact on everyday functioning due to its relationship with thought processing, whether this deficit occurs across modalities, i.e., is supramodal, remains unclear. To investigate the supramodal mechanism in SZ, we examined cross-modal correlations between visual and auditory executive control of attention in a group of patients with schizophrenia (SZ, n = 55) compared to neurotypical controls (NC, n = 55). While the executive control effects were significantly correlated between the two modalities in the NC group, these effects were not correlated in the SZ group, with a significant group difference in the correlation. Further, the inconsistency and magnitude of the cross-modal executive control effects were significantly larger in the SZ group compared to the NC group. Together, these results suggest that there is a disruption of a common supramodal executive control mechanism in patients with schizophrenia, which may be related to the thought processing disorder characterizing the disorder.
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Affiliation(s)
- Alfredo Spagna
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Genxia He
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Department of Neurology, The Second Hospital of Anhui Province, Hefei, Anhui Province, China
| | - Shengchun Jin
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Liling Gao
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Melissa-Ann Mackie
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China.
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China.
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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11
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Visser L, Sinkeviciute I, Sommer IE, Bless JJ. Training switching focus with a mobile-application by a patient suffering from AVH, a case report. Scand J Psychol 2018; 59:59-61. [PMID: 29356004 DOI: 10.1111/sjop.12415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 08/30/2017] [Indexed: 12/21/2022]
Abstract
Auditory verbal hallucinations complicate many psychiatric disorders. Antipsychotic medication is effective in the majority, but a significant minority experiences high burden from resistant hallucinations. Here, we aim to improve executive control, in an attempt to decrease burden from hallucinations. We describe the use of a cognitive trainings app by a young woman with highly resistant hallucinations. With modest training, a significant decrease in the duration of hallucinations was reached. Possibilities of this training technique are discussed.
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Affiliation(s)
- Lucia Visser
- Department of Psychiatry, UMC Utrecht, Utrecht, The Netherlands
| | | | - Iris E Sommer
- Department of Neuroscience, UMC Groningen, Groningen, The Netherlands
| | - Josef J Bless
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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12
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Siddi S, Petretto DR, Burrai C, Scanu R, Baita A, Trincas P, Trogu E, Campus L, Contu A, Preti A. The role of set-shifting in auditory verbal hallucinations. Compr Psychiatry 2017; 74:162-172. [PMID: 28167329 DOI: 10.1016/j.comppsych.2017.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/05/2016] [Accepted: 01/16/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) are a cardinal characteristic of psychosis. Recent research on the neuropsychological mechanism of AVHs has focused on source monitoring failure, but a few studies have suggested the involvement of attention, working memory, processing speed, verbal learning, memory, and executive functions. In this study we examined the neuropsychological profile of patients with AVHs, assuming that the mechanism underlying this symptom could be a dysfunction of specific cognitive domains. METHODS A large neuropsychological battery including set-shifting, working memory, processing speed, attention, fluency, verbal learning and memory, and executive functions was administered to 90 patients with psychotic disorders and 44 healthy controls. The group of patients was divided into two groups: 46 patients with AVHs in the current episode and 44 who denied auditory hallucinations or other modalities in the current episode. AVHs were assessed with the Psychotic Symptom Rating Scales (PSYRATS); the Launay-Slade Hallucination Scale was used to measure long-term propensity to auditory verbal hallucination-like experiences (HLEs) in the sample. RESULTS Patients showed poorer performances on all neuropsychological measures compared to the healthy controls' group. In the original dataset without missing data (n=58), patients with AVHs (n=29) presented poorer set shifting and verbal learning, higher levels of visual attention, and marginally significant poorer semantic fluency compared to patients without AVHs (n=29). In the logistic model on the multiple imputed dataset (n=90, 100 imputed datasets), lower capacity of set shifting and semantic fluency distinguished patients with AVHs from those without them. CONCLUSIONS Patients experiencing persistent AVHs might fail to shift their attention away from the voices; poorer semantic fluency could be a secondary deficit of set-shifting failure.
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Affiliation(s)
- Sara Siddi
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Faculty of Medicine, University of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Donatella Rita Petretto
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy
| | - Caterina Burrai
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Rosanna Scanu
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy
| | - Antonella Baita
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Pierfranco Trincas
- Psychiatric Diagnosis and Treatment Service II, Department of Mental Health, ASL Cagliari, Cagliary, Italy
| | - Emanuela Trogu
- Psychiatric Diagnosis and Treatment Service II, Department of Mental Health, ASL Cagliari, Cagliary, Italy
| | - Liliana Campus
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Augusto Contu
- Head, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Antonio Preti
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy; Genneruxi Medical Center, Cagliari, Italy
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Zhuo C, Zhu J, Qin W, Qu H, Ma X, Yu C. Cerebral blood flow alterations specific to auditory verbal hallucinations in schizophrenia. Br J Psychiatry 2017; 210:209-215. [PMID: 28104737 DOI: 10.1192/bjp.bp.115.174961] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 09/25/2016] [Accepted: 10/07/2016] [Indexed: 01/17/2023]
Abstract
BackgroundAuditory verbal hallucinations (AVHs) have been associated with deficits in auditory and speech-related networks. However, the resting-state cerebral blood flow (CBF) alterations specific to AVHs in schizophrenia remain unknown.AimsTo explore AVH-related CBF alterations in individuals with schizophrenia.MethodIn total, 35 individuals with schizophrenia with AVHs, 41 individuals with schizophrenia without AVHs and 50 controls underwent arterial spin labelling magnetic resonance imaging. The CBF differences were voxel-wise compared across the three groups.ResultsWe found AVH-specific CBF increase in the right superior temporal gyrus and caudate, and AVH-specific CBF decrease in the bilateral occipital and left parietal cortices. We also observed consistent CBF changes in both schizophrenia subgroups (i.e. those with and without AVHs) including decreased CBF in the bilateral occipital regions, the left lateral prefrontal and insular cortices, and the right anterior cingulate cortex and increased CBF in the bilateral lateral temporal regions and putamen, the left middle cingulate cortex and the right thalamus.ConclusionsThe AVH-specific CBF increases in the auditory and striatal areas and CBF reductions in the visual and parietal areas suggest that there exists a CBF redistribution associated with AVHs.
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Affiliation(s)
- Chuanjun Zhuo
- Chuanjun Zhuo, MD, PhD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, and Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin; Jiajia Zhu, MD, Wen Qin, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, China; Hongru Qu, MD, Xiaolei Ma, MD, Department of Psychiatry, Tianjin Anning Hospital, Tianjin, China; Chunshui Yu, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiajia Zhu
- Chuanjun Zhuo, MD, PhD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, and Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin; Jiajia Zhu, MD, Wen Qin, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, China; Hongru Qu, MD, Xiaolei Ma, MD, Department of Psychiatry, Tianjin Anning Hospital, Tianjin, China; Chunshui Yu, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Wen Qin
- Chuanjun Zhuo, MD, PhD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, and Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin; Jiajia Zhu, MD, Wen Qin, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, China; Hongru Qu, MD, Xiaolei Ma, MD, Department of Psychiatry, Tianjin Anning Hospital, Tianjin, China; Chunshui Yu, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongru Qu
- Chuanjun Zhuo, MD, PhD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, and Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin; Jiajia Zhu, MD, Wen Qin, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, China; Hongru Qu, MD, Xiaolei Ma, MD, Department of Psychiatry, Tianjin Anning Hospital, Tianjin, China; Chunshui Yu, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaolei Ma
- Chuanjun Zhuo, MD, PhD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, and Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin; Jiajia Zhu, MD, Wen Qin, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, China; Hongru Qu, MD, Xiaolei Ma, MD, Department of Psychiatry, Tianjin Anning Hospital, Tianjin, China; Chunshui Yu, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunshui Yu
- Chuanjun Zhuo, MD, PhD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, and Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin; Jiajia Zhu, MD, Wen Qin, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, China; Hongru Qu, MD, Xiaolei Ma, MD, Department of Psychiatry, Tianjin Anning Hospital, Tianjin, China; Chunshui Yu, MD, Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
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Preliminary study of a rehabilitation program based on attentional processes to treat auditory hallucinations. Cogn Neuropsychiatry 2016; 21:315-334. [PMID: 27424464 DOI: 10.1080/13546805.2016.1208610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Despite the effectiveness of pharmacological treatment, residual hallucinations do not completely resolve in some medicated patients. The aim of this study was to investigate the efficacy of attention training for reducing hallucinations in individuals with psychosis. METHODS A randomised controlled trial was performed in which 20 individuals suffering auditory hallucinations received auditory stimulation similar to their internal voices, which was integrated into the RehaCom program of attention training. An equal number of individuals suffering auditory hallucinations did not receive this training. Cognitive and symptomatological variables were evaluated before and after the intervention period in both groups. RESULTS Only data of 16 subjects were analysed. Auditory hallucinations no longer occurred by the end of the training program in five of eight individuals, whereas their frequency, intensity and negative content and associated anxiety were significantly reduced in the remaining three. No changes in hallucinations were observed in the control group. Attentional processes and executive functions were significantly better in patients who underwent the training than in those who did not at the end of the intervention period. CONCLUSIONS Attention training can help people with auditory hallucinations develop an ability to ignore them, which can reduce or eliminate them entirely.
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Xu Y, Chai H, Zhang B, Gao Q, Fan H, Zheng L, Mao H, Zhang Y, Wang W. Event-related potentials elicited by the Deutsch "high-low" word illusion in the patients with first-episode schizophrenia with auditory hallucinations. BMC Psychiatry 2016; 16:33. [PMID: 26892784 PMCID: PMC4758162 DOI: 10.1186/s12888-016-0747-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 02/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The exact cerebral structural and functional mechanisms under the auditory verbal hallucinations (AVHs) in schizophrenia are still unclear. The Deutsch "high-low" word illusion might trigger attentional responses mimicking those under AVHs. METHODS We therefore have invited 16 patients with first-episode, paranoid schizophrenia, and 16 age- and gender-matched healthy volunteers to undergo the "oddball" event-related potentials elicited by the illusion. The clinical characteristics of patients were measured with the positive and negative symptom scale. RESULTS Besides the longer reaction time to the illusion, the standard P2 latency was shortened, the N2 latency was prolonged, and both N1 and P3 amplitudes were reduced in patients. The P3 source analyses showed the activated bilateral temporal lobes, parietal lobe and cingulate cortex in both groups, left inferior temporal gyrus in controls, and left postcentral gyrus in schizophrenia. Moreover, the N1 amplitude was positively correlated with the paranoid score in patients. CONCLUSIONS Our results were in line with previous neurophysiological and neuroimaging reports of hallucination or auditory processing in schizophrenia, and illustrated a whole process of cerebral information processing from N1 to P3, indicating this illusion had triggered a dynamic cerebral response similar to that of the AVHs had engaged.
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Affiliation(s)
- You Xu
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Hao Chai
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Bingren Zhang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Qianqian Gao
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Hongying Fan
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Leilei Zheng
- Department of Psychiatry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China.
| | - Hongjing Mao
- Department of Clinical Psychology, Mental Health Center, Zhejiang University College of Medicine, Hangzhou, China.
| | - Yonghua Zhang
- Department of Clinical Psychology, Mental Health Center, Zhejiang University College of Medicine, Hangzhou, China.
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China. .,Department of Clinical Psychology, Mental Health Center, Zhejiang University College of Medicine, Hangzhou, China.
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