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Hayward M, Bibby-Jones AM, Thomas N, Paulik G, Mutanda D, Berry C. Multi-modal hallucinations across diagnoses: What relationships do they have with voice-related distress? Schizophr Res 2024; 265:58-65. [PMID: 37230912 DOI: 10.1016/j.schres.2023.04.005] [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: 11/13/2022] [Revised: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Research into hallucinatory experiences has focused primarily upon hallucinations within the auditory modality, to the relative neglect of other modalities. Furthermore, the exploration of auditory hallucinations (or 'voices') has focused primarily upon the experiences of people with a diagnosis of psychosis. The presence of multi-modal hallucinations may have implications across diagnoses for levels of distress, formulation and the targeting of psychological interventions. METHODS This study presents a cross-sectional analysis of observational data from the PREFER survey (N = 335). Linear regression was used to explore the relationships between voice-related distress and the presence, number, type and timing of multi-modal hallucinations. RESULTS Simple relationships were not found between distress and the presence of hallucinations in visual, tactile, olfactory or gustatory modalities, or in the number of modalities experienced. When considering the degree to which another modality hallucination was experienced simultaneously with voices, there was some evidence that the degree of co-occurrence with visual hallucinations was predictive of distress. CONCLUSIONS The co-occurrence of voices with visual hallucinations may be associated with relatively greater distress, but not consistently, and the association between multimodal hallucinations and clinical impact appear complex and potentially variable from individual to individual. Further study of associated variables such as perceived voice power may further illuminate these relationships.
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Affiliation(s)
- Mark Hayward
- School of Psychology, University of Sussex, Brighton BN1 9RH, UK.
| | | | - Neil Thomas
- Swinburne University of Technology, Australia.
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López-Silva P, Harrow M, Jobe TH, Tufano M, Harrow H, Rosen C. 'Are these my thoughts?': A 20-year prospective study of thought insertion, thought withdrawal, thought broadcasting, and their relationship to auditory verbal hallucinations. Schizophr Res 2024; 265:46-57. [PMID: 35945121 DOI: 10.1016/j.schres.2022.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 11/22/2022]
Abstract
The co-occurrence of delusions and other symptoms at the onset of psychosis is a challenge for theories about the aetiology of psychosis. This paper explores the relatedness of delusions about the experience of thinking (thought insertion, thought withdrawal, and thought broadcasting) and auditory verbal hallucinations by describing their trajectories over a 20-year period in individuals diagnosed with schizophrenia, affective and other psychosis, and unipolar depression nonpsychosis. The sample consisted of 407 participants who were recruited at index hospitalization and evaluated over six follow-ups over 20 years. The symptom structure associated with thought insertion included auditory verbal hallucinations, somatic hallucinations, other hallucinations, delusions of thought-dissemination, delusions of control, delusion of self-depreciation, depersonalization and anxiety. The symptom constellation of thought withdrawal included somatic hallucinations, other hallucinations, delusions of thought dissemination, delusions of control, sexual delusions, depersonalization, negative symptoms, depression, and anxiety. The symptom constellation of thought broadcasting included auditory verbal hallucinations, somatic hallucinations, delusions of thought-dissemination, delusion of self-depreciation, fantastic delusions, sexual delusions, and depersonalization. Auditory verbal hallucinations and delusions of self-depreciation were significantly associated with both thought insertion and thought broadcasting. Thought insertion and thought withdrawal were significantly associated with other hallucinations, delusions of control, and anxiety; thought withdrawal and thought broadcasting were significantly related to sexual delusions. We hypothesize that specific symptom constellations over time might be explained as the product of pseudo-coherent realities created to give meaning to the experience of the world and the self of individuals in psychosis based on both prior top-down and ongoing bottom-up elements.
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Affiliation(s)
- Pablo López-Silva
- Faculty of Social Sciences, School of Psychology, Universidad de Valparaíso, Chile
| | - Martin Harrow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Thomas H Jobe
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Michele Tufano
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Helen Harrow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States.
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Strachan LP, Paulik G, Preece DA, McEvoy PM. Pathways from trauma to unusual perceptual experiences: Modelling the roles of insecure attachment, negative affect, emotion regulation and dissociation. Psychol Psychother 2023; 96:934-951. [PMID: 37493351 DOI: 10.1111/papt.12486] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND A range of traumas have been linked to voices (auditory verbal hallucinations) and unusual perceptual experiences (UPEs) in other perceptual-sensory domains. Models of PTSD and positive symptoms of psychosis are insufficient in explaining the relationship between trauma and voices. The trauma-related voices (TRV) model was developed to generate novel research in this area. AIMS This study aimed to investigate pathways from trauma to the frequency of UPEs based on a subset of hypothesised relationships in the TRV model. MATERIALS The PTSD Diagnostic Scale for DSM-5, State Adult Attachment Measure, Depression Anxiety and Stress Scales-21, Perth Emotion and Regulation Competency Inventory, Dissociative Experiences Measure Oxford, and Multi-modality Unusual Perceptual Experiences Questionnaire. METHODS We used path analysis in a non-clinical sample (N = 528) to model indirect effects from diverse trauma experiences to the frequency of multi-sensory UPEs via a subset of mediators within the TRV model: insecure attachment, emotion regulation deficits, negative affect and dissociation. RESULTS Our model was an excellent fit to the data and accounted for 37.1% of variance in UPE frequency, and all direct (βs = .14-.61) and indirect pathways (βs = .01-.08) were significant (ps < .001). DISCUSSION Our findings suggest that insecure attachment may link diverse trauma experiences to emotion regulation deficits and negative affect, which are linked to UPE frequency via dissociation. CONCLUSION Our findings provide preliminary evidence for a subset of relationships within the TRV model. Future studies are needed to gather stronger evidence of temporality and causation between these factors, and to test broader pathways within the TRV model.
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Affiliation(s)
- Laura P Strachan
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Georgie Paulik
- School of Psychology, Murdoch University, Perth, Western Australia, Australia
- Perth Voices Clinic, Perth, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - David A Preece
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Peter M McEvoy
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
- Centre for Clinical Interventions, Perth, Western Australia, Australia
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4
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Hudon A, Beaudoin M, Phraxayavong K, Potvin S, Dumais A. Enhancing Predictive Power: Integrating a Linear Support Vector Classifier with Logistic Regression for Patient Outcome Prognosis in Virtual Reality Therapy for Treatment-Resistant Schizophrenia. J Pers Med 2023; 13:1660. [PMID: 38138887 PMCID: PMC10744538 DOI: 10.3390/jpm13121660] [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: 10/14/2023] [Revised: 11/11/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Approximately 30% of schizophrenia patients are known to be treatment-resistant. For these cases, more personalized approaches must be developed. Virtual reality therapeutic approaches such as avatar therapy (AT) are currently undergoing investigations to address these patients' needs. To further tailor the therapeutic trajectory of patients presenting with this complex presentation of schizophrenia, quantitative insight about the therapeutic process is warranted. The aim of the study is to combine a classification model with a regression model with the aim of predicting the therapeutic outcomes of patients based on the interactions taking place during their first immersive session of virtual reality therapy. (2) Methods: A combination of a Linear Support Vector Classifier and logistic regression was conducted over a dataset comprising 162 verbatims of the immersive sessions of 18 patients who previously underwent AT. As a testing dataset, 17 participants, unknown to the dataset, had their first immersive session presented to the combinatory model to predict their clinical outcome. (3) Results: The model accurately predicted the clinical outcome for 15 out of the 17 participants. Classification of the therapeutic interactions achieved an accuracy of 63%. (4) Conclusion: To our knowledge, this is the first attempt to predict the outcome of psychotherapy patients based on the content of their interactions with their therapist. These results are important as they open the door to personalization of psychotherapy based on quantitative information about the interactions taking place during AT.
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Affiliation(s)
- Alexandre Hudon
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (A.H.); (M.B.); (S.P.)
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Mélissa Beaudoin
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (A.H.); (M.B.); (S.P.)
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | | | - Stéphane Potvin
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (A.H.); (M.B.); (S.P.)
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Alexandre Dumais
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (A.H.); (M.B.); (S.P.)
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
- Services et Recherches Psychiatriques AD, Montreal, QC H1N 3V2, Canada;
- Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, QC H1C 1H1, Canada
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5
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Collerton D, Barnes J, Diederich NJ, Dudley R, Ffytche D, Friston K, Goetz CG, Goldman JG, Jardri R, Kulisevsky J, Lewis SJG, Nara S, O'Callaghan C, Onofrj M, Pagonabarraga J, Parr T, Shine JM, Stebbins G, Taylor JP, Tsuda I, Weil RS. Understanding visual hallucinations: a new synthesis. Neurosci Biobehav Rev 2023; 150:105208. [PMID: 37141962 DOI: 10.1016/j.neubiorev.2023.105208] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/03/2023] [Accepted: 04/30/2023] [Indexed: 05/06/2023]
Abstract
Despite decades of research, we do not definitively know how people sometimes see things that are not there. Eight models of complex visual hallucinations have been published since 2000, including Deafferentation, Reality Monitoring, Perception and Attention Deficit, Activation, Input, and Modulation, Hodological, Attentional Networks, Active inference, and Thalamocortical Dysrhythmia Default Mode Network Decoupling. Each was derived from different understandings of brain organisation. To reduce this variability, representatives from each research group agreed an integrated Visual Hallucination Framework that is consistent with current theories of veridical and hallucinatory vision. The Framework delineates cognitive systems relevant to hallucinations. It allows a systematic, consistent, investigation of relationships between the phenomenology of visual hallucinations and changes in underpinning cognitive structures. The episodic nature of hallucinations highlights separate factors associated with the onset, persistence, and end of specific hallucinations suggesting a complex relationship between state and trait markers of hallucination risk. In addition to a harmonised interpretation of existing evidence, the Framework highlights new avenues of research, and potentially, new approaches to treating distressing hallucinations.
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Affiliation(s)
- Daniel Collerton
- School of Psychology, Faculty of Medical Sciences, Third Floor, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL UK.
| | - James Barnes
- Fatima College of Health Sciences, Department of Psychology, Al Mafraq, Abu Dhabi, UAE.
| | - Nico J Diederich
- Department of Neurology, Centre Hospitalier de Luxembourg, 4, rue Barblé, L-1210 Luxembourg-City, Luxembourg.
| | - Rob Dudley
- Department of Psychology, University of York, York, YO10 5DD, UK.
| | - Dominic Ffytche
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, de Crespigny Park, London, SE5 8AF, UK.
| | - Karl Friston
- Wellcome Centre for Human Neuroimaging, Queen Square Institute of Neurology, University College London, London, WC1N 3AR.
| | - Christopher G Goetz
- Rush University Medical Center, Suite 755, 1725 W Harrison St, Chicago IL 60612 USA.
| | - Jennifer G Goldman
- Departments of Physical Medicine and Rehabilitation and Neurology; Shirley Ryan AbilityLab, Parkinson's Disease and Movement Disorders; Feinberg School of Medicine Northwestern University, 355 E. Erie Street, Chicago, IL 60611 USA.
| | - Renaud Jardri
- Lille University, INSERM U-1172, Centre Lille Neuroscience & Cognition, CURE platform, Fontan Hospital, CHU Lille, France.
| | - Jaime Kulisevsky
- Movement Disorders Unit, Sant Pau Hospital, Hospital Sant Pau. C/ Mas Casanovas 90. Barcelona (08041) and Universitat Autònoma de Barcelona; CIBERNED (Network Centre for Neurodegenerative Diseases), Spain.
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, 100 Mallett Street, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW 2050, Australia.
| | - Shigetoshi Nara
- Dept. Electrical & Electronic Engineering, Okayama University, Tsushima-naka, 3-1-1, Okayama 700-8530, Japan.
| | - Claire O'Callaghan
- ForeFront Parkinson's Disease Research Clinic, 100 Mallett Street, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW 2050, Australia.
| | - Marco Onofrj
- Clinica Neurologica, Department of Neuroscience, Imaging and Clinical Science, University "G.d'Annunzio" of Chieti-Pescara, via Polacchi 39,66100, Chieti, Italy.
| | - Javier Pagonabarraga
- Movement Disorders Unit, Sant Pau Hospital, Hospital Sant Pau. C/ Mas Casanovas 90. Barcelona (08041) and Universitat Autònoma de Barcelona; CIBERNED (Network Centre for Neurodegenerative Diseases), Spain.
| | - Thomas Parr
- Wellcome Centre for Human Neuroimaging, Queen Square Institute of Neurology, University College London, London, WC1N 3AR.
| | - James M Shine
- ForeFront Parkinson's Disease Research Clinic, 100 Mallett Street, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW 2050, Australia.
| | - Glenn Stebbins
- Rush University Medical Center, Suite 755, 1725 W Harrison St, Chicago IL 60612 USA.
| | - John-Paul Taylor
- Newcastle Biomedical Research Centre, Campus for Ageing and Vitality, Newcastle University NE4 5PL, UK.
| | - Ichiro Tsuda
- Chubu University Academy of Emerging Sciences and Center for Mathematical Science and Artificial Intelligence, Chubu University, Kasugai, Aichi 487-8501, Japan.
| | - Rimona S Weil
- Wellcome Centre for Human Neuroimaging, Queen Square Institute of Neurology, University College London, London, WC1N 3AR; Dementia Research Centre; Movement Disorders Centre, University College London, London, WC1N 3BG UK.
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6
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Dudley R, Denton S, Mathewson J, Pervez S, Aynsworth C, Dodgson G, Barclay N. Prevalence of multisensory hallucinations in people at risk of transition to psychosis. Psychiatry Res 2023; 322:115091. [PMID: 36803842 DOI: 10.1016/j.psychres.2023.115091] [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: 09/10/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
Hallucinations can occur in single or multiple sensory modalities. Greater attention has been paid to single sensory experiences with a comparative neglect of hallucinations that occur across two or more sensory modalities (multisensory hallucinations). This study explored how common these experiences were in people at risk of transition to psychosis (n=105) and considered whether a greater number of hallucinatory experiences increased delusional ideation and reduced functioning, both of which are associated with a greater risk of transition to psychosis. Participants reported a range of unusual sensory experiences, with two or three being common. However, when a strict definition of hallucinations was applied, in which the experience has the quality of a real perception and in which the person believes them to be real experiences, then multisensory experiences were rare and when reported, single sensory hallucinations in the auditory domain were most common. The number of unusual sensory experiences or hallucinations was not significantly associated with greater delusional ideation or poorer functioning. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Robert Dudley
- Early Intervention in Psychosis services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, United Kingdom; Department of Psychology, University of York, York, YO10 5DD UK.
| | - Sophie Denton
- At Risk Mental State Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - Jennifer Mathewson
- At Risk Mental State Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - Sairah Pervez
- At Risk Mental State Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - Charlotte Aynsworth
- Early Intervention in Psychosis services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, United Kingdom
| | - Guy Dodgson
- Early Intervention in Psychosis services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, United Kingdom
| | - Nicola Barclay
- At Risk Mental State Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
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7
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Prevalence and nature of multi-sensory and multi-modal hallucinations in people with first episode psychosis. Psychiatry Res 2023; 319:114988. [PMID: 36463721 DOI: 10.1016/j.psychres.2022.114988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/19/2022] [Accepted: 11/27/2022] [Indexed: 11/29/2022]
Abstract
Hallucinations can occur in single or multiple sensory modalities. This study explored how common these experiences were in people with first episode of psychosis (n = 82). Particular attention was paid to the number of modalities reported and whether the experiences were seen to be linked temporally and thematically. It was predicted that those people reporting a greater number of hallucinations would report more delusional ideation, greater levels of distress generally and lower functioning. All participants reported hallucinations in the auditory domain, given the nature of the recruitment. The participants also reported a range of other unusual sensory experiences, with visual and tactile hallucinations being reported by over half. Moreover, single sensory experiences or unimodal hallucinations were less common than two or more hallucination modalities which was reported by 78% of the participants. The number of hallucinations was significantly associated with greater delusional ideation and higher levels of general distress, but not with reduced functioning. It is clear there is a need to refine psychological treatments so that they are better matched to the actual experiences reported by people with psychosis. Theoretical implications are also considered.
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8
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Aynsworth C, Rolinson J, Pervez M, Collerton D, Dudley R. What is the frequency and nature of visual hallucinations in non-clinical participants? Psychol Psychother 2022; 96:281-295. [PMID: 36504251 DOI: 10.1111/papt.12440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES There is a paucity of psychological treatments for visual hallucinations (VH). A key aspect in the psychological treatment of hallucination-related distress is normalisation to explain that these experiences are commonplace and can be non-distressing. In order to normalise VH, it is vital that more is known about VH in non-clinical populations. This study investigated the prevalence, content, context, appraisals, distress, and behavioural reactions to VH in a non-clinical sample. DESIGN A cross-sectional study was conducted. METHODS 466 students completed the Multi-Modality Unusual Sensory Experiences Questionnaire-VH subscale with additional contextual follow-up questions. RESULTS Of the 466 participants, 395 (84.8%) reported anomalous visual experiences. 176 (37.77%) participants reported VH similar to the content seen in psychosis. Of the overall sample, 17.38% felt their experience met the VH definition. Participants mainly saw figures, when alone and in the evening. Participants endorsed normalising appraisals: 112 out of 176 (78.87%) believed their mind was playing tricks on them and 83 (58.45%) believed they were tired. However, many also believed the VH was a threat to their mental (66, 46.48%) or physical well-being (41, 28.87%). These negative appraisals were associated with distress. CONCLUSION VH are seemingly common in non-clinical populations and are similar in a number of ways to those of people with psychosis. Awareness that VH occur on a continuum could normalise people's experiences and reduce their negative appraisals and related distress.
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Affiliation(s)
- Charlotte Aynsworth
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Julie Rolinson
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Maryam Pervez
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Daniel Collerton
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Robert Dudley
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.,School of Psychology, Newcastle University, Newcastle upon Tyne, UK
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9
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Isaacson M, Hazell CM, Cape J, Hickson E, Islam F, Gill A, Simon K, Patel R, Souray J, Raune D. The cognitive-phenomenological assessment of delusions and hallucinations at the early intervention in psychosis service stage: The results of a quality improvement project. Early Interv Psychiatry 2022; 16:1345-1352. [PMID: 35338593 DOI: 10.1111/eip.13283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/11/2022] [Accepted: 03/13/2022] [Indexed: 01/15/2023]
Abstract
AIM Clinical assessments are vital for gaining an understanding of a patients' presenting problem. A priority for Early Intervention in Psychosis Service staff is understanding and supporting their patients' experiences of hallucinations and/or delusions. We aimed to identify what cognitive-phenomenology dimensions of hallucinations and delusions EIPS staff were assessing with their patients. METHODS We developed a brief checklist of cognitive-phenomenological dimensions of hallucinations and delusions called the Lived Experience Symptom Survey (LESS) based on relevant literature. As part of a Quality Improvement Project, we reviewed the health records of a sub-sample of EIPS patients using the LESS identifying whether each dimension was present or absent. RESULTS We found that all patients had been asked about the content of their hallucinations and/or delusions, and the majority had been asked about the valence of this content. Despite patients having experienced psychosis for almost 2 years on average, less than half of patients were asked about the potential or actual harm associated with these symptoms. All other cognitive-phenomenological dimensions were assessed inconsistently. CONCLUSIONS The assessment of hallucination and delusions in our EIPS was inconsistent and incomprehensive. These findings require replication in other EIPS' but may point to a need for guidelines and training around how to conduct a thorough assessment of hallucinations and delusions for current and future EIPS staff. Improved assessment of these symptoms will aid the development of risk assessments and treatment plans.
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Affiliation(s)
- Maria Isaacson
- Division of Psychology and Language Sciences, University College London, London, UK.,Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
| | - Cassie M Hazell
- Department of Psychology, University of Westminster, London, UK
| | - John Cape
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Emily Hickson
- Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
| | - Faaizah Islam
- Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
| | - Amber Gill
- Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
| | - Kathleen Simon
- Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
| | - Ruchit Patel
- Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
| | - Jonathan Souray
- Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
| | - David Raune
- Harrow and Hillingdon Early Intervention in Psychosis (EIP) Service, London, UK
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10
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Wearne D, Ayalde J, Curtis G, Gopisetty A, Banerjee A, Melvill-Smith P, Orr K, Rajanthiran L, Waters F. Visual phenomenology in schizophrenia and post-traumatic stress disorder: an exploratory study. BJPsych Open 2022; 8:e143. [PMID: 35876067 PMCID: PMC9345685 DOI: 10.1192/bjo.2022.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Visual experiences such as hallucinations are commonly reported by people with psychosis, psychological trauma and dissociative states, although questions remain about their similarities and differences. For diagnostic and therapeutic purposes, clinical research must better delineate and compare the characteristics of these experiences in post-traumatic stress disorder (PTSD) and in schizophrenia. AIMS To compare visual phenomena and dissociation in participants with a primary psychotic illness and those with a trauma diagnosis. METHOD A quantitative group design study comparing visual phenomena in three participant groups who also have a history of hearing voices: schizophrenia and no trauma history (n = 19), PTSD with dissociation (n = 17) and comorbid schizophrenia and PTSD (n = 20). Validated clinical measures included the North-East Visual Hallucination Interview, PTSD Symptoms Scale Interview, Clinician Administered Dissociative States Scale, Psychotic Symptoms Rating Scales and Positive and Negative Syndrome Scale. RESULTS There was a remarkable similarity in visual experiences, including rates of complex visual hallucinations, between the three diagnostic groups. There were no significant differences in the severity or components of distress surrounding the visual experiences. Dissociation predicted visual hallucination severity for the comorbid schizophrenia and PTSD group, but not for PTSD or schizophrenia alone. CONCLUSIONS Visual experiences in PTSD can include visual hallucinations that are indistinguishable from those experienced in schizophrenia. Multimodal hallucinations are frequently observed in both schizophrenia and PTSD. A model for visual hallucinations in PTSD is suggested, following two separate neurobiological pathways based on distinct responses to trauma.
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Affiliation(s)
- Deborah Wearne
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Jeremiah Ayalde
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Guy Curtis
- Department of Psychology, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Aarethi Gopisetty
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Amit Banerjee
- Early Psychosis Program Perth, headspace National Youth Mental Health Foundation, Melbourne, Victoria, Australia
| | - Peter Melvill-Smith
- Department of Psychiatry, Western Australia Department of Health, Perth, Western Australia, Australia
| | - Kenneth Orr
- Department of Psychiatry, St John of God Health Care, Perth, Western Australia, Australia
| | - Leon Rajanthiran
- Department of Psychiatry, St John of God Health Care, Perth, Western Australia, Australia
| | - Flavie Waters
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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11
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Peters E, Hardy A, Dudley R, Varese F, Greenwood K, Steel C, Emsley R, Keen N, Bowe S, Swan S, Underwood R, Longden E, Byford S, Potts L, Heslin M, Grey N, Turkington D, Fowler D, Kuipers E, Morrison A. Multisite randomised controlled trial of trauma-focused cognitive behaviour therapy for psychosis to reduce post-traumatic stress symptoms in people with co-morbid post-traumatic stress disorder and psychosis, compared to treatment as usual: study protocol for the STAR (Study of Trauma And Recovery) trial. Trials 2022; 23:429. [PMID: 35606886 PMCID: PMC9125351 DOI: 10.1186/s13063-022-06215-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background People with psychosis have high rates of trauma, with a post-traumatic stress disorder (PTSD) prevalence rate of approximately 15%, which exacerbates psychotic symptoms such as delusions and hallucinations. Pilot studies have shown that trauma-focused (TF) psychological therapies can be safe and effective in such individuals. This trial, the largest to date, will evaluate the clinical effectiveness of a TF therapy integrated with cognitive behaviour therapy for psychosis (TF-CBTp) on post-traumatic stress symptoms in people with psychosis. The secondary aims are to compare groups on cost-effectiveness; ascertain whether TF-CBTp impacts on a range of other meaningful outcomes; determine whether therapy effects endure; and determine acceptability of the therapy in participants and therapists. Methods Rater-blind, parallel arm, pragmatic randomised controlled trial comparing TF-CBTp + treatment as usual (TAU) to TAU only. Adults (N = 300) with distressing post-traumatic stress and psychosis symptoms from five mental health Trusts (60 per site) will be randomised to the two groups. Therapy will be manualised, lasting 9 months (m) with trained therapists. We will assess PTSD symptom severity (primary outcome); percentage who show loss of PTSD diagnosis and clinically significant change; psychosis symptoms; emotional well-being; substance use; suicidal ideation; psychological recovery; social functioning; health-related quality of life; service use, a total of four times: before randomisation; 4 m (mid-therapy); 9 m (end of therapy; primary end point); 24 m (15 m after end of therapy) post-randomisation. Four 3-monthly phone calls will be made between 9 m and 24 m assessment points, to collect service use over the previous 3 months. Therapy acceptability will be assessed through qualitative interviews with participants (N = 35) and therapists (N = 5–10). An internal pilot will ensure integrity of trial recruitment and outcome data, as well as therapy protocol safety and adherence. Data will be analysed following intention-to-treat principles using generalised linear mixed models and reported according to Consolidated Standards of Reporting Trials-Social and Psychological Interventions Statement. Discussion The proposed intervention has the potential to provide significant patient benefit in terms of reductions in distressing symptoms of post-traumatic stress, psychosis, and emotional problems; enable clinicians to implement trauma-focused therapy confidently in this population; and be cost-effective compared to TAU through reduced service use. Trial registration ISRCTN93382525 (03/08/20) Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06215-x.
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Affiliation(s)
- Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. .,South London & Maudsley NHS Foundation Trust, London, UK.
| | - Robert Dudley
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.,Newcastle University, London, UK
| | - Filippo Varese
- School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Kathryn Greenwood
- Research and Development, Sussex Partnership NHS Foundation Trust, Brighton, UK.,School of Psychology, University of Sussex, London, UK
| | - Craig Steel
- Oxford Centre for Psychological Health, Oxford Health NHS Foundation Trust, Oxford, UK.,Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nadine Keen
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Samantha Bowe
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah Swan
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Raphael Underwood
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Eleanor Longden
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah Byford
- Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Laura Potts
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Margaret Heslin
- Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nick Grey
- Research and Development, Sussex Partnership NHS Foundation Trust, Brighton, UK.,School of Psychology, University of Sussex, London, UK
| | - Doug Turkington
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.,Newcastle University, London, UK
| | - David Fowler
- Research and Development, Sussex Partnership NHS Foundation Trust, Brighton, UK.,School of Psychology, University of Sussex, London, UK
| | - Elizabeth Kuipers
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Anthony Morrison
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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12
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Jimeno N, Gomez-Pilar J, Poza J, Hornero R, Vogeley K, Meisenzahl E, Lichtenstein TK, Rosen M, Kambeitz J, Klosterkötter J, Schultze-Lutter F. (Attenuated) hallucinations join basic symptoms in a transdiagnostic network cluster analysis. Schizophr Res 2022; 243:43-54. [PMID: 35231833 DOI: 10.1016/j.schres.2022.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 01/31/2022] [Accepted: 02/13/2022] [Indexed: 11/16/2022]
Abstract
Hallucinations are considered characteristic symptoms of psychosis and part of the 'psychosis superspectrum' of the Hierarchical Taxonomy Of Psychopathology (HiTOP) initiative. To gain insight into their psychopathological relevance, we studied their dimensional placement within a single dense transdiagnostic network constituting of basic symptoms as well as of attenuated and frank psychotic, and related symptoms. Newman's modularity analysis was used to detect symptom clusters in an earlier generated network (Jimeno, N., et al., 2020. Main symptomatic treatment targets in suspected and early psychosis: New insights from network analysis. Schizophr. Bull. 46, 884-895. https://doi.org/10.1093/schbul/sbz140). The constituting 86 symptoms were assessed with the Schizophrenia Proneness Instrument, Adult version (SPI-A), the Structured Interview for Psychosis-Risk Syndromes (SIPS), and the Positive And Negative Syndrome Scale (PANSS) in three adult samples of an early detection service: clinical high-risk (n = 203), first-episode psychosis (n = 153), and major depression (n = 104). Three clusters were detected: "subjective disturbances", "positive symptoms and behaviors", and "negative and anxious-depressive symptoms". The predominately attenuated hallucinations of both SIPS and PANSS joined the basic symptoms in "subjective disturbances", whereas other positive symptoms entered "positive symptoms and behaviors". Our results underline the importance of insight in separating true psychotic hallucinations from other hallucinatory experiences that, albeit phenomenologically similar are still experienced with some insight, i.e., are present in an attenuated form. We conclude that, strictly, hallucinations held with any degree of insight should not be used to diagnose transition to or presence of frank psychoses and, relatedly, to justify antipsychotic medication.
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Affiliation(s)
- Natalia Jimeno
- Department of Psychiatry, School of Medicine, University of Valladolid, Valladolid, Spain; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; GINCYL, Research Group on Clinical Neuroscience of Castile and Leon, Valladolid, Spain.
| | - Javier Gomez-Pilar
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain; CIBER-BBN, Centro de Investigación Biomédica en Red - Bioingeniería, Biomateriales y Nanomedicina, Valladolid, Spain
| | - Jesus Poza
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain; CIBER-BBN, Centro de Investigación Biomédica en Red - Bioingeniería, Biomateriales y Nanomedicina, Valladolid, Spain; IMUVA, Mathematics Research Institute, University of Valladolid, Valladolid, Spain
| | - Roberto Hornero
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain; CIBER-BBN, Centro de Investigación Biomédica en Red - Bioingeniería, Biomateriales y Nanomedicina, Valladolid, Spain; IMUVA, Mathematics Research Institute, University of Valladolid, Valladolid, Spain
| | - Kai Vogeley
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; INM3, Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Theresa K Lichtenstein
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joachim Klosterkötter
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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13
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Toh WL, Bere M, Rossell SL. Distinguishing multimodal versus multisensory hallucinations in psychosis: Key definitions and a way forward. Aust N Z J Psychiatry 2022; 56:445-450. [PMID: 34256623 DOI: 10.1177/00048674211031455] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The study of hallucinations across multiple senses in psychosis has garnered renewed interest. Recent studies have adopted the term multimodal hallucinations to describe these experiences, yet some appear to be investigating a different, but related, phenomenon. In the current paper, we suggest use of the terms multimodal hallucinations and multisensory hallucinations to categorise distinct events that involve unusual sensory experiences across multiple domains. We propose that the constructs of temporality and relatedness are critical to delineating these experiences, where multimodal hallucinations refer to hallucinations in two or more sensory modes occurring concurrently in time and/or with significant thematic overlaps. Multisensory hallucinations conversely denote similar multisensory experiences, but with no temporal or relatedness constraints. This is accompanied by a decision-making framework for identifying whether a set of unusual perceptual experiences constitutes multimodal hallucinations or otherwise. We conclude by suggesting several priorities for future research, including empirical validation of our proposed model, further investigation of phenomenology, developing appropriate assessment tools and investigating underlying cognitive and other aetiological mechanisms.
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Affiliation(s)
- Wei Lin Toh
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Psychology, Alfred Health, Melbourne, VIC, Australia
| | - Mikaela Bere
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Psychiatry, St. Vincent's Mental Health, Fitzroy, VIC, Australia
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14
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Leptourgos P, Bouttier V, Denève S, Jardri R. From hallucinations to synaesthesia: A circular inference account of unimodal and multimodal erroneous percepts in clinical and drug-induced psychosis. Neurosci Biobehav Rev 2022; 135:104593. [PMID: 35217108 DOI: 10.1016/j.neubiorev.2022.104593] [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: 05/14/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
Psychedelics distort perception and induce visual and multimodal hallucinations as well as synaesthesia. This is in contradiction with the high prevalence of distressing voices in schizophrenia. Here we introduce a unifying account of unimodal and multimodal erroneous percepts based on circular inference. We show that amplification of top-down predictions (descending loops) leads to an excessive reliance on priors and aberrant levels of integration of the sensory representations, resulting in crossmodal percepts and stronger illusions. By contrast, amplification of bottom-up information (ascending loops) results in overinterpretation of unreliable sensory inputs and high levels of segregation between sensory modalities, bringing about unimodal hallucinations and reduced vulnerability to illusions. We delineate a canonical microcircuit in which layer-specific inhibition controls the propagation of information across hierarchical levels: inhibitory interneurons in the deep layers exert control over priors, removing descending loops. Conversely, inhibition in the supragranular layers counterbalances the effects of the ascending loops. Overall, we put forward a multiscale and transnosographic account of erroneous percepts with important theoretical, conceptual and clinical implications.
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Affiliation(s)
- Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT, USA; Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France.
| | - Vincent Bouttier
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France; Univ Lille, INSERM U-1172, Lille Neurosciences & Cognition Centre, Plasticity and Subjectivity Team, & CHU Lille, Fontan Hospital, CURE Platform, Lille, France
| | - Sophie Denève
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France
| | - Renaud Jardri
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France; Univ Lille, INSERM U-1172, Lille Neurosciences & Cognition Centre, Plasticity and Subjectivity Team, & CHU Lille, Fontan Hospital, CURE Platform, Lille, France.
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15
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Melvin K, Rollins CPE, Cromby J, Crossley J, Garrison JR, Murray GK, Suckling J. Arts-based methods for hallucination research. Cogn Neuropsychiatry 2022; 27:199-218. [PMID: 34708671 DOI: 10.1080/13546805.2021.1993807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Neurocognitive models of hallucinations posit theories of misattribution and deficits in the monitoring of mental or perceptual phenomena but cannot yet account for the subjective experience of hallucinations across individuals and diagnostic categories. Arts-based research methods (ABRM) have potential for advancing research, as art depicts experiences which cognitive neuropsychiatry seeks to explain. METHODS To examine how incorporating ABRM may advance hallucination research and theories, we explore data on the lived experiences of hallucinations in psychiatric and neurological populations. We present a multiple case study of two empirical ABRM studies, which used participant-generated artwork and artist collaborations alongside interviews. RESULTS ABRM combined with interviews illustrated that hallucinations were infused with sensory features, characterised by embodiment, and situated within lived circumstances. These findings advance neurocognitive models of hallucinations by nuancing their multimodal nature, illustrating their embodied feelings, and exploring their content and themes. The process of generating artworks aided in disclosing difficult to discuss hallucinations, promoted participant self-reflection, and clarified multimodal details that may have been misconstrued through interview alone. ABRM were relevant and acceptable for participants and researchers. CONCLUSION ABRM may contribute to the development of neurocognitive models of hallucinations by making hallucination experiences more visible, tangible, and accessible.
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Affiliation(s)
- Katie Melvin
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.,Leicestershire Partnership NHS Trust, Leicester, UK.,Innovation, Technology and Operations Division, School of Business, University of Leicester, Leicester, UK
| | | | - John Cromby
- Innovation, Technology and Operations Division, School of Business, University of Leicester, Leicester, UK
| | - Jon Crossley
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.,Leicestershire Partnership NHS Trust, Leicester, UK
| | - Jane R Garrison
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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16
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Montagnese M, Vignando M, Collerton D, Ffytche D, Mosimann UP, Taylor JP, daSilva Morgan K, Urwyler P. Cognition, hallucination severity and hallucination-specific insight in neurodegenerative disorders and eye disease. Cogn Neuropsychiatry 2022; 27:105-121. [PMID: 34338592 DOI: 10.1080/13546805.2021.1960812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Hallucinations occur across neurodegenerative disorders, with increasing severity, poorer cognition and impaired hallucination-specific insight associated with worse outcomes and faster disease progression. It remains unclear how changes in cognition, temporal aspects of hallucinations, hallucination-specific insight and distress relate to each other.Methods: Extant samples of patients experiencing visual hallucinations were included in the analyses: Parkinson's Disease (n = 103), Parkinson's Disease Dementia (n = 41), Dementia with Lewy Bodies (n = 27) and Eye Disease (n = 113). We explored the relationship between factors of interest with Spearman's correlations and random-effect linear models.Results: Spearman's correlation analyses at the whole-group level showed that higher hallucination-specific insight was related to higher MMSE score (rs = 0.39, p < 0.001) and less severe hallucinations (rs = -0.28, p < .01). Linear mixed-models controlling for diagnostic group showed that insight was related to higher MMSE (p < .001), to hallucination severity (p = 0.003), and to VH duration (p = 0.04). Interestingly, insight was linked to the distress component but not the frequency component of severity. No significant relationship was found between MMSE and hallucination severity in these analyses.Conclusion: Our findings highlight the importance of hallucination-specific insight, distress and duration across groups. A better understanding of the role these factors play in VH may help with the development of future therapeutic interventions trans-diagnostically.
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Affiliation(s)
- Marcella Montagnese
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Miriam Vignando
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Daniel Collerton
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Dominic Ffytche
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Urs Peter Mosimann
- Gerontechnology and Rehabilitation, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katrina daSilva Morgan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Prabitha Urwyler
- Gerontechnology and Rehabilitation, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland.,Department of Neurology, University Neurorehabilitation Unit, Inselspital, Bern, Switzerland
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17
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López-Silva P, Cavieres Á, Humpston C. The phenomenology of auditory verbal hallucinations in schizophrenia and the challenge from pseudohallucinations. Front Psychiatry 2022; 13:826654. [PMID: 36051554 PMCID: PMC9424625 DOI: 10.3389/fpsyt.2022.826654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
In trying to make sense of the extensive phenomenological variation of first-personal reports on auditory verbal hallucinations, the concept of pseudohallucination is originally introduced to designate any hallucinatory-like phenomena not exhibiting some of the paradigmatic features of "genuine" hallucinations. After its introduction, Karl Jaspers locates the notion of pseudohallucinations into the auditory domain, appealing to a distinction between hallucinatory voices heard within the subjective inner space (pseudohallucination) and voices heard in the outer external space (real hallucinations) with differences in their sensory richness. Jaspers' characterization of the term has been the target of a number of phenomenological, conceptual and empirically-based criticisms. From this latter point of view, it has been claimed that the concept cannot capture distinct phenomena at the neurobiological level. Over the last years, the notion of pseudohallucination seems to be falling into disuse as no major diagnostic system seems to refer to it. In this paper, we propose that even if the concept of pseudohallucination is not helpful to differentiate distinct phenomena at the neurobiological level, the inner/outer distinction highlighted by Jaspers' characterization of the term still remains an open explanatory challenge for dominant theories about the neurocognitive origin of auditory verbal hallucinations. We call this, "the challenge from pseudohallucinations". After exploring this issue in detail, we propose some phenomenological, conceptual, and empirical paths for future research that might help to build up a more contextualized and dynamic view of auditory verbal hallucinatory phenomena.
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Affiliation(s)
- Pablo López-Silva
- School of Psychology, Faculty of Social Sciences, Universidad de Valparaíso, Valparaíso, Chile.,Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Álvaro Cavieres
- Department of Psychiatry, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - Clara Humpston
- School of Psychology, University of York, York, United Kingdom.,School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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18
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Sakamoto K, Kobayashi R, Yokoi K, Otaka M, Okada O, Hosokawa K, Kimura M, Kawakatsu S, Otani K, Hirayama K. Trimodal hallucination and delusion after right thalamomesencephalic infarction. Psychogeriatrics 2022; 22:149-155. [PMID: 34877739 DOI: 10.1111/psyg.12793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/15/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Kazutaka Sakamoto
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan.,Chitose Shinoda Hospital, Yamagata, Japan
| | - Ryota Kobayashi
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Kayoko Yokoi
- Department of Occupational Therapy, Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Miki Otaka
- Department of Rehabilitation, Shinoda General Hospital, Yamagata, Japan
| | - Oyuki Okada
- Department of Rehabilitation, Shinoda General Hospital, Yamagata, Japan
| | - Kazuki Hosokawa
- Department of Rehabilitation, Akiyama Neurosurgery Hospital, Yokohama, Japan
| | | | - Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Koichi Otani
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Kazumi Hirayama
- Department of Occupational Therapy, Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
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19
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Grent-'t-Jong T, Gajwani R, Gross J, Gumley AI, Lawrie SM, Schwannauer M, Schultze-Lutter F, Williams SR, Uhlhaas PJ. MR-Spectroscopy of GABA and Glutamate/Glutamine Concentrations in Auditory Cortex in Clinical High-Risk for Psychosis Individuals. Front Psychiatry 2022; 13:859322. [PMID: 35422722 PMCID: PMC9002006 DOI: 10.3389/fpsyt.2022.859322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022] Open
Abstract
Psychosis involves changes in GABAergic and glutamatergic neurotransmission in auditory cortex that could be important for understanding sensory deficits and symptoms of psychosis. However, it is currently unclear whether such deficits are present in participants at clinical high-risk for psychosis (CHR-P) and whether they are associated with clinical outcomes. Magnetic Resonance Spectroscopy (MEGAPRESS, 1H-MRS at 3 Tesla) was used to estimate GABA, glutamate, and glutamate-plus-glutamine (Glx) levels in auditory cortex in a large sample of CHR-P (n = 99), CHR-N (clinical high-risk negative, n = 32), and 45 healthy controls. Examined were group differences in metabolite concentrations as well as relationships with clinical symptoms, general cognition, and 1-year follow-up clinical and general functioning in the CHR-P group. Results showed a marginal (p = 0.039) main group effect only for Glx, but not for GABA and glutamate concentrations, and only in left, not right, auditory cortex. This effect did not survive multiple comparison correction, however. Exploratory post-hoc tests revealed that there were significantly lower Glx levels (p = 0.029, uncorrected) in the CHR-P compared to the CHR-N group, but not relative to healthy controls (p = 0.058, uncorrected). Glx levels correlated with the severity of perceptual abnormalities and disorganized speech scores. However, in the CHR-P group, Glx levels did not predict clinical or functional outcomes. Accordingly, the findings from the present study suggest that MRS-measured GABA, glutamate and Glx levels in auditory cortex of CHR-P individuals are largely intact.
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Affiliation(s)
- Tineke Grent-'t-Jong
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom.,Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ruchika Gajwani
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Joachim Gross
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom.,Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
| | - Andrew I Gumley
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stephen M Lawrie
- Department of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Matthias Schwannauer
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stephen R Williams
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom.,Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Thomas L, Torregrossa L, Reniers R, Humpston C. Exploring multimodal hallucinations and disturbances in the basic and bodily self: A cross-sectional study in a non-clinical sample. J Psychiatr Res 2021; 143:144-154. [PMID: 34487991 DOI: 10.1016/j.jpsychires.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/02/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
The bodily self is key to emotional embodiment, which is important for social functioning and emotion regulation. There is a paucity of research systematically assessing how basic and bodily self-disturbances relate to multimodal hallucinations. This study hypothesised that participants with greater hallucination-proneness would report greater degrees of basic and bodily self-disturbance and would demonstrate more ambiguous and less discrete mapping of emotional embodiment. Stage one screened non-clinical participants' degree of hallucination-proneness. Stage two participants completed seven further questionnaires. Hierarchical linear regression modelled the influence of hallucination-proneness and covariates on measures of basic and bodily self-disturbance and sensed presence. Stage two participants also completed a computerised body mapping task (EmBODY) which assessed emotional embodiment. Topographical maps were generated to compare patterns of embodiment between high and low hallucination-proneness groups. 55 respondents participated in stage two, with 18 participants from the high or low hallucination-proneness groups completing EmBODY. In the hierarchical regression analyses, the addition of a measure of hallucination proneness in the final step only increased predictive power where the dependent variable assessed sensed presence (p = 0.035 and p = 0.009, respectively). The EmBODY data revealed that participants with low hallucination-proneness consistently reported more bodily activation across 14 emotional states, whereas the high hallucination-proneness group reported more deactivation. In conclusion, hallucination-proneness was most strongly associated with sensed presence experiences. Patterns of embodiment appeared similar between the two groups, despite consistent differences in activation and deactivation. These findings are exploratory and need to be confirmed in a larger sample.
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Affiliation(s)
- Lucretia Thomas
- Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2GW, UK
| | - Lénie Torregrossa
- Department of Psychology, Vanderbilt University, Nashville, TN, 37240, USA
| | - Renate Reniers
- Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK; Institute for Mental Health, University of Birmingham, Birmingham, B15 2TT, UK
| | - Clara Humpston
- Institute for Mental Health, University of Birmingham, Birmingham, B15 2TT, UK.
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21
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Melvin K, Crossley J, Cromby J. The feeling, embodiment and emotion of hallucinations in first episode psychosis: A prospective phenomenological visual-ecological study using novel multimodal unusual sensory experience (MUSE) maps. EClinicalMedicine 2021; 41:101153. [PMID: 34877510 PMCID: PMC8633969 DOI: 10.1016/j.eclinm.2021.101153] [Citation(s) in RCA: 4] [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] [Received: 04/06/2021] [Revised: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Research and practice typically focus upon unimodal hallucinations, especially auditory verbal hallucinations. Contemporary research has however indicated that voice-hearing may co-occur within a broader milieu of feelings, and multimodal hallucinations may be more common than previously thought. METHODS An observational design asked participants to prospectively document the feeling and modality of hallucinations for one week prior to an interview. Novel visual diary methods involving drawing, writing and body-mapping generated 42 MUSE maps (multimodal unusual sensory experience), analysed with a participatory qualitative method. Twelve people took part: all experiencing hallucinations daily, accessing early intervention in psychosis services, given psychotic-spectrum diagnoses, and living in the community. The study took place during a seven-month period in 2018 at Leicestershire and Rutland's Psychosis Intervention and Early Recovery service (UK). FINDINGS All documented hallucinations co-occurred with bodily feelings. Feelings were localised to specific body areas, generalised across the body and extended beyond the body into peripersonal space. Co-occurring emotional feelings most commonly related to confusion, fear and frustration. INTERPRETATION Hallucinations were characterised by numerous feelings arising at once, often including multimodal, emotional, and embodied features. Within this study, the immediate feeling of hallucination experiences were readily communicated through prospective, visual, and ecological information gathering methods and particularly those which offer multiple modes of communication (e.g. body-map, visual, written, oral). Uptake of visual, ecological and prospective methods may enhance understandings of lived experiences of hallucinations.Funding: University of Leicester.
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Affiliation(s)
- Katie Melvin
- University of Leicester, Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- Leicestershire Partnership National Health Service (NHS) Trust, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- University of Leicester, Division of Innovation, Technology and Operations, Brookfield Campus, 266 London Road, Leicester, LE2 1RQ
- Corresponding Author
| | - Jon Crossley
- University of Leicester, Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
- Leicestershire Partnership National Health Service (NHS) Trust, George Davies Centre, University of Leicester, 15 Lancaster Road, Leicester, LE1 7HA
| | - John Cromby
- University of Leicester, Division of Innovation, Technology and Operations, Brookfield Campus, 266 London Road, Leicester, LE2 1RQ
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22
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Dumas LE, Bonnard-Couton V, Golse B, Askénazy F. [Identifying cognitive and emotional markers in relation to auditory-verbal hallucinations in pediatric population: Physalis study]. Encephale 2021; 48:546-554. [PMID: 34625214 DOI: 10.1016/j.encep.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/16/2021] [Accepted: 06/04/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Auditory-verbal hallucinatory experiences (AVH) represent a prevalence of 12% in the general pediatric population. They are most often considered as a transient and benign developmental phenomenon, associated with mood and anxiety disorders. The persistence of AVHs for several years and into adolescence would represent a poor prognosis of progression into a psychiatric disorder, and more particularly psychotic disorder. The alteration of social and emotional cognitive markers are described as prodromal of this unfavorable progression which should be considered within the continuum between subclinical and clinical signs of the "psychosis phenotype". The objective of this study was to assess these markers in children and adolescents with AVH and their correlation with the presence and persistence of hallucinations. METHODS Multicenter prospective case-control study, longitudinal over 6months. Patients were included based on the presence of HAV on clinical examination. Forty subjects aged 8 to 16years from a clinical pediatric population were included. They were divided into two groups according to the Diagnostic Interview Schedule for Children-Child version (DISC-C): a group with AVH ("AVH+"), and a group without HAV ("AVH-"). A diagnosis of schizophrenia spectrum disorder was a non-inclusion criterion according to the criteria of DSM-5 (K-SADS-PL). This group was matched to the control group without AVH (AVH-) according to sex, age (±6months) and associated psychiatric diagnoses assessed by the MINI-Kid. The marker of social cognition was assessed with the NEPSY II test. The emotional marker was assessed with the self-questionnaires: EED IV, which highlights the emotions currently being felt by the subject, and the BAVQ-R, which categorizes the child's emotions in reaction to AVH. RESULTS No significant link was found between the social and emotional cognition markers and the presence of AVH at T0. At 6months, 50% of subjects in the AVH+ group suffered from persistent AVH and 18% progressed to a diagnosis of schizophrenia spectrum disorder. The persistence of AVH was not significantly correlated with the marker of social cognition, but it was significantly correlated with the presence of negative emotions (sadness, fear, hostility and anger) and inversely correlated with emotions of joy. CONCLUSION In this study, AVH experiences in the pediatric population are not linked to markers of social cognition, but negative emotions appear as early markers of AVH persistence. CLINICALTRIALS. GOV IDENTIFIER NCT02567500.
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Affiliation(s)
- Louise-Emilie Dumas
- Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France.
| | - Valérie Bonnard-Couton
- Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France
| | - Bernard Golse
- Institut contemporain de l'enfance, 30, rue de Bourgogne, 75007 Paris, France
| | - Florence Askénazy
- Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France
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23
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Psychotic-like experiences? Trajectories and typologies of hallucinations and delusions from early adolescence to early adulthood in a population-based sample of Irish youth. Ir J Psychol Med 2021; 39:207-222. [PMID: 33969817 DOI: 10.1017/ipm.2021.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Hallucinations and delusions that occur in the absence of a psychotic disorder are common in children and adolescents. Longitudinal phenomenological studies exploring these experiences are notably lacking. The objective of the current paper was to explore the phenomenology and characteristics of hallucinations and delusions from early adolescence to early adulthood. METHODS Participants were 17 young people aged 18-21 years from the general population, all of whom had a history of childhood hallucinations and/or delusions. Longitudinal data on the phenomenological characteristics and attributions of reported hallucinatory and delusional phenomena spanning nine years were explored using content analysis. RESULTS Hallucinatory and delusional phenomena were transient for two-thirds of the sample. The remaining one-third reported reoccurring hallucinatory and delusional phenomena into early adulthood. In those, two typologies were identified: (1) Paranormal typology and (2) Pathological typology. The former was characterised by hallucinatory and delusional phenomena that were exclusively grounded in subcultural paranormal or spiritual belief systems and not a source of distress. The latter was characterised by delusion-like beliefs that were enmeshed with individuals' mood states and a source of distress. The perceived source, the subcultural context and how young people appraised and integrated their experiences differentiated the Paranormal and Pathological typologies. CONCLUSIONS Not all hallucinatory and delusion-like experiences are psychotic-like in nature. To reliably differentiate between pathological and non-pathological hallucinations and delusions, assessments need to explore factors including the phenomenology of individuals' experiences, how people make sense and appraise them, and the subcultural contexts within which they are experienced.
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Leptourgos P, Fortier-Davy M, Carhart-Harris R, Corlett PR, Dupuis D, Halberstadt AL, Kometer M, Kozakova E, LarØi F, Noorani TN, Preller KH, Waters F, Zaytseva Y, Jardri R. Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison. Schizophr Bull 2020; 46:1396-1408. [PMID: 32944778 PMCID: PMC7707069 DOI: 10.1093/schbul/sbaa117] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The recent renaissance of psychedelic science has reignited interest in the similarity of drug-induced experiences to those more commonly observed in psychiatric contexts such as the schizophrenia-spectrum. This report from a multidisciplinary working group of the International Consortium on Hallucinations Research (ICHR) addresses this issue, putting special emphasis on hallucinatory experiences. We review evidence collected at different scales of understanding, from pharmacology to brain-imaging, phenomenology and anthropology, highlighting similarities and differences between hallucinations under psychedelics and in the schizophrenia-spectrum disorders. Finally, we attempt to integrate these findings using computational approaches and conclude with recommendations for future research.
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Affiliation(s)
- Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | - Martin Fortier-Davy
- Institut Jean Nicod, École des Hautes Études en Sciences Sociales, École Normale Supérieure, PSL Research University, Paris France
| | | | - Philip R Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | - David Dupuis
- Department of Anthropology, University of Durham, Durham, UK
| | - Adam L Halberstadt
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Research Service, VA San Diego Healthcare System, San Diego, CA
| | - Michael Kometer
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Eva Kozakova
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
| | - Frank LarØi
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
- Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
| | | | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Flavie Waters
- School of Psychological Sciences, The University of Western Australia, Perth, Western Australia
| | - Yuliya Zaytseva
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czechia
- Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Renaud Jardri
- Univ. Lille, INSERM U1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY team, Lille, France
- Laboratoire de Neurosciences Cognitives et Computationnelles, ENS, INSERM U960, PSL Research University, Paris, France
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25
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Mourgues C, Negreira AM, Quagan B, Mercan NE, Niles H, Kafadar E, Bien C, Kamal F, Powers AR. Development of Voluntary Control Over Voice-Hearing Experiences: Evidence From Treatment-Seeking and Non-Treatment-Seeking Voice-Hearers. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa052. [PMID: 33196043 PMCID: PMC7643545 DOI: 10.1093/schizbullopen/sgaa052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Voluntary control over voice-hearing experiences is one of the most consistent predictors of functioning among voice-hearers. However, control over voice-hearing experiences is likely to be more nuanced and variable than may be appreciated through coarse clinician-rated measures, which provide little information about how control is conceptualized and developed. We aimed to identify key factors in the evolution of control over voice-hearing experiences in treatment-seeking (N = 7) and non-treatment-seeking (N = 8) voice-hearers. Treatment-seeking voice-hearers were drawn from local chapters of the Connecticut Hearing Voices Network, and non-treatment-seeking voice-hearers were recruited from local spiritually oriented organizations. Both groups participated in a clinical assessment, and a semi-structured interview meant to explore the types of control exhibited and how it is fostered. Using Grounded Theory, we identified that participants from both groups exerted direct and indirect control over their voice-hearing experiences. Participants that developed a spiritual explanatory framework were more likely to exert direct control over the voice-hearing experiences than those that developed a pathologizing framework. Importantly, despite clear differences in explanatory framework and distress because of their experiences, both groups underwent similar trajectories to develop control and acceptance over their voice-hearing experiences. Understanding these factors will be critical in transforming control over voice-hearing experiences from a phenomenological observation to an actionable route for clinical intervention.
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Affiliation(s)
- Catalina Mourgues
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Alyson M Negreira
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Brittany Quagan
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | | | - Halsey Niles
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT
| | | | - Claire Bien
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Faria Kamal
- Department of Psychiatry, Columbia University, New York, NY
| | - Albert R Powers
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT.,Department of Psychology, Yale University, New Haven, CT
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