Better than mermaids and stray dogs? subtyping auditory verbal hallucinations and its implications for research and practice

Simon Mccarthy-Jones, Neil Thomas, Clara Strauss, Guy Dodgson, Nev Jones, Angela Woods, Chris R. Brewin, Mark Hayward, Massoud Stephane, Jack Barton, David Kingdon, Iris E. Sommer

    Research output: Contribution to journalArticle

    51 Scopus citations

    Abstract

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

    Original languageEnglish (US)
    Pages (from-to)S275-S284
    JournalSchizophrenia Bulletin
    Volume40
    Issue numberSUPPL. 4
    DOIs
    StatePublished - Jul 2014

    Keywords

    • AVH
    • hearing voices
    • phenomenology
    • schizophrenia
    • symptom classification
    • trauma

    ASJC Scopus subject areas

    • Psychiatry and Mental health

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    Mccarthy-Jones, S., Thomas, N., Strauss, C., Dodgson, G., Jones, N., Woods, A., Brewin, C. R., Hayward, M., Stephane, M., Barton, J., Kingdon, D., & Sommer, I. E. (2014). Better than mermaids and stray dogs? subtyping auditory verbal hallucinations and its implications for research and practice. Schizophrenia Bulletin, 40(SUPPL. 4), S275-S284. https://doi.org/10.1093/schbul/sbu018