TY - JOUR
T1 - Better than mermaids and stray dogs? subtyping auditory verbal hallucinations and its implications for research and practice
AU - Mccarthy-Jones, Simon
AU - Thomas, Neil
AU - Strauss, Clara
AU - Dodgson, Guy
AU - Jones, Nev
AU - Woods, Angela
AU - Brewin, Chris R.
AU - Hayward, Mark
AU - Stephane, Massoud
AU - Barton, Jack
AU - Kingdon, David
AU - Sommer, Iris E.
PY - 2014/7
Y1 - 2014/7
N2 - 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.
AB - 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.
KW - AVH
KW - hearing voices
KW - phenomenology
KW - schizophrenia
KW - symptom classification
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=84902588459&partnerID=8YFLogxK
U2 - 10.1093/schbul/sbu018
DO - 10.1093/schbul/sbu018
M3 - Article
C2 - 24936087
AN - SCOPUS:84902588459
SN - 0586-7614
VL - 40
SP - S275–S284
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - SUPPL. 4
ER -