Tuesday, 18 December 2018

The ice in voices: Understanding negative content in auditory-verbal hallucinations

In this new article by Frank Larøi, Neil Thomas, André Aleman, Charles Fernyhough, Sam Wilkinson, Felicity Deamer and Simon McCarthy-Jones, the authors explore the complexities of negative content in auditory-verbal hallucinations (AVH), taking into account its theoretical and clinical importance. 

Negative voice-content is the best sole predictor of whether the hearer of an auditory-verbal hallucination will experience distress/impairment necessitating contact with mental health services. Yet, what causes negative voice-content and how interventions may reduce it remains poorly understood. The paper offers definitions of negative voice content and considers what may cause negative voice-content. A framework is proposed in which adverse life-events may underpin much negative voice-content, a relation which may be mediated by mechanisms including hypervigilance, reduced social rank, shame and self-blame, dissociation, and altered emotional processing. At a neurological level, how the involvement of the amygdala and right Broca’s area could drive negative voice-content is noted. As observed, negative interactions between hearers and their voices may further drive negative voice-content. Finally, the role of culture in shaping negative voice-content is considered. 

This framework is intended to deepen and extend cognitive models of voice-hearing and spur further development of psychological interventions for those distressed by such voices. Importantly, much of the relevant research in this area remains to be performed or replicated. In conclusion, more attention needs to be paid to methods for reducing negative voice-content, and further research in this important area is required.

The full text can be accessed via the link below

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