The signal detection ability of patients with auditory hallucination: analysis using the continuous performance test

Signal detection theory is appropriate for analyzing the problem of whether auditory hallucination arises from a sensory or judgmental disorder. In the present study the sensory discrimination ability and decision bias of psychiatric patients with auditory hallucination was investigated by using the visual continuous performance test. Based on signal detection theory the d' (d prime) and the lnbeta value (the natural logarithm of the beta value) were calculated. The d' is indicator of discriminating ability, whereas the lnbeta value is an indicator of decision bias. The psychiatric inpatients with the diagnosis of schizophrenia mainly were divided into 11 patients with auditory hallucinations (AH(+)) and 11 patients without hallucinations (AH(-)). As compared with the AH(-) group, the AH(+) group showed the same d' value and a significantly lower lnbeta value. As compared with the normal control group, the AH(+) group showed a significantly lower d' value and a nearly normal lnbeta value. These results suggest that auditory hallucination is characterized by a cognitive deficit of unreasonably maintaining a relatively risk-taking decision bias in spite of decreased discriminating ability, which opposes the interpretation of Bentall and Slade (1985). The AH(+) group was divided into subgroups with bizarre delusions (BD(+)) and without bizarre delusions (BD(-)). The BD(+) group showed a stronger tendency toward a lower d' value and normal lnbeta value, which the AH(+) group had.