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Individuals with auditory verbal hallucinations (AVHs) in schizophrenia perceive their inner thoughts as louder than external speech. This may explain why they struggle to distinguish AVHs from their own thoughts.

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Area of Science:

  • Cognitive Psychology
  • Psychiatry
  • Neuroscience

Background:

  • Cognitive theories suggest auditory hallucinations (AVHs) arise from misattributing inner speech to external sources.
  • Limited first-hand accounts hinder understanding how patients differentiate AVHs from ordinary thoughts.

Purpose of the Study:

  • To investigate the process by which individuals distinguish auditory verbal hallucinations (AVHs) from ordinary thoughts.
  • To examine the volume perception of inner speech in individuals with schizophrenia experiencing AVHs compared to those without and the general population.

Main Methods:

  • Assessed 89 individuals with schizophrenia (Sz-AVHs and Sz-noAVHs) and 48 general population controls.
  • Utilized the Auditory Hallucinations Assessment Questionnaire (AHAQ) to evaluate subjective experiences.
  • Compared perceived loudness of inner thoughts, AVHs, and spoken words across groups.

Main Results:

  • The Sz-AVHs group perceived their ordinary thoughts at the same volume as AVHs and spoken words.
  • Sz-noAVHs and general population samples perceived spoken words as louder than their thoughts.
  • The Sz-AVHs group described their thoughts as louder compared to the other two groups.

Conclusions:

  • Findings support the cognitive hypothesis of AVHs, suggesting a potential mechanism for source monitoring difficulties.
  • Difficulty distinguishing the source of AVHs may stem from perceiving inner thoughts at a similar volume to external speech and hallucinations.