The Self, Agency and Spatial Externalizations of Inner Verbal Thoughts, and Auditory Verbal Hallucinations

Area of Science:

• Neuroscience
• Cognitive Psychology
• Psychiatry

Background:

• Auditory Verbal Hallucinations (AVH) are often described as externalized inner speech.
• The distinct roles of agency (self vs. other) and spatial (internal vs. external) externalizations in AVH are not fully understood.
• Current research often conflates these two types of externalization.

Purpose of the Study:

• To investigate the relationship between cognitive agency and spatial externalizations of inner speech.
• To examine how these externalizations relate to different types of AVH experiences (self- vs. other-generated voices, internal vs. external space).

Main Methods:

• Twenty-five patients with AVH history and 24 healthy controls completed agency and spatial distinction tasks.
• Tasks involved distinguishing between self-generated and other-generated sentences, and between silently read (internal space) and aloud read (external space) sentences.
• Regression analyses and t tests were used to compare misattribution biases between groups and AVH subtypes.

Main Results:

• Agency and spatial distinction abilities were found to be independent in both patients and controls.
• Subgroups of AVH experienced as self-generated voices (S-AVH) and other-generated voices (O-AVH) differed in S-O bias.
• Subgroups of AVH experienced in internal space (IS-AVH) and external space (ES-AVH) differed in IS-ES bias.

Conclusions:

• Cognitive agency and spatial externalizations of inner speech appear to be independent phenomena at both phenomenological and cognitive levels.
• These externalizations are nevertheless correlated across different levels of experience.
• The findings contribute to a better understanding of AVH and the subjective experience of self.