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The auditory hallucination: a phenomenological survey

  • Tony H. Nayani (a1) and Anthony S. David (a1)

A comprehensive semi-structured questionnaire was administered to 100 psychotic patients who had experienced auditory hallucinations. The aim was to extend the phenomenology of the hallucination into areas of both form and content and also to guide future theoretical development. All subjects heard ‘voices’ talking to or about them. The location of the voice, its characteristics and the nature of address were described. Precipitants and alleviating factors plus the effect of the hallucinations on the sufferer were identified. Other hallucinatory experiences, thought insertion and insight were examined for their inter-relationships. A pattern emerged of increasing complexity of the auditory–verbal hallucination over time by a process of accretion, with the addition of more voices and extended dialogues, and more intimacy between subject and voice. Such evolution seemed to relate to the lessening of distress and improved coping. These findings should inform both neurological and cognitive accounts of the pathogenesis of auditory hallucinations in psychotic disorders.

Corresponding author
1Address for correspondence: Dr A. S. David, Department of Psychological Medicine, Institute of Psychiatry, London SE5 8AF.
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A. Aggernaes (1972). The experienced reality of hallucinations and other psychological phenomena: an empirical analysis. Acta Psychiatrica Scandinavica 48, 220238.

I. Al-Issa (1977). Social and cultural aspects of hallucinations. Psychological Bulletin 84, 570587.

O. Almeida , H. Forstl , R. Howard & A. S. David (1993). Unilateral auditory hallucinations. British Journal of Psychiatry 162, 262264.

M. Annett (1970). A classification of hand preference by association analysis. British Journal of Psychology 61, 303321.

L. Benjamin (1989). Is chronicity a function of the relationship between the person and the auditory hallucination? Schizophrenia Bulletin 15, 291310.

R. Bentall , G. Baker & S. Havers (1991). Reality monitoring and psychotic hallucinations. British Journal of Clinical Psychology 30, 213222.

G. Berrios (1990). Musical hallucinations: a historical and clinical study. British Journal of Psychiatry 156, 188194.

H. Bracha , F. Cabrera , C. Karson & L. Bigelow (1985). Lateralisation of visual hallucinations in chronic schizophrenia. Biological Psychiatry 20, 11321136.

P. Chadwick & M. Birchwood (1994). The omnipotence of voices: a cognitive approach to auditory hallucinations. British Journal of Psychiatry 164, 190201.

S. Chaturvedi 0 & V. Sinha (1990). Recurrence of hallucinations in consecutive episodes of schizophrenia and affective disorder. Schizophrenia Research 3, 103106.

A. David (1990). Insight and psychosis. British Journal of Psychiatry 156, 798808.

A. S. David & L. Appleby (1992). Diagnostic criteria in schizophrenia: accentuate the positive. Schizophrenia Bulletin 18, 551557.

A. S. David & P. Lucas (1993). Auditory–verbal hallucinations and the phonological loop: a cognitive neuropsychological study. British Journal of Clinical Psychology 32, 431441.

A. David , A. Buchanan , A. Reed & O. Almeida (1992). The assessment of insight in psychosis. British Journal of Psychiatry 161, 599602.

J. Dittmann & D. Schuttler (1990). Disease consciousness and coping strategies of patients with schizophrenic psychosis. Acta Psychiatrica Scandinavica 82, 318322.

D. Goodwin (1971). Clinical significance of hallucinations in psychiatric disorders. Archives of General Psychiatry 24, 7680.

E. Hare (1973). A short note on pseudo-hallucinations. British Journal of Psychiatry 122, 469476.

A. B. Heilbrun & N. A. Blum (1980). Impaired recognition of self-expressed thoughts in patients with auditory hallucinations. Journal of Abnormal Psychology 89, 728736.

R. E. Hoffman & S. K. Dobscha (1989). Cortical pruning and development of schizophrenia. Schizophrenia Bulletin 15, 470490.

R. E. Hoffman & S. L. Satel (1993). Language therapy for schizophrenic patients with persistent ‘voices’. British Journal of Psychiatry 162, 755758.

H. Hustig & R. Häfner (1990). Persistent auditory hallucinations and their relationship to delusions and mood. Journal of Nervous and Mental Disease 178, 264267.

J. Junginger & C. L. Frame (1985). Self-report of the frequency and phenomenology of verbal hallucinations. Journal of Nervous and Mental Disease 173, 149155.

L. Kohlberg , J. Yaeger & E. Hjertholm (1968). Private speech: four studies and a review of theories. Child Development 39, 691736.

I. Leuder , P. Thomas & P. Johnson (1992). Self-repair in dialogue of schizophrenics: effects of verbal hallucinations and negative symptoms. Brain and Language 43, 487511.

G. R. Lowe (1973). The phenomenology of hallucinations as an aid to differential diagnosis. British Journal of Psychiatry 123, 621633.

P. K. McGuire , G. M. S. Shah & R. M. Murray (1993). Increased blood flow in Broca's area during auditory hallucinations in schizophrenia. Lancet 342, 703706.

A. Margo , D. Hemsley & P. Slade (1981). The effects of varying auditory input on schizophrenic hallucinations. British Journal of Psychiatry 139, 122127.

C. Mellor (1982). The present status of the first rank symptoms. British Journal of Psychiatry 140, 423424.

J. Mitchell & A. Vierkant (1988). Delusions and hallucinations as a reflection of the subcultural milieu among psychotic patients of the 1930s and 1980s. Journal of Psychology 123, 269274.

A. Modell (1960). An approach to the nature of auditory hallucinations in schizophrenia. Archives of General Psychiatry 3, 259265.

R. Mott , I. Small & J. Anderson (1965). Comparative study of hallucinations. Archives of General Psychiatry 12, 595601.

E. Paulesu , C. Frith & R. Frackowiack (1993). Functional anatomy of the articulatory loop. Nature 362, 342344.

W. Penfield & P. Perot (1963). The brain's record of auditory and visual experience. Brain 86, 568693.

M. A. Romme & M. A. Escher (1989). Hearing voices. Schizophrenia Bulletin 15, 209215.

M. A. Romme , E. Honig , E. Northhoorn & M. A. Escher (1992). Coping with hearing voices: an emancipatory approach. British Journal of Psychiatry 161, 99103.

G. Sedman (1966). Inner voices: phenomenological and clinical aspects. British Journal of Psychiatry 112, 485490.

M. Sinason (1993). Who is the mad voice inside? Psychoanalytic Psychotherapy 7, 207221.

S. Starker & A. Jolin (1982). Imagery and hallucinations in schizophrenic patients. Journal of Nervous and Mental Disease 170, 448450.

N. Tarrier , R. Beckett , S. Harwood , A. Baker , L. Yusupoff & I. Ugaterburu (1993). A trial of two cognitive–behavioural methods of treating residual psychotic symptoms in schizophrenic patients. British Journal of Psychiatry 162, 524532.

P. Taylor & J. Fleminger (1981). The lateralisation of symptoms in schizophrenia. British Journal of Medical Psychology 54, 5965.

A. Tien (1991). Distributions of hallucinations in the population. Journal of Social and Psychiatric Epidemiology 26, 287292.

E. Zigler & L. Philips (1961). Psychiatric diagnosis and symptomatology. Journal of Abnormal and Social Psychology 63, 6975.

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Psychological Medicine
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