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• Auditory hallucinations (AH) occur in ~80% of people with schizophrenia-spectrum disorders, but remain poorly understood and have mixed treatment response
• AH are predominantly negative in content (Johns et al., 2002; Sanjuan et al., 2004). Why?
• Most individuals with AH also endorse hallucinations in at least one other sensory modality. It is unknown if these differ from AH in terms of negative content and emotional impact
• STUDY AIMS: Assess whether hallucination content and emotional distress differ across sensory modalities, and whether content and distress are similarly correlated in each modality. This will inform our understanding of the emotional dimension of hallucinations, which is a potential treatment target (Rosen, 2018)

Negative content and distress across hallucination sensory modalities

Bailey Cation^{1, 2}, Barrett Kern², Emma Herms², Sarah Keedy²

Department of Psychology, Roosevelt University¹;�Department of Psychiatry and Behavioral Neuroscience, The University of Chicago²

Background

References

Conclusions

Inclusion criteria for participants:

• Diagnosed with a psychotic disorder
• Endorsed a history of AH and hallucinations in at least one other modality (≥ 2 modalities total)

Paired samples t-tests were used to compare ratings of negative content and emotional distress between sensory modalities. *p < .05, **p < .01, ***p < .001. ^†p = .086, n = 22.

• Results indicated that AH are experienced more negatively than hallucinations in other sensory modalities
• This suggests that AH may be more vulnerable than other sensory modalities to the influence of mechanisms causing a negative valence of hallucination content
• Future research on the emotional dimension of hallucinations will help continue to explicate the nature of this complex experience affecting ~80% of individuals with schizophrenia-spectrum disorders
• Limitations include:
• Limited generalizability given the sample is majority African-American and diagnosed with schizophrenia or schizoaffective disorder
• Self-report may be biased, inaccurate, or incomplete

Johns, L. C., Hemsley, D., & Kuipers, E. (2002). A comparison of auditory hallucinations in a psychiatric and non‐psychiatric group. British Journal of Clinical Psychology, 41(1), 81-86.

Kern, B., Axelrod, J., Gao, Y., & Keedy, S. (2015). Exchange the magnifying glass for a microscope: The Chicago Hallucination Assessment Tool (CHAT). Schizophrenia Bulletin, 41(suppl 1)., S110.

Rosen, C., McCarthy-Jones, S., Jones, N., Chase, K. A., & Sharma, R. P. (2018). Negative voice-content as a full mediator of a relation between childhood adversity and distress ensuing from hearing voices. Schizophrenia Research, 199, 361-366.

Sanjuan, J., Gonzalez, J. C., Aguilar, E. J., Leal, C., & Van Os, J. (2004). Pleasurable auditory hallucinations. Acta Psychiatrica Scandinavica, 110(4), 273-278.

Acknowledgements

This research was supported by K23MH092702 and R01MH103368

Methods

Participants reported subjective characteristics of their hallucinations using the CHAT (Kern et al., 2015):

• A semi-structured interview for assessing physical, cognitive, and emotional dimensions of hallucinations in separate modules for each sensory modality
• Ratings are made for current and past/worst hallucinations
• The emotional subscale measures emotional responses to hallucinations and their specific emotional content

Participants reported their past/worst experience of chronic hallucinations on the CHAT. Past/worst scores were used due to small sample size for current hallucination ratings.

Degree of Past/Worst �Negative Content

Results

Bivariate Pearson correlations were used to determine the relationship between negative content and emotional distress within each sensory modality. ***p < .001. Strength of the correlation was significantly weaker for VH than for AH (p = .049).

Chicago Hallucination Assessment Tool (CHAT)