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Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?

Simon McCarthy-Jones, Eleanor Longden

Frontiers in Psychology 2015 DOI: 10.3389/fpsyg.2015.01071 (opens in new tab)

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AI-extracted from the abstract
Characteristics Theoretical or philosophical paper Peer reviewed
Topics PTSD Philosophy of mind
Keywords Abuse Dissociation Hallucinations Hearing voices Memory Psychosis Traumatology
Key points Argues that a notable subset of people diagnosed with schizophrenia who hear voices have experiences phenomenologically and aetiologically identical to PTSD patients who hear voices, and proposes that the divide between 'dissociative AVH' and 'psychotic AVH' should be torn down, implying a common trans-diagnostic, trauma-focused treatment strategy.

Abstract

Auditory verbal hallucinations (AVH: 'hearing voices') are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual's personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed 'dissociative AVH') and AVH in schizophrenia (so-called 'psychotic AVH') needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.

Comparable studies

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Study Year Design Participants
Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. 2024 Theoretical or philosophical paper
The potential use of N-methyl-3,4-methylenedioxyamphetamine (MDMA) assisted psychotherapy in the treatment of eating disorders comorbid with PTSD. 2021 Theoretical or philosophical paper
MDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations. Adolescents with PTSD 2024 Theoretical or philosophical paper
Agency in Post-traumatic Stress Disorder: Implications for Therapy 2023 Theoretical or philosophical paper
The Inner World in the Outer World: The Phenomenology of Posttraumatic Stress Disorder from a Psychoanalytic Perspective 1996 Theoretical or philosophical paper

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PTSD Philosophy of mind