Ear with golden grid backgroundEarlier this week we saw the publication of ‘The Spectra of Soundless Voices and Audible Thoughts: Towards an Integrative Model of Auditory Verbal Hallucinations and Thought Insertion’ by Clara S. Humpston and HtV collaborator Matthew Broome in the Review of Philosophy and Psychology.

This paper is the first article to be published in the Review of Philosophy and Psychology special issue on ‘Voices and Thoughts in Psychosis’, which is being guest edited by our postdoctoral researchers Ben Alderson-Day and Sam Wilkinson.

Abstract: Patients with psychotic disorders experience a range of reality distortions. These often include auditory-verbal hallucinations (AVHs), and thought insertion (TI) to a lesser degree; however, their mechanisms and relationships between each other remain largely elusive. Here we attempt to establish a integrative model drawing from the phenomenology of both AVHs and TI and argue that they in fact can be seen as ‘spectra’ of experiences with varying degrees of agency and ownership, with ‘silent and internal own thoughts’ on one extreme and ‘fully external and clearly audible voices’ in the absence of a speaker on the other. We believe a spectral model will add emphasis to the continuity of experience and help to better understand how one type of psychotic symptom may interact with another, and put forward the argument that the experience of TI itself is not sufficient to classify as a delusion. In addition we aim to discuss some of the conceptual issues surrounding AVHs and TI with first-person accounts and current philosophical and neuropsychological theories in mind. We propose that the mechanisms behind AVHs and TI are more complex than source-monitoring deficits; indeed, to understand such phenomena one must appreciate that their very ‘existence’ and ‘reality’ as experienced by the individual have much deeper implications and meaning, both philosophically and clinically.

Readers from subscribing institutions can read the article in full online here.

About the authors:

Clara S. Humpston is a doctoral researcher in the School of Psychology, Cardiff University

Professor Matthew Broome is a Consultant Psychiatrist and Senior Clinical Research Fellow in the Department of Psychiatry, University of Oxford.

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