The presence of these symptoms during a 1-month period, together with another “characteristic symptom” such as delusions or disorganized speech, points to a diagnosis of SZ according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-5, if accompanied by social or occupational dysfunction during a 6-month period. AVHs in SZįrom a diagnostic viewpoint, AVHs provide considerable weight toward a diagnosis of SZ. In turn, this has important implications regarding possible intervention strategies. It has been argued 4 that different (neurological and cognitive) models are needed to explain different phenomenological signatures of AVHs, each entailing differing causal mechanisms. Finally, a better understanding will illuminate the mechanisms underlying hallucinatory experiences and allow investigations that are tailored to the phenomenological features of AVHs. 3 Enhanced specification of phenomenological features may furthermore unveil unique “hallucination signatures” in different disorders and provide tools to differentiate between experiences that call for treatment and those that do not. Also, phenomenological changes are considered an indication of treatment response, and certain phenomenological features may be used as discriminatory indicators for differential diagnosis. For example, increased understanding may lead to more sophisticated categorizations of the phenomenon, which may, in turn, improve the reliability of assessments and provide more focused interventions. Phenomenological studies promise to advance our understanding of AVHs on multiple empirical, theoretical, and clinical levels. The significance of AVHs lies in the fact that they are prevalent in psychopathological and neurological disorders and in the general population, yet they remain poorly understood and difficult to define. No previous review has examined the phenomenological characteristics of AVHs in schizophrenia (SZ) in detail nor incorporated comparisons with those AVHs reported in other clinical and nonclinical groups. Given our empirical focus, the former use of the term will primarily be employed in this article, although intermittent reference to philosophical phenomenological approaches is also made (see “The Phenomenology of Prehallucinatory Experiences” and “Limits” sections). The term “phenomenology” can refer to the detailed description of the clinical and/or descriptive features of signs and symptoms observed in psychopathological conditions or to a method of analysis of the constitution of subjective experience within the philosophical tradition of phenomenology. In this article, we review the characteristics of AVHs in clinical and nonclinical groups, using findings derived from empirical studies that have used quantitative measures of hallucination characteristics. Hallucinations, hallucinosis, hearing voices, psychosis, transdiagnostic IntroductionĪlthough there is no clear consensus concerning the definition of hallucinations, 1 from an empiricist-rationalist perspective, a hallucination may be referred to as “a sensory experience, which occurs in the absence of corresponding external stimulation of the relevant sensory organ, has a sufficient sense of reality to resemble a veridical perception, over which the subject does not feel s/he has direct and voluntary control and which occurs in the awake state.” 2 Auditory verbal hallucinations (AVHs) are the main focus of this article because this type of hallucination has been the most often examined in the literature.
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