ReviewAuditory hallucinations: a review of psychological treatments
Section snippets
Background
Auditory hallucinations (AH) occur frequently amongst psychiatric patients, being most common in schizophrenia and often described as `voices'. A review of 16 studies (Slade and Bentall, 1988) found an average prevalence of 60% for AH in patients with a diagnosis of schizophrenia (range 25–94%). AH may also occur in normal individuals, with surveys estimating life-time prevalence rates of 10–39% in the general population (McKellar, 1968; Posey and Losch, 1983; Bentall and Slade, 1985; Tien, 1991
Search strategy
The search strategy included the following sources: The Cochrane Controlled Trials Register, MEDLINE (from 1987 to June 1997), Embase (from 1987 to May 1997) and Psychlit (from 1987 to June 1997). The reference lists of all relevant papers were checked for additional studies. Initially, randomised controlled trials and review articles were sought using the search strategy recommended by the University of York NHS Centre for reviews and dissemination. There were no double-blind randomised
Aetiological theories
First we will consider aetiological theories of AH which have a psychological therapeutic potential; for a more comprehensive review of the aetiology of AH the reader is referred to Bentall (1990). `Organic' conditions associated with AH can provide clues to the neural regions which may generate AH. Temporal lobe lesions may lead to AH (Penfield and Jasper, 1954; Perez et al., 1985). However, brain stimulation experiments have failed to provide a convincing model of `functional' AH, as the
Strategies used by patients (Table 1)
Falloon and Talbot (1981)reported on 40 patients with schizophrenia who experienced AH every day. They found that the most commonly used strategies could be grouped as (1) modification of behaviour, (2) modification of sensory input, and (3) cognitive techniques. The most common behavioural approaches were lying down or walking, attending to hobbies or reading, listening to music/television, having interpersonal contact and taking medication. Sensory modification was achieved by relaxing or
Psychological treatments
A summary of treatment studies carried out since 1988 is shown in Table 2. The more recent studies have been categorised according to their theoretical underpinnings, and the coping strategies used by patients.
References (65)
- et al.
Stimulus interference and conditioned inhibition of auditory hallucinations
J. Behav. Ther. Exp. Psychiatry
(1976) - et al.
Removal and diversion tactics and the control of auditory hallucinations
Behav. Res. Ther.
(1985) The signs and symptoms of schizophrenia
Compr. Psychiatry
(1985)- et al.
Reliability of a measure of disposition towards hallucination
Personal. Indiv. Diff.
(1985) - et al.
Cognitive behaviour therapy for persistent auditory hallucinations: from theory to therapy
Behav. Ther.
(1994) - et al.
Cognitive restructuring in the treatment of psychotic symptoms in schizophrenia: a critical analysis
Behav. Ther.
(1996) - et al.
Use of patient-administered shock to suppress hallucinations
Behav. Ther.
(1970) - et al.
Perceptual and attentional asymmetries in schizophrenia: further evidence for a left hemisphere deficit
Psychiatry Res.
(1996) - et al.
The development and reliability of the Mental Health Research Institute Unusual Perceptions Schedule (MUPS): an instrument to record auditory hallucinatory experience
Schizophr. Res.
(1995) A case of auditory hallucinations treated by satiation
Behav. Res. Ther.
(1985)