Verbal self-monitoring and auditory verbal hallucinations in patients with schizophrenia
Abstract
BACKGROUND: Contemporary cognitive models of auditory verbal hallucinations propose that they arise through defective self-monitoring. We used a paradigm that engages verbal self-monitoring to investigate this theory in patients with schizophrenia. METHODS: Ten patients with auditory verbal hallucinations and delusions (hallucinators), eight patients with delusions but no hallucinations (non-hallucinators), and 20 non-psychiatric control subjects were tested. Participants read single adjectives aloud, under the following randomized conditions: reading aloud; reading aloud with acoustic distortion of their own voice; reading aloud with alien feedback (someone else's voice); and reading aloud with distorted alien feedback. Immediately after articulating each word, participants identified the source of the speech they heard ('self'/'other'/'unsure'), via a button press. Response choice and reaction time were recorded. RESULTS: When reading aloud with distorted feedback of their own voice, patients in both groups made more errors than controls; they either misidentified its source or were unsure. Hallucinators were particularly prone to misattributing their distorted voice to someone else, and were more likely to make errors when the words presented were derogatory. Both patient groups made faster decisions than controls about the source of distorted or alien speech, but faster responses were only associated with errors in the former condition. CONCLUSIONS: Impaired verbal self-monitoring was evident in both hallucinators and non-hallucinators. As both groups had delusions, the results suggest an association between delusions and impaired judgements about ambiguous sensory stimuli. The specific tendency of hallucinators to misattribute their distorted voice to someone else may reflect impaired awareness of internally generated verbal material.
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Patients with AVHs are worse at making the self/other judgement correctly on distorted voice tasks.
“Studies utilizing this task have shown that patients with AVHs are worse at making the self/other judgement correctly (Johns et al., 2001).”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Johns et al., 2001
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- Authors
- JOHNS, L. C., ROSSELL, S., FRITH, C., AHMAD, F., HEMSLEY, D., KUIPERS, E., & McGUIRE, P. K.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2001-05
- Volume
- 31
- Issue
- 4
- Pages
- 705-715
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2140050282
- Cited by
- 272
- References
- 26
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 9 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 10 · 2019: 11 · 2018: 5 · 2017: 12 · 2016: 14 · 2015: 13 · 2014: 9 · 2013: 13 · 2012: 21
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- auditory verbal hallucinations, schizophrenia, verbal self-monitoring, delusions, source monitoring, reaction time
- MeSH terms
- Adult, Female, Hallucinations, Humans, Male, Middle Aged, Schizophrenia, Schizophrenic Psychology, Self Concept, Verbal Behavior
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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