Reality testing and auditory hallucinations: a signal detection analysis
Abstract
The hypothesis that hallucinators are deficient in the metacognitive skill of reality testing was tested using the methodology of signal detection theory. In Expt 1 undergraduate subjects scoring high or low on a scale measuring predisposition to hallucination were tested on an auditory signal detection task. High scorers on the scale were found to differ from low scorers on a measure of perceptual bias but not on a measure of sensitivity. In Expt 2 a similar methodology was used with hallucinating and non-hallucinating schizophrenic patients, with similar results. These results support the hypothesis that hallucinators or subjects highly disposed towards hallucination are deficient in reality testing and are therefore prone to identify imaginary events as real.
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People prone to hallucinations experience a perceptual bias which increases the influence of prior (top-down) information over bottom-up sensory input ('over-weighted priors').
“There is evidence that people prone to hallucinations experience a perceptual bias which increases the influence of prior (top-down) information over bottom-up sensory input (“over-weighted priors”). 26 , 31 , 32”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [31]
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Hemsley, D. R. (1987) · Behavioral and Brain Sciences · doi:10.1017/s0140525x00023943 · Cited by 53 · see citing works
Cognitive-Behavioral Therapy in Schizophrenia
Seckinger, R. A., & AMADOR, X. F. (2001) · Journal of Psychiatric Practice · doi:10.1097/00131746-200105000-00005 · Cited by 51 · see citing works
Mental rotation in schizophrenia
de Vignemont, F., Zalla, T., Posada, A., Louvegnez, A., Koenig, O., Georgieff, N., & Nicolas Franck, B. (2005) · Consciousness and Cognition · doi:10.1016/j.concog.2005.08.001 · Cited by 52 · see citing works
“…a deficit of self-monitoring associated with a kind of overactivity of mental imagery: patientsÕ inner life is particularly intense and vivid and the patients are unable to realize that their mental images come from themselves rather from the external world (Bentall & Slade, 1985; Horowitz, 1975).”
BackgroundDisposition towards hallucination, gender and EPQ scores: a brief report
Young, H. F., Bentall, R. P., Slade, P. D., & Dewey, M. E. (1986) · Personality and Individual Differences · doi:10.1016/0191-8869(86)90065-6 · Cited by 52 · see citing works
Self-citationWickham, S., Shryane, N., Lyons, M., Dickins, T., & Bentall, R. (2014) · Journal of Public Mental Health · doi:10.1108/jpmh-06-2013-0049 · Cited by 48 · see citing works
Hallucination-Like Experiences in the Nonclinical Population
Vellante, M., Larøi, F., Cella, M., Raballo, A., Петретто, Д. Р., & Preti, A. (2012) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31824cb2ba · Cited by 49 · see citing works
“Notably, further converging evidence indicates that higher scores on the LSHS are associated with higher degrees of misattribution of internal events to an external source, which is a feature commonly observed in hallucinating patients with schizophrenia (Bentall and Slade, 1985; Jakes and Hemsley, 1986; Rankin and O’…”
BackgroundMethodInfluentialCorlett, P. R. (2009) · Frontiers in Behavioral Neuroscience · doi:10.3389/neuro.08.053.2009 · Cited by 47 · see citing works
“…November 2009 | Volume 3 | Article 53 | 6 The present fi nding is redolent of investigations of healthy individuals prone to hallucinations who show a similar bias toward reporting stimuli that did not occur (Bentall and Slade, 1985; Tsakanikos and Reed, 2005a,b; Reed et al., 2008).”
Psychotic Experiences and Working Memory: A Population-Based Study Using Signal-Detection Analysis
Rossi, R., Zammit, S., Button, K. S., Munafò, M. R., Lewis, G., & David, A. S. (2016) · PLOS ONE · doi:10.1371/journal.pone.0153148 · Cited by 48 · see citing works
Auditory hallucinations, top-down processing and language perception: a general population study
de Boer, J. N., Linszen, M. M. J., de Vries, J., Schutte, M. J. L., Begemann, M., Heringa, S. M., Bohlken, M. M., Hugdahl, K., Aleman, A., Wijnen, F. N. K., et al. (2019) · Psychological Medicine · doi:10.1017/s003329171800380x · Cited by 46 · see citing works
“A related line of research is that of signal detection, which shows that a balance between attention or focus on a stimulus, the actual sensory input and the cognitive modulation of that input is essential for a correct recognition of perceptual information (Bentall and Slade, 1985; Servan-Schreiber et al., 1996; Sart…”
BackgroundReality monitoring failure in schizophrenia: The role of selective attention
Brébion, G., SMITH, M. J., Gorman, J. M., & AMADOR, X. F. (1996) · Schizophrenia Research · doi:10.1016/s0920-9964(96)00054-0 · Cited by 48 · see citing works
“Finally, an increased rate of false alarms has been linked to hallucinations (Bentall and Slade, 1985) and thought disorders (Harvey, 1985; Harvey et al.”
Backgroundvan de Ven, V. G., & Merckelbach, H. L. G. J. (2003) · Personality and Individual Differences · doi:10.1016/s0191-8869(02)00304-5 · Cited by 45 · see citing works
“The full version of Bing Crosby’s White Christmas song was presented to participants and following this, they were asked whether they were familiar with the song.”
BackgroundMethodResultInfluentialDeterminants of outcome in the pathways through care for children hearing voices
Escher, S., Morris, M., Buiks, A., Delespaul, P., van Os, J., & Romme, M. (2004) · International Journal of Social Welfare · doi:10.1111/j.1369-6866.2004.00315.x · Cited by 43 · see citing works
Hallucinations, Negative Symptoms, and Response Bias in a Verbal Recognition Task in Schizophrenia.
Brébion, G., David, A. S., JONES, H. M., & Pilowsky, L. S. (2005) · Neuropsychology · doi:10.1037/0894-4105.19.5.612 · Cited by 45 · see citing works
- Authors
- Bentall, R. P., & Slade, P. D.
- Affiliations
- University of Liverpool (GB)
- Corresponding author
- Bentall, R. P.
- ORCID
- Bentall, R. P.
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 1985-09
- Volume
- 24
- Issue
- 3
- Pages
- 159-169
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W1987901560
- Cited by
- 362
- References
- 0
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 5 · 2023: 16 · 2022: 11 · 2021: 13 · 2020: 7 · 2019: 14 · 2018: 14 · 2017: 16 · 2016: 7 · 2015: 7 · 2014: 15 · 2013: 10 · 2012: 17
- FWCI
- 8.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Aberystwyth University
- Bangor University
- 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
- reality testing, auditory hallucinations, signal detection theory, metacognition, perceptual bias, sensitivity, schizophrenia, hallucination proneness
- MeSH terms
- Adult, Auditory Perception, Decision Making, Ego, Hallucinations, Humans, Imagination, Male, Reality Testing, Schizophrenic Psychology
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