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Reality monitoring and psychotic hallucinations
Abstract
Hallucinating psychiatric patients, patients with delusions but without a history of hallucinations and normal controls were compared on a reality-monitoring task in which they were first required to generate answers to easy or difficult clues and to listen to low-probability or high-probability paired associates. After an interval of one week, the subjects were presented with a list in which their answers to the clues were mixed with the associates and with words not previously presented, and they were required to identify the source of each item (self-generated, presented by the experimenter or new). The psychiatric patients were generally less accurate in identifying the source of the items in comparison with the normal controls. However, hallucinators more often misattributed high cognitive effort self-generated items (answers to difficult clues) to the experimenter than either the psychiatric or the normal controls. The results are interpreted as consistent with the hypothesis that hallucinations are self-generated events misattributed to an external source.
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In the citing paper
“Findings typically indicate that hallucinating patients or hallucination-prone participants are more likely to misattribute recalled items to the experimenter (Bentall et al., 1991; Laroi et al., 2004)”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Bentall et al., 1991
In the citing paper
“There is evidence supporting the theory that voice-hearing results from inner speech being misattributed to an external source, that is, a problem of source monitoring. 23-25”
From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [23]
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“An association between hallucinations and an externalization bias has been reported for schizophrenia patients [1, 2, 4, 5] and for healthy subjects who report hearing voices [6].”
BackgroundPrevalence of multisensory hallucinations in people at risk of transition to psychosis
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“[44,45] Several studies report a general impairment of action monitoring in schizophrenia patients.”
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Lower P300 amplitudes for internally-generated events in patients with schizophrenia
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“Research has found evidence, albeit somewhat mixed, to support associations between source monitoring impairment and these core psychotic symptoms (Bentall et al., 1991; Keefe et al., 1999; Brunelin et al., 2006).”
ResultHigh delusional ideation is associated with false pictorial memory
Evans, L. H., McCann, H. M., Isgar, J. G., & Gaston, A. (2018) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2018.09.005 · Cited by 8
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BackgroundChinchani, A. M., Menon, M., Roes, M., Hwang, H., Allen, P., Bell, V., Bless, J. J., Bortolon, C., Cella, M., Fernyhough, C., et al. (2021) · Cortex · doi:10.1016/j.cortex.2021.08.014 · Cited by 6
Associative interference does not affect recognition memory in schizophrenia
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“Evidence for this ‘‘externalisation bias’’ in patients with AVH was first reported by Bentall, Baker, and Havers (1991), and has since been reported in a number of other studies with hallucinating patient groups (e.g., Brébion et al., 2000; Gorman, Amador, Malaspina, & Sharif, 2002; Costafreda,…”
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“, taking a new event for an old one) and more misattributions of self generated events to an external source than patients with no hallucinations (Bentall et al. 1991; Brébion et al., 2000; Brunelin et al., 2006; Woodward et al., 2007).”
BackgroundCognitive correlates of auditory hallucinations in schizophrenia spectrum disorders
Aleksandrowicz, A., Kowalski, J., Stefaniak, I., Elert, K., & Gawęda, Ł. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115372 · Cited by 5
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Metadata
- Authors
- Bentall, R. P., Baker, G. A., & Havers, S.
- Affiliations
- University of Liverpool (GB)
- Corresponding author
- Bentall, Richard P.
- ORCID
- Bentall, Richard P.
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 1991-09
- Volume
- 30
- Issue
- 3
- Pages
- 213-222
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W2068781732
- Cited by
- 312
- References
- 0
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 15 · 2018: 8 · 2017: 9 · 2016: 7 · 2015: 11 · 2014: 12 · 2013: 14 · 2012: 18
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- reality monitoring, delusions, source monitoring, self-generated information, misattribution, paired associates, cognitive effort
- MeSH terms
- Adult, Attention, Delusions, Female, Hallucinations, Humans, Internal-External Control, Male, Paired-Associate Learning, Reality Testing, Schizophrenia, Schizophrenic Psychology, Speech Perception
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