Citation:
McCarthy-Jones S and Longden E (2015) Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause,common intervention

Auditory verbal hallucinations (AVH: ‘hearing voices’) are found in both schizophreniaand post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVHin these two diagnoses share a qualitatively similar phenomenology. We then showthat the presence of AVH in schizophrenia is often associated with earlier exposureto traumatic/emotionally overwhelming events, as it is by definition in PTSD. We nextargue that the content of AVH relates to earlier traumatic events in a similar way inboth PTSD and schizophrenia, most commonly having direct or indirect thematic linksto emotionally overwhelming events, rather than being direct re-experiencing. We thenpropose, following cognitive models of PTSD, that the reconstructive nature of memorymay be able to account for the nature of these associations between trauma and AVHcontent, as may threat-hypervigilance and the individual’s personal goals. We concludethat a notable subset of people diagnosed with schizophrenia with AVH are havingphenomenologically and aetiologically identical experiences to PTSD patients who hearvoices. As such we propose that the iron curtain between AVH in PTSD (often termed‘dissociative AVH’) and AVH in schizophrenia (so-called ‘psychotic AVH’) needs to betorn down, as these are often the same experience. One implication of this is thatthese trauma-related AVH require a common trans-diagnostic treatment strategy. Whilstantipsychotics are already increasingly being used to treat AVH in PTSD, we argue forthe centrality of trauma-based interventions for trauma-based AVH in both PTSD and inpeople diagnosed with schizophrenia.

Link to free article: Auditory Verbal hallucinations in schizophrenia and PTSD