title: Dissecting auditory verbal hallucinations into two components: audibility (Gedankenlautwerden) and alienation (thought insertion).
abstract: This study proposes a theoretical framework which dissects auditory verbal hallucinations (AVH) into 2 essential components: audibility and alienation. Audibility, the perceptual aspect of AVH, may result from a disinhibition of the auditory cortex in response to self-generated speech. In isolation, this aspect leads to audible thoughts: Gedankenlautwerden. The second component is alienation, which is the failure to recognize the content of AVH as self-generated. This failure may be related to the fact that cerebral activity associated with AVH is predominantly present in the speech production area of the right hemisphere. Since normal inner speech is derived from the left speech area, an aberrant source may lead to confusion about the origin of the language fragments. When alienation is not accompanied by audibility, it will result in the experience of thought insertion. The 2 hypothesized components are illustrated using case vignettes.
authors.affiliation: UMC Utrecht, Utrecht, The Netherlands.
authors.forename: Iris E
authors.initials: IE
authors.lastname: Sommer
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Selten
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Diederen
authors.forename: Jan Dirk
authors.initials: JD
authors.lastname: Blom
mesh_terms: D000328:Adult; D003702:Delusions / Q000175:diagnosis / Q000523:psychology*; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D008297:Male; D011936:Reality Testing; D021641:Recognition, Psychology; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D013067:Speech Perception; D013850:Thinking; D055815:Young Adult