Auditory pseudohallucinations in United Kingdom war veterans and civilians with posttraumatic stress disorder.
OBJECTIVE
Hearing voices is a little-known feature of posttraumatic stress disorder (PTSD), mainly reported in US war veterans; it may be better conceived of as a dissociative than as a psychotic phenomenon. We investigated this feature in a pair of studies: Study 1 tested whether hearing voices was also reported by United Kingdom war veterans and whether it was associated with other dissociative reactions. Study 2 tested whether reports of hearing voices would generalize to a civilian sample, evaluated whether it was specific to PTSD or could be explained by trauma exposure alone, and investigated its phenomenological characteristics in more detail.


METHODS
Study 1, which was conducted from 2005 to 2008 at numerous sites in the United Kingdom, contrasted male war veterans with current PTSD, past PTSD, and no PTSD on measures of dissociation and hearing voices. Study 2, which was conducted from 2004 to 2008 in London, United Kingdom, compared hearing voices in civilian patients with PTSD, healthy controls exposed to trauma, and depressed patients.


RESULTS
Study 1 showed that more veterans with current or past PTSD than no PTSD described hearing voices, which was related to other dissociative reactions. Study 2 confirmed that hearing voices was also present in a civilian sample, that it was specific to PTSD, and that it had the characteristics of a pseudohallucination.


CONCLUSIONS
The results emphasize the dissociative nature of PTSD, identify a little-known symptom that causes considerable distress, and suggest new directions for the assessment and treatment of PTSD in military and civilian populations.
Brewin
Chris R
CR
Clinical, Educational and Health Psychology, University College London, Gower St, London WC1E 6BT, United Kingdom. c.brewin@ucl.ac.uk
Patel
Trishna
T
D000328:Adult; D003130:Combat Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D004213:Dissociative Disorders / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006212:Hallucinations / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D008131:London / Q000453:epidemiology; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D014857:Warfare