title: Better than mermaids and stray dogs? Subtyping auditory verbal hallucinations and its implications for research and practice.
abstract: The phenomenological diversity of auditory verbal hallucinations (AVH) is not currently accounted for by any model based around a single mechanism. This has led to the proposal that there may be distinct AVH subtypes, which each possess unique (as well as shared) underpinning mechanisms. This could have important implications both for research design and clinical interventions because different subtypes may be responsive to different types of treatment. This article explores how AVH subtypes may be identified at the levels of phenomenology, cognition, neurology, etiology, treatment response, diagnosis, and voice hearer's own interpretations. Five subtypes are proposed; hypervigilance, autobiographical memory (subdivided into dissociative and nondissociative), inner speech (subdivided into obsessional, own thought, and novel), epileptic and deafferentation. We suggest other facets of AVH, including negative content and form (eg, commands), may be best treated as dimensional constructs that vary across subtypes. After considering the limitations and challenges of AVH subtyping, we highlight future research directions, including the need for a subtype assessment tool.
authors.affiliation: Department of Cognitive Science, ARC Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, Australia; Department of Psychology, Durham University, Durham, UK; s.mccarthyjones@gmail.com.
authors.forename: Simon
authors.initials: S
authors.lastname: McCarthy-Jones
authors.affiliation: Brain and Psychological Sciences Centre, Swinburne University, Melbourne, Australia; Monash Alfred Psychiatry Research Centre, Melbourne, Australia;
authors.forename: Neil
authors.initials: N
authors.lastname: Thomas
authors.affiliation: School of Psychology, University of Sussex, Sussex, UK; Sussex Partnership NHS Foundation Trust, Sussex, UK;
authors.forename: Clara
authors.initials: C
authors.lastname: Strauss
authors.affiliation: Early Intervention in Psychosis, Northumberland, Tyne and Wear NHS FT, Newcastle, UK;
authors.forename: Guy
authors.initials: G
authors.lastname: Dodgson
authors.affiliation: Department of Psychology, DePaul University, Chicago, IL;
authors.forename: Nev
authors.initials: N
authors.lastname: Jones
authors.affiliation: Centre for Medical Humanities, Durham University, Durham, UK;
authors.forename: Angela
authors.initials: A
authors.lastname: Woods
authors.affiliation: Division of Psychology & Language Sciences, University College London, London, UK;
authors.forename: Chris R
authors.initials: CR
authors.lastname: Brewin
authors.affiliation: School of Psychology, University of Sussex, Sussex, UK; Sussex Partnership NHS Foundation Trust, Sussex, UK;
authors.forename: Mark
authors.initials: M
authors.lastname: Hayward
authors.affiliation: Department of Psychiatry, Oregon Health and Science University, Portland, OR;
authors.forename: Massoud
authors.initials: M
authors.lastname: Stephane
authors.affiliation: Department of Psychology, Durham University, Durham, UK;
authors.forename: Jack
authors.initials: J
authors.lastname: Barton
authors.affiliation: Department of Psychiatry, University of Southampton, Southampton, UK;
authors.forename: David
authors.initials: D
authors.lastname: Kingdon
authors.affiliation: Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Iris E
authors.initials: IE
authors.lastname: Sommer
mesh_terms: D006212:Hallucinations / Q000145:classification / Q000523:psychology*; D006801:Humans; D012106:Research; D012559:Schizophrenia; D012565:Schizophrenic Psychology
keywords: AVH; hearing voices; phenomenology; schizophrenia; symptom classification; trauma