title: A linguistic comparison between auditory verbal hallucinations in patients with a psychotic disorder and in nonpsychotic individuals: Not just what the voices say, but how they say it.
abstract: Auditory verbal hallucinations (AVH) in psychotic patients are associated with activation of right hemisphere language areas, although this hemisphere is non-dominant in most people. Language generated in the right hemisphere can be observed in aphasia patients with left hemisphere damage. It is called "automatic speech", characterized by low syntactic complexity and negative emotional valence. AVH in nonpsychotic individuals, by contrast, predominantly have a neutral or positive emotional content and may be less dependent on right hemisphere activity. We hypothesize that right hemisphere language characteristics can be observed in the language of AVH, differentiating psychotic from nonpsychotic individuals.
  
  
  
  17 patients with a psychotic disorder and 19 nonpsychotic individuals were instructed to repeat their AVH verbatim directly upon hearing them. Responses were recorded, transcribed and analyzed for total words, mean length of utterance, proportion of grammatical utterances, proportion of negations, literal and thematic perseverations, abuses, type-token ratio, embeddings, verb complexity, noun-verb ratio, and open-closed class ratio.
  
  
  
  Linguistic features of AVH overall differed between groups F(13,24)=3.920, p=0.002; Pillai's Trace 0.680. AVH of psychotic patients compared with AVH of nonpsychotic individuals had a shorter mean length of utterance, lower verb complexity, and more verbal abuses and perseverations (all p<0.05). Other features were similar between groups.
  
  
  
  AVH of psychotic patients showed lower syntactic complexity and higher levels of repetition and abuses than AVH of nonpsychotic individuals. These differences are in line with a stronger involvement of the right hemisphere in the origination of AVH in patients than in nonpsychotic voice hearers.
authors: University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.
authors: J N
authors: JN
authors: de Boer
authors: University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands. Electronic address: s.m.heringa@umcutrecht.nl.
authors: S M
authors: SM
authors: Heringa
authors: University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.
authors: E
authors: E
authors: van Dellen
authors: Utrecht Institute of Linguistics OTS, Utrecht University, Trans 10, 3512 JK Utrecht, Netherlands.
authors: F N K
authors: FNK
authors: Wijnen
authors: University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.
authors: I E C
authors: IEC
authors: Sommer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006212:Hallucinations / Q000503:physiopathology*; D006801:Humans; D008037:Linguistics; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000503:physiopathology* / Q000523:psychology*; D013060:Speech; D014705:Verbal Behavior; D014831:Voice
keywords: Auditory verbal hallucinations; Emotional valence; Hemisphere; Language; Lateralization; Linguistics; Psychosis; Syntax; Verbal abuses; Voice hearing