Autonomic Regulation and Auditory Hallucinations in Individuals With Schizophrenia: An Experience Sampling Study.
Auditory Hallucinations (AH) cause substantial suffering and dysfunction, yet remain poorly understood and modeled. Previous reports have linked AH to increases in negative emotions, suggesting a role for the autonomic nervous system (ANS) in underlying this link. Employing an Experience Sampling Method (ESM) approach, 40 individuals with schizophrenia completed a 36-hour ambulatory assessment of AH and cardiac autonomic regulation. Participants carried mobile electronic devices that prompted them to report 10 times/d the severity of their momentary AH, along with a Holter monitor that continuously recorded their cardiac autonomic regulation. The clocks of the devices and monitors were synchronized, allowing for high time-resolution temporal linking of the AH and concurrent autonomic data. Power spectral analysis was used to determine the relative vagal (parasympathetic) contribution to autonomic regulation during 5 minutes prior to each experience sample. The participants also completed interview-based measures of AH (SAPS; PSYRATS). The ESM-measured severity of AH was significantly correlated with the overall SAPS-indexed AH severity, along with the PSYRATS-indexed AH frequency, duration, loudness, degree of negative content, and associated distress. A mixed-effect regression model indicated that momentary increases in autonomic arousal, characterized by decreases in vagal input, significantly predicted increases in ESM-measured AH severity. Vagal input averaged over the 36-hour assessment displayed a small but significant inverse correlation with the SAPS-indexed AH. The results provide preliminary support for a link between ANS regulation and AH. The findings also underscore the highly dynamic nature of AH and the need to utilize high time-resolution methodologies to investigate AH.
Department of Psychiatry, Columbia University, New York, NY.|New York State Psychiatric Institute, New York, NY.
David
D
Kimhy
Department of Psychiatry, Columbia University, New York, NY.|New York State Psychiatric Institute, New York, NY.
Melanie M
MM
Wall
New York State Psychiatric Institute, New York, NY.
Marie C
MC
Hansen
Department of Psychiatry, Columbia University, New York, NY.
Julia
J
Vakhrusheva
New York State Psychiatric Institute, New York, NY.
C Jean
CJ
Choi
Departments of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands.
Philippe
P
Delespaul
Department of Psychology, University of Manchester, Manchester, UK.
Nicholas
N
Tarrier
Department of Psychiatry, Columbia University, New York, NY.|New York State Psychiatric Institute, New York, NY.
Richard P
RP
Sloan
Department of Psychiatry & Child Psychiatry, New York University Medical Center, New York, NY.
Dolores
D
Malaspina
D000328:Adult; D001143:Arousal / Q000502:physiology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D000072860:Ecological Momentary Assessment; D004644:Emotions / Q000502:physiology; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012720:Severity of Illness Index; D014630:Vagus Nerve / Q000503:physiopathology; D055815:Young Adult
arousal; auditory hallucinations; autonomic regulation; cardiac; experience sampling method; heart; heart rate variability; mobile devices; negative emotions; psychosis; schizophrenia; stress; vagal