Auditory Hallucinations in Dissociative Identity Disorder and Schizophrenia With and Without a Childhood Trauma History

Department of Psychology, University of Canterbury, Christchurch, 8140, New Zealand.
The Journal of nervous and mental disease (Impact Factor: 1.69). 12/2009; 197(12):892-8. DOI: 10.1097/NMD.0b013e3181c299ea
Source: PubMed


Little is known about similarities and differences in voice hearing in schizophrenia and dissociative identity disorder (DID) and the role of child maltreatment and dissociation. This study examined various aspects of voice hearing, along with childhood maltreatment and pathological dissociation in 3 samples: schizophrenia without child maltreatment (n = 18), schizophrenia with child maltreatment (n = 16), and DID (n = 29). Compared with the schizophrenia groups, the DID sample was more likely to have voices starting before 18, hear more than 2 voices, have both child and adult voices and experience tactile and visual hallucinations. The 3 groups were similar in that voice content was incongruent with mood and the location was more likely internal than external. Pathological dissociation predicted several aspects of voice hearing and appears an important variable in voice hearing, at least where maltreatment is present.

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    • "In a Turkish study, DID participants (N=20) had higher childhood sexual, physical and emotional abuse histories than those with schizophrenia (N=20) and panic disorder (N=20), but did not differ from the schizophrenia group on emotional neglect (Yargiç, Şar, Tutkun, & Alyanek, 1998). Childhood physical, sexual and emotional abuse, along with physical and emotional neglect was found to be higher in a DID sample than a schizophrenia sample who reported child abuse and neglect (Dorahy et al., 2009). Compared to a sample with complex partial epilepsy (N=20), a DID group had higher childhood sexual abuse (Yargiç et al., 1998). "
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    ABSTRACT: Only a select number of studies have examined different forms of child maltreatment in complex dissociative disorders in comparison to other groups. Few of these have used child abuse-related chronic PTSD and mixed psychiatric patients with maltreatment as comparison groups. This study examined child sexual, physical and emotional abuse, as well as physical and emotional neglect in dissociative disorder (DD; n = 39), chronic PTSD (C-PTSD; n = 13) and mixed psychiatric (MP; n = 21) samples, all with abuse and neglect histories. The predictive capacity of these different forms of maltreatment across the 3 groups were assessed for pathological dissociation, shame, guilt, relationship esteem, relationship anxiety, relationship depression and fear of relationships. All forms of maltreatment differentiated the DD from the MP group, while sexual abuse differentiated the DD sample from the C-PTSD group. Childhood sexual abuse was the only predictor of pathological dissociation. Emotional abuse predicted shame, guilt, relationship anxiety and fear of relationships. Emotional neglect predicted relationship anxiety and relationship depression. Physical neglect was associated with less relationship anxiety. Different forms of abuse and neglect are associated with different symptom clusters in psychiatric patients with maltreatment histories.
    Journal of Trauma & Dissociation 08/2015; DOI:10.1080/15299732.2015.1077916 · 1.72 Impact Factor
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    • "Whilst habitually identified as a sign of madness and schizophrenia, at least in contemporary western society (McCarthy-Jones, 2013), they are neither disorder nor disease specific. For example, auditory hallucinations (AH)—most often in the form of hearing “voices”2—occur in schizoaffective and bipolar disorder (Shinn et al., 2012); borderline personality disorder (Slotema et al., 2012; Schroeder et al., 2013); post-traumatic stress disorder (Jessop et al., 2008); dissociative identity disorder (Dorahy et al., 2009) and disorders of anxiety and depression (Varghese et al., 2011; Wigman et al., 2012). Hallucinations are also more common than is often realized in healthy individuals in the general community, including children, adolescents, adults and the elderly with no diagnosis of mental illness (Kelleher et al., 2012a,b; Laurens et al., 2012; de Leede-Smith and Barkus, 2013). "
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    ABSTRACT: The National Institute of Mental Health initiative called the Research Domain Criteria (RDoC) project aims to provide a new approach to understanding mental illness grounded in the fundamental domains of human behavior and psychological functioning. To this end the RDoC framework encourages researchers and clinicians to think outside the [diagnostic] box, by studying symptoms, behaviors or biomarkers that cut across traditional mental illness categories. In this article we examine and discuss how the RDoC framework can improve our understanding of psychopathology by zeroing in on hallucinations- now widely recognized as a symptom that occurs in a range of clinical and non-clinical groups. We focus on a single domain of functioning-namely cognitive [inhibitory] control-and assimilate key findings structured around the basic RDoC "units of analysis," which span the range from observable behavior to molecular genetics. Our synthesis and critique of the literature provides a deeper understanding of the mechanisms involved in the emergence of auditory hallucinations, linked to the individual dynamics of inhibitory development before and after puberty; favors separate developmental trajectories for clinical and non-clinical hallucinations; yields new insights into co-occurring emotional and behavioral problems; and suggests some novel avenues for treatment.
    Frontiers in Human Neuroscience 03/2014; 8:180. DOI:10.3389/fnhum.2014.00180 · 3.63 Impact Factor
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    • "Further, while voices are common after trauma, the content of the voices does not always directly re¯ect the traumatic event ± in fact it usually doesn't (Scott et al. 2007) ± and essential characteristics of auditory hallucinations, including perceived source location, do not differ among persons diagnosed with PTSD, Dissociative Identity Disorder (DID) and schizophrenia. Indeed, the speci®c types of auditory hallucinations considered typical of schizophrenia ± voices commenting and conversing ± are more common in DID (Dorahy et al. 2009). Finally, the evidence that voices are related to traumatic experiences and are essentially dissociative in nature is robust. "
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    ABSTRACT: For most of the past half century, auditory hallucinations (hearing voices) have been viewed by the psychiatric community (along with much of the general public) as synonymous with madness. The image of someone talking to themselves, as portrayed in movies and in the media, has become shorthand for mental illness. Indeed, since 1980, one can receive a diagnosis of schizophrenia in most parts of the world solely on the basis of hearing a voice commenting on one's behaviour or hearing two or more voices con-versing with each other. And yet it has been known for well over 150 years (Berrios and Dening 1996) and con®rmed with a spate of recent research studies that many people who hear voices are more accurately diagnosed with post-traumatic stress disorder (PTSD) than with schizophrenia, and even more never come to the attention of mental health professionals, suffer psychiatric distress or report any (other) symptom of mental illness (Moskowitz and Corstens 2007). The mainstream response to this is to insist thapsychotic' voices differ from those that are post-traumatic in nature or present in non-clinical populations ± and that only the former arètrue' hallucinations in contrast to thèpseudo-hallucinations' heard by the other two groups. But this distinction is deeply problematic: every attempt to parsèpseudo' (auditory) hallucinations frotrue' hallucina-tions on the basis of some reported characteristic of the voice (most often perceived location) has failed, leading some commentators to refer to pseudo-hallucinations as àjoker in the diagnostic game' (Berrios and Dening 1996). Such a joker, Berrios and Dening (1996: 761) propose, is often used tòcall into question the genuineness of some true hallucinatory experiences' when the clinician wishes, for other reasons, to avoid some diagnostic label. The traditional psychiatric perspective is to view the above as a problem ± namely, how a core symptom of schizophrenia can be experienced by other diagnostic groups and by the general population in a form that is not readily distinguished from àpsychotic' symptom. An alternative perspec-tive, however, which we have advocated (Moskowitz and Corstens 2007), Trauma, Dissociation and Multiplicity. Valerie Sinason (Ed). Copyright © 2012. Published by Routledge. This proof is for the use of the author only. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden.
    Trauma, Dissociation and Multiplicity: Working on Identity and Selves., 01/2012: chapter 2: pages 22-34; Taylor & Francis.
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