In this paper, an account of auditory hallucinations is outlined, incorporating the phenomena of intrusive thoughts; this is done with reference to the prevailing cognitive models of auditory hallucinations. The account proposes that metacognitive beliefs inconsistent with intrusive thoughts lead to their external attribution as auditory hallucinations, and that such a misattribution is maintained by reducing cognitive dissonance. It is also suggested that the appraisal of the resulting hallucinatory experience elicits behavioural, emotional and physiological responses that may be involved in the maintenance process. The possibility of extending such an account to certain other positive symptoms is discussed, and the theoretical and clinical implications of such an account are considered, and illustrated with a case example. Finally, a number of testable predictions are made.
IntroductionThere has been a long tradition within clinical psychology of using theories of normal psychological processes to inform our understanding of clinical phenomena. This paper will attempt to outline a potentially useful, but speculative, account of certain positive symptoms of schizophrenia incorporating the phenomena of intrusive mental experiences. This will be done with reference to existing cognitive models of positive symptoms, and will initially focus on explaining auditory hallucinations, although other symptoms (thought insertion, visual hallucinations and delusions of control) will be considered briefly.
The symptoms of schizophreniaSchizophrenia has received much attention from researchers over the last century, but the aetiology of this syndrome is still unknown. Recent Acknowledgements: The authors are grateful to Dr Adrian Wells for his helpful comments on an earlier version of this paper.Reprint requests to Tony Morrison,