Compelling imagery, unanticipated speech and deceptive memory: neurocognitive models of auditory verbal hallucinations in schizophrenia

Abstract

Introduction: The application of neurocognitive models to study schizophrenia has been influential in understanding the nature of this complex and heterogeneous disorder. However, a comprehensive and empirically validated account of auditory hallucinations remains elusive. The aim of this review was to critically assess the current evidence for specific neurocognitive deficits associated with auditory verbal hallucinations (AVHs) in schizophrenia.

Methods: A systematic literature search was conducted of research involving three influential cognitive models of auditory hallucinations: those implicating dysfunction in auditory imagery, verbal self-monitoring, and episodic memory.

Results: The findings of the review suggested that AVHs have been associated with impaired verbal self-monitoring, impaired memory for self-generated speech, heightened influence of top-down processing on perception, and an externalising response bias.

Conclusions: On the basis of the findings of the review a multidimensional model of AVHs is proposed incorporating the identified cognitive deficits and biases.