inner speech model for verbal auditory hallucinations

inner speech model for verbal auditory hallucinations
   Also known as misattribution model for verbal auditory hallucinations. The two names are used interchangeably to denote a hypothetical model attributing the mediation of some types of "verbal auditory hallucination (VAH) to a disorder of " inner speech. The inner speech model suggests that individuals experiencing VAH are unaware of their own verbal thoughts and that they may subsequently misattribute these to an external source. Traditionally, the inner speech model comes in two variants. These are referred to as the " input model (which attributes the mediation of VAH to disinhibited neuronal activity within "Wernicke's speech reception area) and the "output model (which seeks to explain the mediation of VAH by reference to disinhibited neuronal activity within Broca's speech production area). A third variant of the inner speech model, which seeks to explain the misattribution of inner speech to a default in the corollary discharge from the frontal speech production areas towards the speech perception areas, is known as the "defective corollary discharge model for hallucinations. Conceptually, the inner speech model for VAH constitutes an elaboration of the "bicameral mind theory of the American psychologist Julian Jaynes (19201997). Jaynes's theory relates the 'voices' heard by individuals in ancient cultures to the purported presence of two virtual rooms or chambers within their minds, one of which is envisaged as being involved in the mediation of verbal thoughts and the other as being involved in their reception. According to Jaynes, having a bicameral mind used to lead to the individual's perception of endogenously mediated verbal thoughts, although he was not capable of determining their endogenous origin. The inner speech model has served as the principal conceptual framework for many of the neuropsychological and imaging studies of VAH carried out from the 1980s onwards. Although these studies have succeeded in corroborating the role of the speech centres in the mediation of VAH, a number of conceptual and empirical issues have yet to be addressed. In the version outlined above, the inner speech model would seem to be suitable as an explanatory model for the mediation of thought insertion, thought intrusion, and even "psychomotor verbal hallucinations, which are conceptualized as being inaudible in nature. As inner speech is conceptualized as a cognitive rather than a perceptual phenomenon, and most versions of the inner speech model leave the role of the primary auditory cortex out of the equation, it is as yet unclear how inner speech - whether it originates from Broca's area or not - might be converted into a perceptual phenomenon such as a VAH. (A hypothetical model designed to explain this conversion is known as the "perceptualization of the concept.) If it were possible to settle this issue to universal satisfaction, the inner speech model might also serve as an explanatory model for the mediation of " Gedankenlautwerden.But it would still be something of a challenge to imagine how inner speech might contribute to the mediation of other types of VAH, which are generally perceived as spoken in the voice of a third person, or how they might contribute to the mediation of various voices speaking simultaneously or a voice speaking in a foreign language not mastered by the affected individual. Given the fact that inner speech was originally conceptualized by Vygotsky as a psychological interface between culturally sanctioned symbolic systems (such as natural languages) and one's own private thought, it is not easy to envisage its role in the mediation of VAH consisting of 'foreign' voices. Thus it would seem that inner speech models for verbal auditory hallucinations tend to be based only loosely on Vygotsky's original notion of inner speech. Instead, they would seem to go back to a slightly broader notion, introduced in 1958 by the American psychiatrist and psychoanalyst Arnold H. Modell (b.1924) and referred to as " hallucinated inner speech. Modell envisages the notion of hallucinated inner speech as a type of inner speech involving not only the ego's verbal thoughts but also the verbal utterances of internalized objects. In Modell's own words, "The voices are identified as formerly loved persons, principally the parents, who in some unexplained way are fused to the self. These voice objects function as parents in terms of giving advice and being a source of prohibitions, and also in gratifying wishes stemming from all stages of infantile development." For a comparison of the respective notions formulated by Vygotsky and Modell, see the entries Inner speech and Hallucinated inner speech.
   References
   Ford, J.M., Mathalon, D.H., Heinks, T., Kalba, S., Faustman, W.O., Roth, W.T. (2001). Neu-rophysiological evidence of corollary discharge dysfunction in schizophrenia. American Journal of Psychiatry, 158,2069-2071. McGuire, P.K., Silbersweig, D.A., Wright, I., Murray, R.M., David, A.S., Frackowiak, R.S.J., Frith, C.D. (1995). Abnormal monitoring of inner speech: A physiological basis for auditory hallucinations. Lancet, 346, 596-600.
   Mechelli, A., Allen, P., Amaro, E., Fu, C.H., Williams, S.C., Brammer, M.J., Johns, L.C., McGuire, P.K. (2007). Misattribution of speech and impaired connectivity in patients with auditory verbal hallucinations. Human Brain Mapping, 28, 1213-1222. Modell, A.H. (1958). The theoretical implications of hallucinatory experiences in schizophrenia. Journal ofthe American Psychoanalytical Society, 6, 442-480.

Dictionary of Hallucinations. . 2010.

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  • defective corollary discharge model for verbal auditory hallucinations —    This is a term used to denote a variant of the inner speech model for verbal auditory hallucinations (VAH) that seeks to explain the misat tribution of inner speech which is deemed to underlie the mediation of (some types of) VAH or voices by… …   Dictionary of Hallucinations

  • inner speech —    Also known as inner language, internalized speech, inner thought, and self talk. All five terms are used interchangeably to denote speech spoken by oneself without vocalization (also referred to as verbal thought or thinking in words ). The… …   Dictionary of Hallucinations

  • misattribution of inner speech —    see inner speech model for verbal auditory hallucinations …   Dictionary of Hallucinations

  • auditory hallucination —    Also known as acoustic hallucination, aural hallucination, and hallucination of hearing. Auditory hallucinations are the most prevalent type of hallucinations in adults with or without a history of psychiatric illness. It is estimated that the …   Dictionary of Hallucinations

  • input model of hallucinatory activity —    In hallucinations research the term input model is used as a generic term for a group of explanatory models which stress the contribution of information perception areas in the mediation of hallucinations. The term input model derives from a… …   Dictionary of Hallucinations

  • output model of hallucinatory activity —    In hallucinations research, the term output model is used as a generic term for a group of explanatory models which emphasize the role of information production areas (as opposed to information reception areas) in the mediation of… …   Dictionary of Hallucinations

  • perceptualization of the concept —    Perceptualization of the concept is the name of a hypothetical model for the mediation of hallucinations which utilizes the general idea that hallucinations are transformations of thoughts. The French psychologist Louis Françisque Lélut (1804… …   Dictionary of Hallucinations

  • bicameral mind theory —    The expression bicameral mind is indebted to the Latin words bi (two) and camera (room). It refers to the purported existence of two virtual rooms or compartments within the mind. The bicameral mind theory was formulated during the 1960s, and… …   Dictionary of Hallucinations

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