PowerPoint Presentation

The Multidimensional Nature of Auditory HallucinationsSarah K. Keedy, Ph.D.

Assistant Professor of Psychiatry and Behavioral NeuroscienceDirector, Cognition and Emotion Neuroscience LabUniversity of Chicago

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Different neural system sets likely lead to hallucinations Analogous to feverBetween group variabilityWithin group variabilityVarying severity

Empirical work endeavoring rational measurement of hallucinatory experience confirms and unravels multiple facets of hallucinatory experience

Using the latter (#2) to inform the former (#1) is a needed research direction and fits RDoC framework

Auditory Hallucinations Are Complex and Varied

LanguagenetworkSalience networkEmotion regulationSarah Keedy, PhD05.28.2014

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The PSYRATS(AH)The gold standard AH severity scaleAH scale is 11 items scored 0-4 on the basis of an interviewTotal score range of 0-44Sarah Keedy, PhD05.28.2014

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Dimensions of Auditory Hallucinations in PSYRATS(AH)3 factors a,b1. EmotionalAmount negative contentDegree of negative contentFrequency of distressIntensity of distress2. PhysicalFrequencyDurationLoudness3. CognitiveLocationOrigin beliefs DisruptionControl4 factors c,d1. EmotionalAmount negative contentDegree of negative contentFrequency of distressIntensity of distress2. PhysicalFrequencyDuration3. CognitiveLocationOrigin beliefs4. ControlLoudnessDisruptionControl

4(ish) factors e1. Emotional (Distress)Amount negative contentDegree of negative contentFrequency of distressIntensity of distressControl2. Physical (Frequency)FrequencyDurationDisruption3. Cognitive (Attribution)LocationOrigin beliefs 4. Loudness

Haddock et al., 1999, Psychol MedDrake et al., 2007, Schizophr ResKronmuller et al., 2011, Compr PsychiatrySteele et al., 2007, Int J Methods Psychiatr Res*Woodward et al. (in press) Schiz Bull

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Mapping the Emotional Factor to RDoCEmotional FactorAmount of negative contentDegree of negative contentFrequency of distressIntensity of distressSuggested RDoC Domain: Negative ValenceDomain constructs:Acute ThreatSustained Threat

http://www.nimh.nih.gov/research-priorities/rdoc/rdoc-constructs.shtml#sustained_threat

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Mapping the Physical Factor to RDoCPhysical FactorFrequencyDurationLoudnessDisruption

Suggested RDoC Domain: Cognitive Systems

Suggested constructs:Perceptionsubconstructs: Auditory AttentionLanguageCognitive Control

http://www.nimh.nih.gov/research-priorities/rdoc/rdoc-constructs.shtml#auditory_perception

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THE PANSS hallucination item

Sarah Keedy, PhD05.28.2014

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Hallucination Dimensions Beyond Those in PSYRATS(AH)Treatment responsivenessRepetitive vs. spontaneous contentFamiliar vs. unfamiliar voicesMulti-sensoryInsight______________

Sarah Keedy, PhD05.28.2014

thank you!

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