Thought as action: inner speech, self-monitoring, and auditory verbal hallucinations

Passivity experiences in schizophrenia are thought to be due to a failure in a neurocognitive action self-monitoring system (NASS). Drawing on the assumption that inner speech is a form of action, a recent model of auditory verbal hallucinations (AVHs) has proposed that AVHs can be explained by a failure in the NASS. In this article, we offer an alternative application of the NASS to AVHs, with separate mechanisms creating the emotion of self-as-agent and other-as-agent. We defend the assumption that inner speech can be considered as a form of action, and show how a number of previous criticisms of applying the NASS to AVHs can be refuted. This is achieved in part through taking a Vygotskian developmental perspective on inner speech. It is suggested that more research into the nature and development of inner speech is needed to further our understanding of AVHs.     

Auditory verbal hallucinations: Dialoguing between the cognitive sciences and phenomenology

Auditory verbal hallucinations (AVHs) are a highly complex and rich phenomena, and this has a number of important clinical, theoretical and methodological implications. However, until recently, this fact has not always been incorporated into the experimental designs and theoretical paradigms used by researchers within the cognitive sciences. In this paper, we will briefly outline two recent examples of phenomenologically informed approaches to the study of AVHs taken from a cognitive science perspective. In the first example, based on Larøi and Woodward (Harv Rev Psychiatry 15:109–117, 2007), it is argued that reality monitoring studies examining the cognitive underpinnings of hallucinations have not reflected the phenomenological complexity of AVHs in their experimental designs and theoretical framework. The second example, based on Jones (Schizophr Bull, in press, 2010), involves a critical examination of the phenomenology of AVHs in the context of two other prominent cognitive models: inner speech and intrusions from memory. It will be shown that, for both examples, the integration of a phenomenological analysis provides important improvements both on a methodological, theoretical and clinical level. This will be followed by insights and critiques from philosophy and clinical psychiatry—both of which offer a phenomenological alternative to the empiricist–rationalist conceptualisation of AVHs inherent to the cognitive sciences approach. Finally, the paper will conclude with ideas as to how the cognitive sciences may integrate these latter perspectives into their methodological and theoretical programmes.     

Shot through with voices: Dissociation mediates the relationship between varieties of inner speech and auditory hallucination proneness

Inner speech is a commonly experienced but poorly understood phenomenon. The Varieties of Inner Speech Questionnaire (VISQ; McCarthy-Jones & Fernyhough, 2011) assesses four characteristics of inner speech: dialogicality, evaluative/motivational content, condensation, and the presence of other people. Prior findings have linked anxiety and proneness to auditory hallucinations (AH) to these types of inner speech. This study extends that work by examining how inner speech relates to self-esteem and dissociation, and their combined impact upon AH-proneness. 156 students completed the VISQ and measures of self-esteem, dissociation and AH-proneness. Correlational analyses indicated that evaluative inner speech and other people in inner speech were associated with lower self-esteem and greater frequency of dissociative experiences. Dissociation and VISQ scores, but not self-esteem, predicted AH-proneness. Structural equation modelling supported a mediating role for dissociation between specific components of inner speech (evaluative and other people) and AH-proneness. Implications for the development of “hearing voices” are discussed.     

The varieties of inner speech: links between quality of inner speech and psychopathological variables in a sample of young adults

A resurgence of interest in inner speech as a core feature of human experience has not yet coincided with methodological progress in the empirical study of the phenomenon. The present article reports the development and psychometric validation of a novel instrument, the Varieties of Inner Speech Questionnaire (VISQ), designed to assess the phenomenological properties of inner speech along dimensions of dialogicality, condensed/expanded quality, evaluative/motivational nature, and the extent to which inner speech incorporates other people’s voices. In response to findings that some forms of psychopathology may relate to inner speech, anxiety, depression, and proneness to auditory and visual hallucinations were also assessed. Anxiety, but not depression, was found to be uniquely positively related to both evaluative/motivational inner speech and the presence of other voices in inner speech. Only dialogic inner speech predicted auditory hallucination-proneness, with no inner speech variables predicting levels of visual hallucinations/disturbances. Directions for future research are discussed.     

The roles of thought suppression and metacognitive beliefs in proneness to auditory verbal hallucinations in a non-clinical sample

In a non-clinical sample (N = 751), we investigated relations among two subscales (self-reported intrusiveness of unwanted thoughts and thought suppression) of the White Bear Suppression Inventory (WBSI), metacognitive beliefs, and proneness to auditory verbal hallucinations (AVHs). Both subscales of the WBSI were found to be related to AVH-proneness and strongly positively related to metacognitive beliefs about the uncontrollability and danger of thoughts. Regression analyses were used to test models of the relations among AVH-proneness and a range of metacognitive beliefs. When the WBSI subscale relating to the self-reported intrusiveness of unwanted thoughts was controlled for, the metacognitive style that was the strongest predictor of AVH-proneness was cognitive self-consciousness. Cognitive confidence and beliefs about the uncontrollability of thoughts were also significant predictors of AVH-proneness. These findings are used to revise existing models of the relations between metacognitive beliefs and AVHs. Implications for the management of AVHs are discussed.     

Irrelevant speech and serial recall: Implications for theories of attention and working memory

Irrelevant speech markedly impairs serial recall of visually presented lists, even though the person is asked to ignore the speech. In this, the first major review of the phenomenon, we conclude that (i) the effect occurs in memory rather than at encoding; (ii) within memory, the disruption occurs as a result of a confluence of information at the phonological rather than at the articulatory stage of coding; (iii) speech does not have privileged access to memory, since its disruptive effects may be attenuated by habituation; and (iv) disruption occurs as a result of the changing state of the auditory channel, not as had previously been thought the phonological similarity of visual and auditory streams, and is particularly sensitive to pitch changes in both speech and non-speech stimuli. These conclusions are discussed in the light of two complementary theoretical constructs: a cascading filter system responsible for the access of speech to memory and a system of coding within memory sensitive to changing state of the stream responsible for disruption of serial order. Recommendations are made also for empirical work to refine these constructs.     

An inter-subjective multi-factorial model of auditory verbal hallucinations in schizophrenia

Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli that in individuals with schizophrenia very often feature distressing contents. AVH frequently interfere with social relationships or result in dangerous behaviours. We hypothesize that in schizophrenia several vulnerability factors, especially when a subject is engaged in real or represented interpersonal transactions, lead to the appearance of AVHs, and favour their self-perpetuation over time. We analyse the different psychological factors that, according to empirical studies and clinical experience with persons with schizophrenia, seem involved in the genesis of AVHs. Several vulnerability factors appear to interact with situational ones to trigger AVHs: a) a facilitation of neural transmission from the premotor regions to the perceptual ones; b) a difficulty attuning with others, c) interpersonal schemas, provoking emotional suffering, intrusive thoughts and rumination; d) metacognitive dysfunctions. Once AVHs have appeared, further factors promote their perpetuation over time: a) cognitive factors like ruminative processing on AVHs, b) metacognitive beliefs about AVHs. An integrated theoretical model of AVHs is described and ideas for its empirical testing are suggested.     

A Time for Silence? Its Possibilities for Dialogue and for Reflective Learning

From the beginning of history sounds have played a fundamentally important role in humanity’s development as ways of expression and of communication. However in contemporary western society, and indeed globally, we are experiencing an excess of speech and a relentless encouragement to expression. Such excess indicates a misunderstanding about what expression and dialogue should be. This condition encourages us to think about silence, solitude and contemplation and the role they might play in restoring the realm of personal understanding of the Self and of one’s authentic experience of the Other. The purpose of this article is to explore the potency of a silence that arises from our participation in the world. We present first some ideas about silence as a human phenomenon. This is followed by an examination of silence and language, an investigation of silence in dialogue, and of its educational implications. The article concludes by emphasising the value of silence as potency in itself, assisting in recovering the expressive powers of language. We argue that it is important to understand the positive status of silence in order to recognise and avoid repressive speech and to introduce its potential for reflective learning.     

The roles of thought suppression and metacognitive beliefs in proneness to auditory verbal hallucinations in a non-clinical sample

In a non-clinical sample (N = 751), we investigated relations among two subscales (self-reported intrusiveness of unwanted thoughts and thought suppression) of the White Bear Suppression Inventory (WBSI), metacognitive beliefs, and proneness to auditory verbal hallucinations (AVHs). Both subscales of the WBSI were found to be related to AVH-proneness and strongly positively related to metacognitive beliefs about the uncontrollability and danger of thoughts. Regression analyses were used to test models of the relations among AVH-proneness and a range of metacognitive beliefs. When the WBSI subscale relating to the self-reported intrusiveness of unwanted thoughts was controlled for, the metacognitive style that was the strongest predictor of AVH-proneness was cognitive self-consciousness. Cognitive confidence and beliefs about the uncontrollability of thoughts were also significant predictors of AVH-proneness. These findings are used to revise existing models of the relations between metacognitive beliefs and AVHs. Implications for the management of AVHs are discussed.     

Theology after Dialogue: Christian–Muslim Engagement Today and Tomorrow

The phenomenon of Christian–Muslim dialogue has had a very chequered history. At varying times, three broad modes of engagement can be said to have operated: antipathy, affinity and inquiry, and these three modes can be found still in today's world. In some places, hostility and antipathy abound. In others, voices and actions express cordial friendship, détente and affinity. In this latter climate, the prospect of engagement in mutual inquiry and cooperative ventures is not only theoretically possible, but actively pursued, and in the first decade of the twenty-first century, a number of notable initiatives in the arena of mutual inquiry have taken place. This article addresses aspects of the context and development of Christian–Muslim dialogue as a modern phenomenon, and then turns to a review of three twenty-first century developments – the Building Bridges seminar series; the Stuttgart-based Christian–Muslim Theological Forum and the “Common Word” letter. It also reflects on the models and theology of dialogue, including not only theology for dialogue, but also theology in and – importantly – after dialogue.     

Metacognitive Interpersonal Therapy for Treating Auditory Verbal Hallucinations in First-onset Schizophrenia

Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli, occurring in two thirds of schizophrenia patients, where they often cause emotional suffering and dangerous behaviors, and interfere with social relationships. Patients with schizophrenia involving AVHs can also be drug-resistant or they may discontinue medications. The most well-known psychotherapeutic intervention for voice-hearing is cognitive behavioral therapy (CBT), which focuses on reducing distress by modifying hearers’ beliefs about their voices. We hypothesize that it is possible to reinforce the clinical approach to AVHs by taking into consideration (a) that patients generally hear voices in particular interpersonal contexts where they experience negative emotions; (b) the relationship between AVHs and metacognition, namely the ability to make sense of mental states. On this basis, AVHs can be seen not just as a cause of emotional distress as CBT postulates, but the outcome of difficulties in meta-cognitively making sense of interpersonal exchanges. In this paper, we describe the treatment of a young man at the onset of schizophrenia with pervasive negative AVHs. The patient was treated with metacognitive interpersonal therapy (MIT), aimed to promote the patient’s metacognition. With this aim, in the first part of the treatment, each time AVHs emerged, the patient’s level of arousal was high and his metacognitive ability very low, the therapist treated AVHs helping the patient to understand and cope with the emotional suffering connected with AVHs. At a more advanced stage of therapy, the therapist helped the patient reach the point of understanding the social triggers which, together with the patient’s self-schemas, ignited his auditory hallucinations; this created the conditions for a significant reduction of the pervasiveness of AVHs.     

The use of time during lexical processing and segmentation: A review

Speech, by its very nature, is a time-based phenomenon. Speech sounds are temporally distributed, with the presentation of one sound roughly conditioned by the fading of the previous one. In this review, three classes of models are discussed with respect to the sequential nature of speech. It is argued that the three resulting conceptions of time are linked to the type of segmentation process proposed by these models to deal with speech continuity. In the first one, lexical activation is viewed as perfectly synchronized with the temporal deployment of speech. This type of model corresponds to the traditional left-to-right (proactive) account of lexical processing. Because serious segmentation problems exist for such an approach (e.g.,car andcard are embedded incardinal), the second type of model treats word recognition as the result of a mechanism that sometimes delays commitment on word identity beyond word offset. Lexical activation, instead of shadowing the unfolding of time, lags behind it until an unambiguous decision can be made. The temporarily unprocessed information is stored in a memory buffer. In the third approach, a prosodic cue (lexical stress) contributes actively to speech segmentation and lexical processing. Every stressed syllable encountered in the signal is postulated as a word onset and thus constitutes the starting point of lexical activation. However, with non-initial-stressed words, retroactive procedures going “back in time” must be used. Finally, the use of time (including proactive, delayed, and retroactive procedures) is discussed in light of cross-linguistic phonological differences.     

A phenomenological survey of auditory verbal hallucinations in the hypnagogic and hypnopompic states

The phenomenology of auditory verbal hallucinations (AVHs) occurring in hypnagogic and hypnopompic (H&H) states has received little attention. In a sample of healthy participants (N = 325), 108 participants reported H&H AVHs and answered subsequent questions on their phenomenology. AVHs in the H&H state were found (1) to be more likely to only feature the occasional clear word than to be clear, (2) to be more likely to be one-off voices than to be recurrent voices, (3) to be more likely to be voices of people known to the individual than unknown persons, (4) to be more likely to talk directly to the person rather than not, and (5) to only rarely give commands, ask questions, or to result in an interactive conversation. Their phenomenology was similar to normative AVHs in wakefulness (as established by previous research) in that the voice-hearer was usually the target of the voice, and the voice was more likely to be of a recognized person. However, H&H AVHs differed from AVHs in wakefulness in that commands and questions were rare, and there was typically no dialogical engagement with the voice. We conclude by proposing that two distinct types of H&H AVHs may exist (which we term “dialogic” and “monologic”), based on an analysis of the phenomenology of the experience, and suggest avenues for future research.     

Beliefs about hearing voices

People who experience auditory verbal hallucinations (AVHs) vary in whether they believe their AVHs are self-generated or caused by external agents. It remains unclear whether these differences are influenced by the “intensity” of the voices, such as their frequency or volume, or other aspects of their phenomenology. We examined 35 patients with schizophrenia or schizoaffective disorder who experienced AVHs. Patients completed a detailed structured interview about their AVHs, including beliefs about their cause. In response, 20 (57.1%) reported that their AVHs were self-generated, 9 (25.7%) were uncertain, and 6 (17.1%) reported that their AVHs were caused by external agents. Several analytical approaches revealed little or no evidence for associations between either AVH intensity or phenomenology and beliefs about the AVH’s cause; the evidence instead favoured the absence of these associations. Beliefs about the cause of AVHs are thus unlikely to be explained solely by the phenomenological qualities of the AVHs.     

Relationship between inner dialog and ideas of reference and the mediating role of dissociation

Recent lines of research have begun to concentrate on internal dialogue and its relationship to a diversity of psychopathological phenomena present in psychotic disorders. This study was intended as a preliminary exploration of the relationship of internal dialogue, dissociation and ideas of reference. To do this, a sample of 318 students filled in an internal dialogue scale (the VISQ, McCarthy‐Jones & Fernyhough), one for dissociation (DES‐II, Carlson & Putnam) and another for ideas of reference (REF, Lenzenweger, Bennett & Lilenfeld). The results confirm the hypothesis posed in the sense that internal dialogue was positively associated with dissociation and with ideas of reference. A partial mediation effect of dissociation was also found between inner speech and ideas of reference. Lines of future research this study opens and its possible integration in a model on ideas of reference are discussed.     

Error biases in inner and overt speech: evidence from tongue twisters

To compare the properties of inner and overt speech, Oppenheim and Dell (2008) counted participants' self-reported speech errors when reciting tongue twisters either overtly or silently and found a bias toward substituting phonemes that resulted in words in both conditions, but a bias toward substituting similar phonemes only when speech was overt. Here, we report 3 experiments revisiting their conclusion that inner speech remains underspecified at the subphonemic level, which they simulated within an activation-feedback framework. In 2 experiments, participants recited tongue twisters that could result in the errorful substitutions of similar or dissimilar phonemes to form real words or nonwords. Both experiments included an auditory masking condition, to gauge the possible impact of loss of auditory feedback on the accuracy of self-reporting of speech errors. In Experiment 1, the stimuli were composed entirely from real words, whereas, in Experiment 2, half the tokens used were nonwords. Although masking did not have any effects, participants were more likely to report substitutions of similar phonemes in both experiments, in inner as well as overt speech. This pattern of results was confirmed in a 3rd experiment using the real-word materials from Oppenheim and Dell (in press). In addition to these findings, a lexical bias effect found in Experiments 1 and 3 disappeared in Experiment 2. Our findings support a view in which plans for inner speech are indeed specified at the feature level, even when there is no intention to articulate words overtly, and in which editing of the plan for errors is implicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved).     

Medieval Disputationes de obligationibus as Formal Dialogue Systems

Formal dialogue systems model rule-based interaction between agents and as such have multiple applications in multi-agent systems and AI more generally. Their conceptual roots are in formal theories of natural argumentation, of which Hamblin’s formal systems of argumentation in Hamblin (Fallacies. Methuen, London, 1970, Theoria 37:130–135, 1971) are some of the earliest examples. Hamblin cites the medieval theory of obligationes as inspiration for his development of formal argumentation. In an obligatio, two agents, the Opponent and the Respondent, engage in an alternating-move dialogue, where the Respondent’s actions are governed by certain rules, and the goal of the dialogue is establishing the consistency of a proposition. We implement obligationes in the formal dialogue system framework of Prakken (Knowl Eng Rev 21(2):163–188, 2006) using Dynamic Epistemic Logic (van Ditmarsch et al. in Dynamic epistemic logic, Synthese Library Series. Springer, Berlin, 2007). The result is a new type of inter-agent dialogue, for consistency-checking, and analyzing obligationes in this way also sheds light on interpretational and historical questions concerning their use and purpose in medieval academia.     

智力开发的基本理念与实践

以高度分化的g因素研究为理论基础,智力开发活动形成了神经潜能开发、心理管理与反省经验开发、专家技能开发、多元智力开发、社会分布式认知开发、知识表征重组开发、环境重组开发等智力要素开发理念以及一些代表性的实践。随着对智力结构的整合研究的出现和不断深入,智力开发理念和模式将由分化的要素开发向整合开发转变,以智力与其他心理结构、智力与内部世界和外部世界系统关系为基础的智力开发将是理论和实践研究的重点内容     

Inner speech sustains predictable task switching: direct evidence in adults

It has been proposed that inner speech supports task selection in task-switching studies, especially when the need for endogenous control is increased. This has been established through the suppression of inner speech in cognitive-flexibility tasks that leads to poorer performance. The aim of this study is to quantify the role of inner speech in a flexibility task by using surface laryngeal electromyography, which, contrary to previous studies, enables participants to freely verbalise the tasks. We manipulated endogenous and exogenous flexibility in a mathematical switching task paradigm. Experiment 1 shows that inner speech acts as a support for switching and is recruited more often when the tasks are of an endogenous type. The main result of Experiment 2 that language is recruited more for the mixing cost than for the switch cost (regardless of the endogenous factor) extends past findings obtained through articulatory suppression.