Psychotic symptoms and violence toward others — a literature review of some preliminary findings: Part 2. Hallucinations

According to the clinical impressions of a number of authors and mental health professionals, an increased risk of violence is associated with the presence of hallucinations and — in particular — command hallucinations. In contrast to this, some empirical studies have reported that there is no evidence of such a relationship. The present review examines the role of hallucinations in violence toward others. Possible empirical evidence for a violence-escalating interaction between delusions and hallucinations is also analyzed. Among the main findings were: There appears to be no evidence that auditory command hallucinations are dangerous per se. However, there is some evidence that voices ordering acts of violence toward others may increase compliance and thereby be conducive to violent behavior. Finally, the evidence for or against the existence of a possible violence-escalating interaction between delusions and hallucinations is inconclusive. The findings are discussed particularly in relation to problems of measurement and other research design factors. Discrepancies between some of the findings of the present review and current clinical lore are also briefly considered.