One proposition is that PTSD-AVH are ego-syntonic ‘pseudo hallucinations’ (recognized as one’s own cognitions), whereas SZ-AVH are ego-dystonic ‘true hallucinations’ (experienced as externally generated).

The Phenomenology of AVH in PTSD and Schizophrenia Arguments for DissimilaritiesĪrguments that the phenomenology of PTSD-AVH is qualitatively distinct from that of SZ-AVH are not supported by contemporary research. Finally, we will explore the implications of this for the treatment of SZ-AVH and PTSD-AVH. Next, we will show that the phenomenology of AVH in both schizophrenia and PTSD relate to earlier traumas, when present, in a comparable fashion, and examine how this can be accounted for. We will then demonstrate that whilst traumatic life events are associated with AVH in PTSD by definition, they are also associated with AVH in schizophrenia. In this paper we will first argue that AVH in PSTD (PTSD-AVH) have a qualitatively similar phenomenology to AVH in schizophrenia (SZ-AVH). In the most studied sub-group of people with PTSD, military veterans, recent studies have reported an AVH prevalence ranging from 50–67% ( Holmes and Tinnin, 1995 Anketell et al., 2010 Brewin and Patel, 2010). They are also found with notable regularity in post-traumatic stress disorder (PTSD Butler et al., 1996 Anketell et al., 2010 Brewin and Patel, 2010). Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.Īuditory verbal hallucinations (AVH), hearing voices in the absence of appropriate external stimuli, are reported by approximately three in four people diagnosed with schizophrenia ( Thomas et al., 2007). One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. As such we propose that the iron curtain between AVH in PTSD (often termed ‘dissociative AVH’) and AVH in schizophrenia (so-called ‘psychotic AVH’) needs to be torn down, as these are often the same experience. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual’s personal goals. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing.

We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. 2Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UKĪuditory verbal hallucinations (AVH: ‘hearing voices’) are found in both schizophrenia and post-traumatic stress disorder (PTSD).1Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.Simon McCarthy-Jones 1* and Eleanor Longden 2

Auditory hallucinations example