The other items referred to a wider range of emotional and content links with hallucinations and delusions. They reported that individuals who had suffered abuse scored high on their measure of “trauma related content score.” However, this measure contained nine items only one of which assessed a direct memory of a traumatic event. (2011) assessed 30 individuals for potential relationships between childhood abuse and adult psychotic symptoms. However, the previous conversations being assessed were not necessarily stressful or traumatic experiences. Of these, 12% reported that they heard voices which were identical replays of memories of previous conversations that they had heard, whilst 31% reported that the relationship was similar but not identical. The largest phenomenological survey of auditory hallucinations to date involved interviewing 199 voice hearers ( McCarthy-Jones et al., 2014). In this study individuals were required to report if their images were “associated” with a past event, so it is unclear whether the content was a direct re-experiencing. Examples include an individual who had been raped and sexually abused as a child, reporting an intrusive image of a bearded man shouting. (2002) interviewed 35 people with a diagnosis of schizophrenia and reported that 74.3% were able to identify an image in relation to their psychotic symptoms and, of those, 70.8% ( n = 17) made an explicit link between the image and a particular event in their past. However, with respect to hearing voices, the available data was limited to seven patients. Read and Argyle (1999) report that approximately half the symptoms for which content was recorded appeared to be related to childhood abuse. Linking the Content of Hallucinations with the Content of Trauma MemoriesĪn early study in this field involved the assessment of case records of 100 patients admitted to a psychiatric unit. Whereas theoretical developments drawing on psychological models of PTSD have predominantly focussed on intrusive images. Consequently, most of the research aimed at understanding psychotic phenomena with respect to traumatic events has focussed on hearing voices. Whereas, with respect to schizophrenia, the intrusive sensory phenomena that have received most attention are in the auditory modality, i.e., hearing voices. At this point it is worth noting that the hallmark symptom of PTSD is considered an intrusive memory of a traumatic event, most likely in the form of a visual image. For example, hearing voices/seeing visions may be both a hallucination, in terms of the diagnostic criteria for schizophrenia, and categorized as the re-experiencing of a traumatic event with respect to PTSD. However, there is debate as to whether these diagnoses are distinct conditions or whether the same phenomena may fulfill the diagnostic criteria for both disorders. It has been estimated that 15% of this group will also be suffering from posttraumatic stress disorder (PTSD Achim et al., 2011). Recently, there has been increased awareness of the prevalence of traumatic life events within individuals diagnosed with schizophrenia (see Grubaugh et al., 2011, for a review). Implications for current clinical practice and future research are also discussed. This review discusses the extent to which the content of auditory and visual hallucinations, hereafter referred to as voices and visions, may be directly related to traumatic events. Naturally, as the disciplines of psychology and psychiatry develop, our understanding of these relationships also develops. Freud (1936) argued that the phenomenon of hallucinations was a product of forgotten or repressed traumatic memories entering the conscious mind. The idea that stressful and traumatic life events may be relevant to the content of hallucinatory experiences is not a new one. There is a need for the development of evidence-based interventions in this area. Recent clinical studies, which adopt interventions aimed at the symptoms of posttraumatic stress disorder in people diagnosed with a psychotic disorder, are reviewed. Our current theoretical understanding of these relationships, along with methodological difficulties associated with research in this area, are considered. However, there has been limited research specifically investigating the extent to which hallucinations are the re-experiencing of a traumatic event. Evidence suggests that intrusive images occur frequently within individuals who also report hallucinatory experiences. This review discusses the extent to which auditory and visual hallucinations may be directly related to traumatic events. The relationship between hallucinations and life events is a topic of significant clinical importance. School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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