![]() ![]() This model can be used to explain variations in phenomenological features (bottom row, dotted lines), so that the severity or location of the cognitive deficits determine individual differences in the extent to which AH features are present.The randomised controlled trial compared the avatar therapy to a form of supportive counselling (adapted specifically for the study). These top-down mechanisms include: (1) deficits in signal detection that lead to errors in processing (2) intentional inhibition deficits that contribute to a diminished sense of control over this perceptual experience (3) a background of expectations, imagery, and memories that provide information that is personally relevant (4) contributions from lack of insight and delusional beliefs that provide a set of beliefs about AH and (5) the contribution of emotions that impacts on all aspects of processing and that ensures that emotional material is processed over neutral information. Temporal unfolding of auditory hallucinations (AHs) in clinical and nonclinical populations (the boxes shaded in gray represent processing that maybe more characteristic of schizophrenia and that differentiate clinical and nonclinical AH): In this model, AH arise from an interaction between (a) signals arising from overactivation of auditory brain neural activity and (b) a range of top-down mechanisms that produce a highly complex and multidimensional experience. Our model is distinctively powerful in explaining a range of phenomenological characteristics of AH across a spectrum of disorders. Emotional factors play a particular prominent role at all levels of this hierarchy. We suggest that AHs arise from an interaction between abnormal neural activation patterns that produce salient auditory signals and top-down mechanisms that include signal detection errors, executive and inhibition deficits, a tapestry of expectations and memories, and state characteristics that influence how these experiences are interpreted. Finally, we put forward an integrated model of AHs that incorporates the above findings. Second, consistent with SZ studies, findings in other population groups point to the role of top-down processing, abnormalities in executive inhibition, and negative emotions. First, SZ studies show that the cognitive underpinnings of AHs include self-source-monitoring deficits and executive and inhibitory control dysfunctions as well as distortions in top-down mechanisms, perceptual and linguistic processes, and emotional factors. The objectives of this article were to (1) present an up-to-date review regarding the cognitive mechanisms of AHs in SZ, (2) review findings from cognitive research conducted in other clinical and nonclinical groups, and (3) integrate these recent findings into a cohesive framework. ![]() Recent advances derived from SZ studies can therefore be utilized to make substantial progress on AH research in other groups. While the majority of cognitive studies on auditory hallucinations (AHs) have been conducted in schizophrenia (SZ), an increasing number of researchers are turning their attention to different clinical and nonclinical populations, often using SZ findings as a model for research.
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