EHS
EHS

Voice Hearing in Borderline Personality Disorder Across Perceptual, Subjective, and Neural Dimensions



Strawson, Will H;

Wang, Hao-Ting;

Quadt, Lisa;

Sherman, Maxine;

Larsson, Dennis EO;

Davies, Geoff;

Mckeown, Bronte LA;

Garfinkel, Sarah N; + view all

Strawson, Will H;

Wang, Hao-Ting;

Quadt, Lisa;

Sherman, Maxine;

Larsson, Dennis EO;

Davies, Geoff;

Mckeown, Bronte LA;

Silva, Marta;

Fielding-Smith, Sarah;

Jones, Anna-Marie;

Hayward, Mark;

Smallwood, Jonathan;

Critchley, Hugo D;

Garfinkel, Sarah N;

– view fewer

(2021)

Voice Hearing in Borderline Personality Disorder Across Perceptual, Subjective, and Neural Dimensions.

International Journal of Neuropsychopharmacology


10.1093/ijnp/pyab093.

(In press).

Abstract

BACKGROUND: Auditory verbal hallucinations (AVH) commonly occur in the context of borderline personality disorder (BPD) yet remain poorly understood. AVH are often perceived by patients with BPD as originating from inside the head and hence viewed clinically as ‘pseudohallucinations’, but they nevertheless have a detrimental impact on wellbeing. METHODS: The current study characterised perceptual, subjective and neural expressions of AVH by using an auditory detection task, experience sampling and questionnaires, and functional neuroimaging respectively. RESULTS: Perceptually, reported AVH correlated with a bias for reporting the presence of a voice in white noise. Subjectively, questionnaire measures indicated that AVH were significantly distressing and persecutory. In addition, AVH intensity, but not perceived origin (i.e. inside vs. outside the head), was associated with greater concurrent anxiety. Neurally, fMRI of BPD participants demonstrated that, relative to imagining or listening to voices, periods of reported AVH induced greater BOLD activity in anterior cingulate and bilateral temporal cortices (regional substrates for language processing). AVH symptom severity was associated with weaker functional connectivity between anterior cingulate and bilateral insular cortices. CONCLUSION: In summary, our results indicate that AVH in participants with BPD are; 1) underpinned by aberrant perceptual-cognitive mechanisms for signal detection; 2) experienced subjectively as persecutory and distressing, and; 3) associated with distinct patterns of neural activity that inform proximal mechanistic understanding. Our findings are similar to analogous observations in patients with schizophrenia and validate the clinical significance of the AVH experience in BPD, often dismissed as ‘pseudohallucinations’. These highlight a need to reconsider this experience as a treatment priority.

Type: Article

Title: Voice Hearing in Borderline Personality Disorder Across Perceptual, Subjective, and Neural Dimensions
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/ijnp/pyab093
Publisher version: https://doi.org/10.1093/ijnp/pyab093
Language: English
Additional information: This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Keywords: Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Neurosciences, Pharmacology & Pharmacy, Psychiatry, Neurosciences & Neurology, Auditory verbal hallucinations, borderline personality disorder, fMRI, hallucinations, AUDITORY VERBAL HALLUCINATIONS, SIGNAL-DETECTION, SCHIZOPHRENIA, PSEUDOHALLUCINATIONS, INDIVIDUALS, LANGUAGE, BELIEFS, BRAIN, QUESTIONNAIRE, CORTEX
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Institute of Cognitive Neuroscience
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10146096
Download activity – last month
Download activity – last 12 months
Downloads by country – last 12 months

Archive Staff Only

View Item View Item



Source link

EHS
Back to top button