Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?

Auditory verbal hallucinations (AVH: ‘hearing voices’) are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. 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. 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 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 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. 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.
One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. 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.

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nice link. It brings hope, that one can heal from schiz.

A propranolol based PTSD treatment currently inclinical trials:

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A 10 min clip of EMDR based PTSD treatment:

A propranolol based PTSD treatment currently inclinical trials:

The med taken during this therapy is propranolol immediate release 40mg and propranolol prolonged release 80mg, both taken simultaneously immediately AFTER (not before) reading the trauma script. There should be no propranolol other than this taken.

Personally I am doing an iteration of this therapy every 2nd day and have completed about 150 iterations so far. I have written various types of trauma scripts including paranoia scripts, apathy scripts, worthlessness scripts, social fear scripts, etc.

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I’m among those who have been rattling cages for years to try t get it across that sz is very often (maybe always?) the result of overwhelming stress crashing into genetic and epigenetic (see https://en.wikipedia.org/wiki/Epigenetics) predispositions.

And though I know this going to sound however it sounds to anyone who reads this, I am so f-----g tired of people writing mountains of unreadable gobbledygook obfuscating* what is a very easy thing to understand if one knows how the autonomic nervous systems functions in those who are perceptually and cognitively compromised.

*because their profs require certain formatting

(Sorry. Just venting.)

I certainly think stress is a factor though there are many who experience high levels of stress that don’t develop psychosis/schizophrenia which possibly lends itself to your therapy @notmoses .
I don’t necessarily think it has to be a high level of stress by general standards rather than a level of stress that exceeds the individual’s coping mechanism. It may be that with a higher genetic predisposition lower levels of stress are needed to tip someone over into psychosis/schizophrenia.
With a strong family history of psychosis/schizophrenia it may be that fairly minimal levels of stress are needed.
I have no first or second generation relatives with psychosis and have experienced moderately high levels of stress . This combination could explain why I have experienced mild levels of psychosis and not the severe end of schizophrenia.
The possible flaw to my thinking is that my brother also experienced moderately high levels of stress but although prone to paranoia(cannabis etc induced) has never been diagnosed with psychosis.
There would seem to be a difference between my brother and I that can’t be explained by family history and stress. Personality wise we were very different as children. I was shy and into solitary activities with problems interacting with others, ,best described as physically and socially awkward, while my brother was not.

Agreed.

Agreed.

Agreed.

Agreed.

Which points to the so-called “sensitivity” theory propounded since Freud’s time. That theory suggested that combination genetic (and later, epigenetic) and social influences for hyper-sensitivity to stimulation from the environment would be more likely to induce florid sz in those who had the appropriate genetic and epigenetic set-up for perceptual and cognitive distortions, as well as for autonomic dysregulation.