October brings more voice-hearing research….
Accessible summary: A number of areas of the brain have been linked to ‘hearing voices’. These include Broca’s area (involved in speech production) and Wernicke’s area, (involved in speech comprehension). This study examined the way these two brain areas communicated with each other in voice-hearers, to see if it was different to non-voice hearers. The study found that people who heard voices had weaker connections between Broca’s and Wernicke’s areas when performing inner speech, and suggest this may play a role in creating the voice-hearing experience.
Link to paper: http://dx.doi.org/10.1093/schbul/sbs107
Accessible summary: This study involved interviews with 10 Italian voice-hearers who had never been in contact with psychiatric services. It is hard to summarise qualitative research, but if it had to be done, one phrase in the author’s discussion stands out as a handy representation of their findings: “Many people who hear voices are already living lives that they love and the voices enhance their well-being, or their experiences simply do not detract from it”.
Link to paper: http://dx.doi.org/10.1111/jpm.12008
Accessible summary: This study examined how hallucinations changed over the course of 20 years in people diagnosed with psychotic and mood disorders, examining them at six separate time points. It didn’t look at the phenomenology of the hallucinations (unfortunately), but rather their presence and their associations with how well people functioned. The authors conclude that “hallucinations which persist in the first few years after the acute phase are an indication in many cases of a more severe vulnerability to hallucinations, with this vulnerability influencing subsequent functioning and future outcome.” They also state that “experiencing a period of recovery or achieving adequate work functioning is unlikely for a large group of patients.” If I may editorialise, this should lead us to ask, what is wrong with what we are currently doing, and how can help improve?
Link to paper: http://dx.doi.org/10.1017/S0033291712002206
Accessible summary: This study examined the relation between meta-cognition (thinking about thinking) and hallucinations. How we think about our thinking can have significant effects on us. For example, the metacognitive beliefs that some thoughts are uncontrollable and dangerous, can affect our mood and how we try to deal with thoughts (e.g., trying to suppress them) which can have further negative consequences. The study concluded that that metacognitive beliefs are unlikely to play a role in causing hallucinations, but that they may impact voice-hearers’ need for care and their levels of distress.
Link to paper: http://dx.doi.org/10.1111/j.2044-8260.2012.02039.x
Accessible summary: Transcranial magnetic stimulation (TMS) involves the painless application of a changing magnetic field over part of the skull, which causes electrical changes in the brain. This meta-analysis (involving compiling the results from large number of studies) found evidence that TMS applied over the left temporoparietal junction (a part of the brain known to be involved in hallucinations) caused people’s hallucinations to improve. However, firstly the authors noted that whereas earlier reviews studies had found large effects of TMS, their review now found a smaller effect, and secondly that one-month after TMS treatment, there was no evidence that hallucinations were improved.
Link to paper: http://dx.doi.org/10.1016/j.schres.2012.08.025
Other interesting papers this month include:
- Casstevens et al: Mentored Self-Help: A promising approach to exploring voices. http://dx.doi.org/10.1891/1559-43188.8.131.52
- David Cameron & Patrick McGowan: The Mental Health Social Worker as a transitional participant: Actively listening to ‘voices’ and getting into the recovery position. http://dx.doi.org/10.1080/02650533.2012.732047
- The paper above is also discussed in a Powerpoint by the authors – which you can download here.
Hope this has been of some use. More next month.