Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia

Auditory hallucinations (AH) are the most common symptom of psychosis. The voices people hear make comments that are benign or even encouraging, but most often voices are threatening and derogatory. Negative AH are often highly distressing and contribute to suicide risk and violent behavior. Biologi...

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Main Authors: Anna R. Knippenberg, Sabrina Yavari, Gregory P. Strauss
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Schizophrenia Research: Cognition
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Online Access:http://www.sciencedirect.com/science/article/pii/S2215001324000350
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author Anna R. Knippenberg
Sabrina Yavari
Gregory P. Strauss
author_facet Anna R. Knippenberg
Sabrina Yavari
Gregory P. Strauss
author_sort Anna R. Knippenberg
collection DOAJ
description Auditory hallucinations (AH) are the most common symptom of psychosis. The voices people hear make comments that are benign or even encouraging, but most often voices are threatening and derogatory. Negative AH are often highly distressing and contribute to suicide risk and violent behavior. Biological mechanisms underlying the valence of voices (i.e., positive, negative, neutral) are not well delineated. In the current study, we examined whether AH voice valence was associated with increased activation of the Defensive Motivational System, as indexed by central and autonomic system response to unpleasant stimuli. Data were evaluated from two studies that used a common symptom rating instrument, the Psychotic Symptom Rating Scale (PSY-RATS), to measure AH valence. Participants included outpatients diagnosed with SZ. Tasks included: Study 1: Trier Social Stress Task while heart rate was recorded via electrocardiography (N = 27); Study 2: Passive Viewing Task while participants were exposed to pleasant, unpleasant, and neutral images from the International Affective Picture System (IAPS) library while eye movements, pupil dilation, and electroencephalography were recorded (N = 25). Results indicated that negative voice content was significantly associated with: 1) increased heart rate during an acute social stressor, 2) increased pupil dilation to unpleasant images, 3) higher neural reactivity to unpleasant images, and 4) a greater likelihood of having bottom-up attention drawn to unpleasant stimuli. Findings suggest that negative AH are associated with greater Defensive Motivational System activation in terms of central and autonomic nervous system response.
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spelling doaj-art-9ec23b4a44f14a779fac7dae9497315d2025-08-20T02:21:07ZengElsevierSchizophrenia Research: Cognition2215-00132025-03-013910033410.1016/j.scog.2024.100334Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophreniaAnna R. Knippenberg0Sabrina Yavari1Gregory P. Strauss2Department of Psychology, University of Georgia, United States of AmericaDepartment of Psychology, University of Georgia, United States of AmericaCorresponding author at: University of Georgia, Department of Psychology, 125 Baldwin St., Athens, GA 30602, United States of America.; Department of Psychology, University of Georgia, United States of AmericaAuditory hallucinations (AH) are the most common symptom of psychosis. The voices people hear make comments that are benign or even encouraging, but most often voices are threatening and derogatory. Negative AH are often highly distressing and contribute to suicide risk and violent behavior. Biological mechanisms underlying the valence of voices (i.e., positive, negative, neutral) are not well delineated. In the current study, we examined whether AH voice valence was associated with increased activation of the Defensive Motivational System, as indexed by central and autonomic system response to unpleasant stimuli. Data were evaluated from two studies that used a common symptom rating instrument, the Psychotic Symptom Rating Scale (PSY-RATS), to measure AH valence. Participants included outpatients diagnosed with SZ. Tasks included: Study 1: Trier Social Stress Task while heart rate was recorded via electrocardiography (N = 27); Study 2: Passive Viewing Task while participants were exposed to pleasant, unpleasant, and neutral images from the International Affective Picture System (IAPS) library while eye movements, pupil dilation, and electroencephalography were recorded (N = 25). Results indicated that negative voice content was significantly associated with: 1) increased heart rate during an acute social stressor, 2) increased pupil dilation to unpleasant images, 3) higher neural reactivity to unpleasant images, and 4) a greater likelihood of having bottom-up attention drawn to unpleasant stimuli. Findings suggest that negative AH are associated with greater Defensive Motivational System activation in terms of central and autonomic nervous system response.http://www.sciencedirect.com/science/article/pii/S2215001324000350PsychosisAuditory hallucinationsValenceMotivational system
spellingShingle Anna R. Knippenberg
Sabrina Yavari
Gregory P. Strauss
Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia
Schizophrenia Research: Cognition
Psychosis
Auditory hallucinations
Valence
Motivational system
title Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia
title_full Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia
title_fullStr Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia
title_full_unstemmed Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia
title_short Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia
title_sort negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia
topic Psychosis
Auditory hallucinations
Valence
Motivational system
url http://www.sciencedirect.com/science/article/pii/S2215001324000350
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AT sabrinayavari negativeauditoryhallucinationsareassociatedwithincreasedactivationofthedefensivemotivationalsysteminschizophrenia
AT gregorypstrauss negativeauditoryhallucinationsareassociatedwithincreasedactivationofthedefensivemotivationalsysteminschizophrenia