Towards a theory of auditory hallucinations: outline of an hypothetical four-factor model.

The research findings of the writer to date on auditorily hallucinated patients are briefly summarized and an hypothetical four-factor model outlined to account for them. This general working model envisages auditory hallucinations as stemming from the interaction of psychological stress with an underlying hallucinatroy predisposition which is to a large extent genetically determined. A third factor of external stimulation is seen as exerting an inhibitory effect on the conscious experience of the hallucination. While a fourth speculative factor of a positive feedback loop is introduced to account for a number of otherwise incompatible observations. Each of the four factors in the hypothetical model is defined as precisely as is possible at present and discussed in relation to other research findings in this area and to the literature more generally. An attempt is made to spell out some of the theoretical predictions and clinical implications of the model.