Hoffman R E, Rapaport J, Mazure C M, Quinlan D M
Department of Psychiatry, Yale University School of Medicine, New Haven, Conn., USA.
Am J Psychiatry. 1999 Mar;156(3):393-9. doi: 10.1176/ajp.156.3.393.
The authors tested a model of hallucinated "voices" based on a neural network computer simulation of disordered speech perception.
Twenty-four patients with schizophrenia spectrum disorders who reported hallucinated voices were compared with 21 patients with schizophrenia spectrum disorders who did not report voices and 26 normal subjects. Narrative speech perception was assessed through use of a masked speech tracking task with three levels of superimposed phonetic noise. A sentence repetition task was used to assess grammar-dependent verbal working memory, and an auditory continuous performance task was used to assess nonlanguage attention.
Masked speech tracking task and sentence repetition performance by hallucinating patients was impaired relative to both nonhallucinating patients and normal subjects. Although both hallucinating and nonhallucinating patients demonstrated auditory attention impairments when compared to normal subjects, the two patient groups did not differ with respect to these variables.
Results support the hypothesis that hallucinated voices in schizophrenia arise from disrupted speech perception and verbal working memory systems rather than from nonlanguage cognitive or attentional deficits.
作者基于言语感知障碍的神经网络计算机模拟测试了一种幻觉“声音”模型。
将24名报告有幻觉声音的精神分裂症谱系障碍患者与21名未报告有声音的精神分裂症谱系障碍患者及26名正常受试者进行比较。通过使用带有三个叠加语音噪声水平的掩蔽言语跟踪任务来评估叙事言语感知。使用句子重复任务评估依赖语法的言语工作记忆，使用听觉持续操作任务评估非语言注意力。
与未出现幻觉的患者和正常受试者相比，出现幻觉的患者的掩蔽言语跟踪任务和句子重复表现受损。尽管与正常受试者相比，出现幻觉和未出现幻觉的患者均表现出听觉注意力受损，但这两组患者在这些变量方面并无差异。
结果支持以下假设，即精神分裂症中的幻觉声音源于言语感知和言语工作记忆系统的紊乱，而非非语言认知或注意力缺陷。
