Hoffman R E, Satel S L
Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
Br J Psychiatry. 1993 Jun;162:755-8. doi: 10.1192/bjp.162.6.755.
One of us has hypothesised that the 'voices' of schizophrenic patients reflect altered preconscious planning of discourse that can produce involuntary 'inner speech' as well as incoherent overt speech. Some schizophrenic patients reporting voices do not, however, have disorganised speech. We hypothesise that these 'counterexample' patients compensate for impairments of discourse planning by reducing language complexity and relying on highly rehearsed topics. A 'language therapy' designed to challenge and enhance novel discourse planning was administered to four such patients; three had significant albeit temporary reductions in the severity of their voices. These clinical findings provide further evidence that alterations of discourse planning may underlie hallucinated voices.
我们中的一人曾提出假设，即精神分裂症患者的“幻听”反映了话语前意识规划的改变，这种改变会产生不由自主的“内心言语”以及语无伦次的公开言语。然而，一些报告有幻听的精神分裂症患者并没有言语紊乱。我们推测，这些“反例”患者通过降低语言复杂性并依赖高度排练过的话题来弥补话语规划的缺陷。一种旨在挑战和增强新颖话语规划的“语言疗法”被应用于四名这样的患者；其中三名患者的幻听严重程度虽有显著但暂时的减轻。这些临床发现进一步证明，话语规划的改变可能是幻听的基础。
