Baker C A, Morrison A P
University of Wales, Bangor.
Psychol Med. 1998 Sep;28(5):1199-208. doi: 10.1017/s0033291798007314.
Cognitive models suggest that auditory hallucinations are experienced when mental events are misattributed to an external source; therefore, this study was designed to examine attributional biases in patients experiencing auditory hallucinations. The study also examined the role of metacognitive beliefs in the experience of auditory hallucinations, as some theories have implicated metacognition in the development and maintenance of auditory hallucinations.
Fifteen participants with a diagnosis of schizophrenia experiencing auditory hallucinations were compared with 15 non-hallucinating schizophrenics and 15 non-psychiatric control subjects on several measures, including an immediate source monitoring task and a questionnaire assessing metacognitive beliefs.
Results indicated that patients experiencing hallucinations exhibited the predicted bias towards misattributing internal events to an external source, as measured by ratings of internality of responses in a word association task. All groups had lower perceived levels of internality and control for emotionally salient words, which provides further evidence for the importance of emotional content in hallucinations. Patients experiencing hallucinations were found to score higher than the other two groups on metacognitive beliefs about uncontrollability and danger and positive beliefs about worry. In addition, a logistic regression analysis showed that beliefs about uncontrollability and danger were predictive of whether subjects experienced auditory hallucinations or not.
These results offer considerable support to cognitive bias models of auditory hallucinations, particularly those that implicate metacognition.
认知模型表明，当心理事件被错误地归因于外部来源时，就会出现幻听；因此，本研究旨在检查幻听患者的归因偏差。该研究还考察了元认知信念在幻听体验中的作用，因为一些理论认为元认知与幻听的产生和维持有关。
将15名被诊断为患有精神分裂症且有幻听的参与者与15名无幻听的精神分裂症患者以及15名非精神科对照受试者在多项指标上进行比较，包括一项即时来源监测任务和一份评估元认知信念的问卷。
结果表明，通过单词联想任务中反应的内在性评分来衡量，有幻听的患者表现出将内部事件错误归因于外部来源的预期偏差。所有组对情绪突出词汇的内在性和可控性的感知水平都较低，这为情绪内容在幻听中的重要性提供了进一步的证据。发现有幻听的患者在关于不可控性和危险性的元认知信念以及关于担忧的积极信念方面得分高于其他两组。此外，逻辑回归分析表明，关于不可控性和危险性的信念可预测受试者是否经历幻听。
这些结果为幻听的认知偏差模型提供了相当大的支持，特别是那些涉及元认知的模型。
