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Am J Psychiatry 1994; 151:357-362
Copyright © 1994 by American Psychiatric Association
Dichotic listening during auditory hallucinations in patients with schizophrenia
MF Green, K Hugdahl and S Mitchell
Department of Psychiatry and Biobehavioral Sciences, UCLA.
OBJECTIVE: Auditory hallucinations are a serious problem for a large
subgroup of psychotic patients who do not respond optimally to neuroleptic
medication. It has been hypothesized that hearing imaginary voices involves
the same physiological processes as those involved in hearing real voices,
but this hypothesis has not been conclusively confirmed. METHOD: In this
study a consonant-vowel version of the Dichotic Listening Test was used to
assess the functional integration of the left hemisphere in hallucinating
and nonhallucinating psychotic patients. The test was administered under
three conditions: a nonforced attention condition, a condition in which
attention was forced to the left ear, and one in which attention was forced
to the right ear. RESULTS: The nonhallucinating patients showed the normal
right ear advantage, which indicates a left hemisphere superiority in the
processing of linguistic stimuli. In contrast, the hallucinating patients
showed no ear advantage. Neither group was able to modify its performance
when instructed to attend to either the left or the right ear. A subgroup
of patients was tested in both hallucinating and nonhallucinating states,
but the ear asymmetry was not noticeably different between these states.
CONCLUSIONS: The results suggest that auditory hallucinations are
associated with abnormalities in left hemisphere functioning and that these
abnormalities might not be limited to the time of the auditory
hallucinations. It is hypothesized that a relatively enduring left
hemisphere abnormality may leave some patients at risk for auditory
hallucinations.
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