Studying Auditory Verbal Hallucinations Using the RDoC framework

Abstract

In this paper, I explain why I adopted an RDoC approach to study the neurobiology of auditory verbal hallucinations (AVH), or voices. I explain that the RDoC construct of “Agency” fits well with AVH phenomenology. To the extent that voices sound non-self, voice hearers lack a sense of agency over the voices. Using a vocalization paradigm like those used with non-human primates to study mechanisms subserving the sense of agency, we find that the auditory N1 ERP is suppressed during vocalization, that EEG synchrony preceding speech onset is related to N1 suppression, and that both are reduced in patients with schizophrenia. Reduced cortical suppression is also seen across multiple psychotic disorders and in clinically high-risk youth. The motor activity preceding talking and connectivity between frontal and temporal lobes during talking have both proved sensitive to AVH, suggesting neural activity and connectivity associated with intentions to act may be a better way to study agency and predictions based on agency.