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Impaired verbal self-monitoring in individuals at high risk of psychosis

Published online by Cambridge University Press:  02 December 2009

L. C. Johns ,
P. Allen ,
I. Valli ,
T. Winton-Brown ,
M. Broome ,
J. Woolley ,
P. Tabraham ,
F. Day ,
O. Howes  and
T. Wykes
...Show all authors
L. C. Johns*
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
P. Allen
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
I. Valli
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
T. Winton-Brown
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
M. Broome
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
J. Woolley
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
P. Tabraham
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
F. Day
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
O. Howes
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
T. Wykes
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
P. McGuire
Affiliation:
Departments of Psychological Medicine and Psychology, Institute of Psychiatry, King's College London, UK
*
*Address for correspondence: Dr L. C. Johns, Department of Psychology, PO77, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK. (Email: louise.johns@kcl.ac.uk)
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Abstract

Background

Cognitive models suggest that auditory verbal hallucinations arise through defective self-monitoring and the external attribution of inner speech. We used a paradigm that engages verbal self-monitoring (VSM) to examine whether this process is impaired in people experiencing prodromal symptoms, who have a very high risk of developing psychosis.

Method

We tested 31 individuals with an At-Risk Mental State (ARMS) and 31 healthy volunteers. Participants read single adjectives aloud while the source and pitch of the online auditory verbal feedback was manipulated, then immediately identified the source of the speech they heard (Self/Other/Unsure). Response choice and reaction time were recorded.

Results

When reading aloud with distorted feedback of their own voice, ARMS participants made more errors than controls (misidentifications and unsure responses). ARMS participants misidentified the source of their speech as ‘Other’ when the level of acoustic distortion was severe, and misidentification errors were inversely related to reaction times.

Conclusions

Impaired VSM is evident in people with an ARMS, although the deficit seems to be less marked than in patients with schizophrenia. Follow-up of these participants may clarify the extent to which the severity of this impairment predicts the subsequent onset of psychosis and development of positive symptoms.

Keywords

At-Risk Mental Statepsychosisself-monitoring
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 9 , September 2010 , pp. 1433 - 1442
Copyright
Copyright © Cambridge University Press 2009

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