Autonomic Regulation and Auditory Hallucinations in Individuals With Schizophrenia: An Experience Sampling Study

David Kimhy*, Melanie M. Wall, Marie C. Hansen, Julia Vakhrusheva, C. Jean Choi, Philippe Delespaul, Nicholas Tarrier, Richard P. Sloan, Dolores Malaspina

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

25 Citations (Web of Science)

Abstract

Auditory Hallucinations (AH) cause substantial suffering and dysfunction, yet remain poorly understood and modeled. Previous reports have linked AH to increases in negative emotions, suggesting a role for the autonomic nervous system (ANS) in underlying this link. Employing an Experience Sampling Method (ESM) approach, 40 individuals with schizophrenia completed a 36-hour ambulatory assessment of AH and cardiac autonomic regulation. Participants carried mobile electronic devices that prompted them to report 10 times/d the severity of their momentary AH, along with a Holter monitor that continuously recorded their cardiac autonomic regulation. The clocks of the devices and monitors were synchronized, allowing for high time-resolution temporal linking of the AH and concurrent autonomic data. Power spectral analysis was used to determine the relative vagal (parasympathetic) contribution to autonomic regulation during 5 minutes prior to each experience sample. The participants also completed interview-based measures of AH (SAPS; PSYRATS). The ESM-measured severity of AH was significantly correlated with the overall SAPS-indexed AH severity, along with the PSYRATS-indexed AH frequency, duration, loudness, degree of negative content, and associated distress. A mixed-effect regression model indicated that momentary increases in autonomic arousal, characterized by decreases in vagal input, significantly predicted increases in ESM-measured AH severity. Vagal input averaged over the 36-hour assessment displayed a small but significant inverse correlation with the SAPS-indexed AH. The results provide preliminary support for a link between ANS regulation and AH. The findings also underscore the highly dynamic nature of AH and the need to utilize high time-resolution methodologies to investigate AH.

Original languageEnglish
Pages (from-to)754-763
Number of pages10
JournalSchizophrenia Bulletin
Volume43
Issue number4
DOIs
Publication statusPublished - Jul 2017

Keywords

  • schizophrenia
  • psychosis
  • auditory hallucinations
  • autonomic regulation
  • arousal
  • cardiac
  • heart
  • stress
  • vagal
  • experience sampling method
  • negative emotions
  • heart rate variability
  • mobile devices
  • SUPERFICIAL WHITE-MATTER
  • CLINICAL HIGH-RISK
  • EMOTION REGULATION
  • INTERNATIONAL CONSORTIUM
  • VERBAL HALLUCINATIONS
  • DAILY-LIFE
  • PERSECUTORY DELUSIONS
  • PSYCHOTIC SYMPTOMS
  • FUTURE-RESEARCH
  • STRESS

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