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

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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