Intrusive Thoughts and Auditory Hallucinations: A Cognitive Approach

In this paper, an account of auditory hallucinations is outlined, incorporating the phenomena of intrusive thoughts; this is done with reference to the prevailing cognitive models of auditory hallucinations. The account proposes that metacognitive beliefs inconsistent with intrusive thoughts lead to their external attribution as auditory hallucinations, and that such a misattribution is maintained by reducing cognitive dissonance. It is also suggested that the appraisal of the resulting hallucinatory experience elicits behavioural, emotional and physiological responses that may be involved in the maintenance process. The possibility of extending such an account to certain other positive symptoms is discussed, and the theoretical and clinical implications of such an account are considered, and illustrated with a case example. Finally, a number of testable predictions are made.