Perceiving social salience: a research
domain linking normal and
pathological hallucination
Ralph Hoffman MD
Department of...
AVHs in Sz achieve high
“social salience”
• Acoustic “voiceprint” connotes specific speakers;
• particular sounding voices...
Normal AHs prompted by ↑
social salience
• Erroneously hearing one’s name in
public (57% college students; Posey
and Losch...
Social withdrawal precedes and is
possible risk factor for AVHs
• 87% of first-episode patients w/SZ reported prior
social...
• Phantom limb following amputation
• Charles Bonnet Syndrome
Sensory deafferentation:
hallucinations due to network
reorg...
What about “social
deafferentation?”
• Brain is dedicated to social meaning;
• high levels of plasticity in “social brain”...
Suggestive evidence
• Baseline active social avoidance (ASA)
during the prodrome correlated with
hallucinations (PRIME stu...
Greater dendritic length in amygdala neurons in
socially isolated rats (Wang et al. 2011)
New-born
hippocampal
neurons
after
knockdown
of DISC-1
gene
expression
Duan et al. Cell, 2007
oncoretrovirus-
mediated RNA...
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Perceiving social salience

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Presentation made by Dr. Ralph Hoffman at the May 28, 2014 Live Webinar hosted by the Schizophrenia Forum - http://schizophreniaforum.org/for/live/detail.asp?liveID=92

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  • 25 minutes
    Alternative mechanistic framework for AVHs, to consider processes reflecting the brain’s drive to discover, in the vast and complex world we live in, social salience and connection with others. We are alas group animals.
  • Brain and mind dedicated to discovering social salience
  • Disrupted in Schizophrenia 1
  • Perceiving social salience

    1. 1. Perceiving social salience: a research domain linking normal and pathological hallucination Ralph Hoffman MD Department of Psychiatry Yale University School of Med 28 May 2014 ralph.hoffman@yale.edu
    2. 2. AVHs in Sz achieve high “social salience” • Acoustic “voiceprint” connotes specific speakers; • particular sounding voices have distinctive characteristics – “their own personality…” • attributed to specific persons/agents, angels, God, the dead, or the devil, often given names; • typically patient has conversations with voices…
    3. 3. Normal AHs prompted by ↑ social salience • Erroneously hearing one’s name in public (57% college students; Posey and Losch 1983); • vibration and pager tone hallucinations – 80-90% of medical interns, not correlated with anxiety or depression (Lin et al. 2013). • Bereavement hallucinations, typically AVHs; fills in for lost loved one
    4. 4. Social withdrawal precedes and is possible risk factor for AVHs • 87% of first-episode patients w/SZ reported prior social withdrawal vs 3% for non-psychotic patients (Tan 2001); • 71% of SZ pts with AVHs report significant drop-off in social involvement 1-6 month before first onset • Move to new city, new school, solo travel in Europe or across the US, peace corp duty, dissertation takes over…
    5. 5. • Phantom limb following amputation • Charles Bonnet Syndrome Sensory deafferentation: hallucinations due to network reorganization filling in for absent percepts
    6. 6. What about “social deafferentation?” • Brain is dedicated to social meaning; • high levels of plasticity in “social brain” regions • What happens when brain deprived of social experience?? • Could AVHs with high social salience “fill in” for absent social connection
    7. 7. Suggestive evidence • Baseline active social avoidance (ASA) during the prodrome correlated with hallucinations (PRIME study, unpublished) • at baseline, correlation = 0.18; • at 1 year, correlation = 0.54. • Prisoners in solitary confinement: 36% had auditory/verbal hallucinations (Grassian Am J Psychiatry 1983); mean age 28, 11 days to 10 months SC • What other factors besides social disconnection might come into play???
    8. 8. Greater dendritic length in amygdala neurons in socially isolated rats (Wang et al. 2011)
    9. 9. New-born hippocampal neurons after knockdown of DISC-1 gene expression Duan et al. Cell, 2007 oncoretrovirus- mediated RNA interference
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