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Keedy RdoC multidimensional avhfinal
- 1. The Multidimensional Nature of Auditory Hallucinations Sarah K. Keedy, Ph.D. Assistant Professor of Psychiatry and Behavioral Neuroscience Director, Cognition and Emotion Neuroscience Lab University of Chicago
- 2. 1. Different neural system sets likely lead to hallucinations – Analogous to fever – Between group variability – Within group variability – Varying “severity” 2. Empirical work endeavoring rational measurement of hallucinatory experience confirms and unravels multiple facets of hallucinatory experience Using the latter (#2) to inform the former (#1) is a needed research direction and fits RDoC framework Auditory Hallucinations Are Complex and Varied Language network Salience network Emotion regulation … Sarah Keedy, PhD 05.28.2014
- 3. The PSYRATS(AH) • The gold standard AH severity scale • AH scale is 11 items scored 0-4 on the basis of an interview • Total score range of 0-44 Sarah Keedy, PhD 05.28.2014
- 4. Dimensions of Auditory Hallucinations in PSYRATS(AH) 3 factorsa,b 1. Emotional • Amount negative content • Degree of negative content • Frequency of distress • Intensity of distress 2. Physical • Frequency • Duration • Loudness 3. Cognitive • Location • Origin beliefs • Disruption • Control 4 factorsc,d 1. Emotional • Amount negative content • Degree of negative content • Frequency of distress • Intensity of distress 2. Physical • Frequency • Duration 3. Cognitive • Location • Origin beliefs 4. Control • Loudness • Disruption • Control 4(ish) factors e 1. Emotional (Distress) • Amount negative content • Degree of negative content • Frequency of distress • Intensity of distress • Control 2. Physical (Frequency) • Frequency • Duration • Disruption 3. Cognitive (Attribution) • Location • Origin beliefs 4. Loudness a) Haddock et al., 1999, Psychol Med b) Drake et al., 2007, Schizophr Res c) Kronmuller et al., 2011, Compr Psychiatry d) Steele et al., 2007, Int J Methods Psychiatr Res e) *Woodward et al. (in press) Schiz Bull
- 5. Mapping the Emotional Factor to RDoC Emotional Factor • Amount of negative content • Degree of negative content • Frequency of distress • Intensity of distress Suggested RDoC Domain: Negative Valence Domain constructs: Acute Threat Sustained Threat http://www.nimh.nih.gov/research-priorities/rdoc/rdoc-constructs.shtml#sustained_threat
- 6. Mapping the Physical Factor to RDoC Physical Factor • Frequency • Duration • Loudness • Disruption Suggested RDoC Domain: Cognitive Systems Suggested constructs: Perception subconstructs: Auditory Attention Language Cognitive Control http://www.nimh.nih.gov/research-priorities/rdoc/rdoc-constructs.shtml#auditory_perception
- 7. THE PANSS hallucination item Sarah Keedy, PhD 05.28.2014
- 8. Hallucination Dimensions Beyond Those in PSYRATS(AH) • Treatment responsiveness • Repetitive vs. spontaneous content • Familiar vs. unfamiliar voices • Multi-sensory • Insight • ______________ Sarah Keedy, PhD 05.28.2014 …thank you!