Trauma-intrusive hallucinations and the dissociative state

BACKGROUND: Research has supported a model of dissociation mediating the experience of hearing voices in traumatised individuals. AIMS: To further understand this model by examining subtypes of the dissociative experience involved in trauma-intrusive hallucinations. METHOD: The study involved four hospitals, 11 psychiatrists and 69 participants assessed using the Psychotic Symptoms Rating scale, the PTSD Symptoms Scale Interview and the Dissociative Subtype of PTSD Score RESULTS: In total, 59% (n = 41) of the participants heard voices and they were compared with the 41% (n = 28) who did not. The severity of PTSD symptoms did not predict experience of hearing voices. Regression analysis indicated that two scales of dissociation (derealisation/depersonalisation and loss of awareness) were equally good predictors of the extent of hearing voices. Adding other possible predictors (age of trauma <18, sexual violence) was relevant but did not enhance the prediction. CONCLUSIONS: This research supports the proposal that trauma-intrusive voices are mediated by symptoms of dissociation. The supported model describes general, rather than trauma specific, symptoms of dissociation mediating the experience of hearing voices. The concept of anchoring is discussed and suggests a potential treatment strategy, which could be useful in the clinical management of hearing voices. DECLARATION OF INTEREST: None.