Auditory Hallucinations in Psychotic and Non-Psychotic Populations

Auditory hallucinations—commonly experienced as voices or sounds in the absence of external stimuli—occur across a spectrum of individuals, from those with psychotic disorders to otherwise healthy people. In clinical populations, these experiences often present with high frequency, negative content and associated distress, contributing to functional impairment and increased care needs. By contrast, non-clinical voice-hearers may experience similar perceptual phenomena yet report greater control, less emotional valence and reduced distress. Contemporary research has emphasised a continuum model, in which the same basic neurocognitive mechanisms underlie hallucinations in both groups, but modulatory factors—such as appraisal style, coping strategies and social support—determine clinical outcome. Neuroimaging studies reveal altered patterns of functional connectivity, while cognitive work highlights the role of top-down expectations and memory intrusions in driving hallucinatory content. Phenomenological surveys underscore diversity in voice character, localisation and multisensory features, pointing to the need for person-centred models that integrate psychological, neural and cultural dimensions. Practically, this body of work supports early-intervention approaches that target maladaptive appraisals and boost resilience in atypical voice-hearers, and informs the development of tailored therapies that engage voices as social agents rather than mere symptoms.

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Auditory Hallucinations in Psychotic and Non-Psychotic Populations publication trend

The graph below shows the total number of articles in auditory hallucinations in psychotic and non-psychotic populations across all publications each year (not limited to Nature Index journals).

Technical terms

Auditory verbal hallucination (AVH): Perceptual experience of hearing speech or voices without an external source.

Leading eigenvector dynamics analysis (LEiDA): A neuroimaging method that captures rapid fluctuations in brain network connectivity at sub-second resolution.

Functional connectivity: Statistical dependence between activity patterns in distinct brain regions over time, reflecting network integration.

Phenomenology: Qualitative study of subjective features of experience, including content, emotional tone and sensory modalities of hallucinations.

References

1. Time varying dynamics of hallucinations in clinical and non-clinical voice-hearers. NeuroImage Clinical (2023).
2. The Arabic Questionnaire for Psychotic Experiences in patients with psychotic disorders: a clinical validation. BMC Psychiatry (2023).
3. Auditory verbal hallucinations and continuum models of psychosis: A systematic review of the healthy voice-hearer literature. Clinical Psychology Review (2016).
4. Experiences of hearing voices: analysis of a novel phenomenological survey. The Lancet Psychiatry (2015).
5. Clinical relevance of appraisals of persistent psychotic experiences in people with and without a need for care: an experimental study. The Lancet Psychiatry (2017).
6. Voice-Hearing and Personification: Characterizing Social Qualities of Auditory Verbal Hallucinations in Early Psychosis. Schizophrenia Bulletin (2020).