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Childhood trauma and auditory verbal hallucinations

  • K. Daalman (a1), K. M. J. Diederen (a1), E. M. Derks (a1), R. van Lutterveld (a1), R. S. Kahn (a1) and Iris E. C. Sommer (a1)...



Hallucinations have consistently been associated with traumatic experiences during childhood. This association appears strongest between physical and sexual abuse and auditory verbal hallucinations (AVH). It remains unclear whether traumatic experiences mainly colour the content of AVH or whether childhood trauma triggers the vulnerability to experience hallucinations in general. In order to investigate the association between hallucinations, childhood trauma and the emotional content of hallucinations, experienced trauma and phenomenology of AVH were investigated in non-psychotic individuals and in patients with a psychotic disorder who hear voices.


A total of 127 non-psychotic individuals with frequent AVH, 124 healthy controls and 100 psychotic patients with AVH were assessed for childhood trauma. Prevalence of childhood trauma was compared between groups and the relation between characteristics of voices, especially emotional valence of content, and childhood trauma was investigated.


Both non-psychotic individuals with AVH and patients with a psychotic disorder and AVH experienced more sexual and emotional abuse compared with the healthy controls. No difference in the prevalence of traumatic experiences could be observed between the two groups experiencing AVH. In addition, no type of childhood trauma could distinguish between positive or negative emotional valence of the voices and associated distress. No correlations were found between sexual abuse and emotional abuse and other AVH characteristics.


These results suggest that sexual and emotional trauma during childhood render a person more vulnerable to experience AVH in general, which can be either positive voices without associated distress or negative voices as part of a psychotic disorder.


Corresponding author

*Address for correspondence: K. Daalman, M.Sc., Neuroscience Division, University Medical Center Utrecht and Rudolf Magnus Institute for Neuroscience, B01.206, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. (Email:


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Andersen, SL, Tomoda, A, Vincow, ES, Valente, E, Polcari, A, Teicher, MH (2008). Preliminary evidence for sensitive periods in the effect of childhood sexual abuse on regional brain development. Journal of Neuropsychiatry and Clinical Neurosciences 20, 292301.
Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615623.
Andrew, EM, Gray, NS, Snowden, RJ (2008). The relationship between trauma and beliefs about hearing voices: a study of psychiatric and non-psychiatric voice hearers. Psychological Medicine 38, 14091417.
Badcock, JC, Waters, FAV, Maybery, MT, Michie, PT (2005). Auditory hallucinations: failure to inhibit irrelevant memories. Cognitive Neuropsychiatry 10, 125136.
Bauer, EP, Paz, R, Paré, D (2007). Gamma oscillations coordinate amygdalo-rhinal interactions during learning. Journal of Neuroscience 27, 93699379.
Beavan, V, Read, J, Cartwright, C (2011). The prevalence of voice-hearers in the general population: a literature review. Journal of Mental Health 20, 281292.
Bernstein, D, Fink, L (1998). Childhood Trauma Questionnaire: A Retrospective Self-Report. The Psychological Corporation: San Antonio, TX.
Bernstein, DP, Fink, L, Handelsman, L, Foote, J, Lovejoy, M, Wenzel, K, Sapareto, E, Ruggiero, J (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry 151, 11321136.
Bernstein, DP, Stein, JA, Newcomb, MD, Walker, E, Pogge, D, Ahluvalia, T, Stokes, J, Handelsman, L, Medrano, M, Desmond, D, Zule, W (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect 27, 169190.
Birchwood, M, Meaden, A, Trower, P, Gilbert, P, Plaistow, J (2000). The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychological Medicine 30, 337344.
Brill, N, Reichenberg, A, Rabinowitz, J, Harary, E, Lubin, G, Davidson, M, Weiser, M (2007). Accuracy of self-reported premorbid functioning in schizophrenia. Schizophrenia Research 97, 103108.
Daalman, K, Boks, MPM, Diederen, KMJ, de Weijer, AD, Blom, JD, Kahn, RS, Sommer, IEC (2011 a). The same or different? A phenomenological comparison of auditory verbal hallucinations in healthy and psychotic individuals. Journal of Clinical Psychiatry 72, 320325.
Daalman, K, van Zandvoort, M, Bootsman, F, Boks, MPM, Kahn, RS, Sommer, IEC (2011 b). Auditory verbal hallucinations and cognitive functioning in healthy individuals. Schizophrenia Research 132, 203207.
De Weijer, AD, Mandl, RC, Diederen, KM, Neggers, SF, Kahn, RS, Hulshoff Pol, HE, Sommer, IE (2011). Microstructural alterations of the arcuate fasciculus in schizophrenia patients with frequent auditory verbal hallucinations. Schizophrenia Research 130, 6877.
Diederen, KMJ, Neggers, SFW, Daalman, K, Blom, JD, Kahn, RS, Sommer, IE(2010 a). Deactivation of the parahippocampal gyrus preceding auditory hallucinations in schizophrenia. American Journal of Psychiatry 167, 427435.
Diederen, KM, De Weijer, AD, Daalman, K, Blom, JD, Neggers, SF, Kahn, RS, Sommer, IE (2010 b). Decreased language lateralization is characteristic of psychosis, not auditory hallucinations. Brain 133, 37343744.
Ensink, B (1992). Confusing Realities: A Study of Child Sexual Abuse and Psychiatric Symptoms. VU University Press: Amsterdam.
Famularo, R, Kinscherff, R, Fenton, T (1992). Psychiatric diagnoses of maltreated children: preliminary findings. Journal of the American Academy of Child and Adolescent Psychiatry 31, 863867.
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1995). The Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Part 1: Description. Journal of Personality Disorders 9, 8391.
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, PE (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189195.
Goldman, JDG, Padayachi, UK (2000). Some methodological problems in estimating incidence and prevalence in child sexual abuse research. Journal of Sex Research 37, 305314.
Graham, KR (1996). The childhood victimization of sex offenders: an underestimated issue. International Journal of Offender Therapy and Comparative Criminology 3, 192203.
Haddock, G, McCarron, J, Tarrier, N, Faragher, EB (1999). Scales to measure dimensions of hallucinations and delusions: the Psychotic Symptom Rating Scales (PSYRATS). Psychological Medicine 29, 879889.
Hammersley, P, Dias, A, Todd, G, Bowen-Jones, K, Reilly, B, Bentall, R (2003). Childhood traumas and hallucinations in bipolar affective disorder. British Journal of Psychiatry 182, 543547.
Hardy, A, Fowler, D, Freeman, D, Smith, B, Steel, C, Evans, J, Garety, P, Kuipers, E, Bebbington, P, Dunn, G (2005). Trauma and hallucinatory experience in psychosis. Journal of Nervous and Mental Disease 193, 501507.
Heim, C, Newport, DJ, Heit, S, Graham, YP, Wilcox, M, Bonsall, R, Miller, AH, Nemeroff, CB (2000). Pituitary–adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association 284, 592597.
Hoffman, RE, Anderson, AW, Varanko, M, Gore, JC, Hampson, M (2008). Time course of regional brain activation associated with onset of auditory/verbal hallucinations. British Journal of Psychiatry 193, 424425.
Honig, A, Romme, MAJ, Ensink, BJ, Escher, SDMA, Pennings, MHA, De Vries, MW (1998). Auditory hallucinations: a comparison between patients and nonpatients. Journal of Nervous and Mental Disease 186, 646651.
Janssen, I, Krabbendam, L, Bak, M, Hanssen, M, Vollebergh, W, de Graaf, R, van Os, J (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica 190, 3845.
Jardri, R, Pouchet, A, Pins, D, Thomas, P (2011). Cortical activations during auditory verbal hallucinations in schizophrenia: a coordinate-based meta-analysis. American Journal of Psychiatry 168, 7381.
Jones, SR (2010). Do we need multiple models of auditory verbal hallucinations? Examining the phenomenological fit of cognitive and neurological models. Schizophrenia Bulletin 36, 566575.
Leuner, B, Gould, E (2010). Structural plasticity and hippocampal function. Annual Review of Psychology 61, 111C3.
McCarthy-Jones, S (2011). Voices from the storm: a critical review of quantitative studies of auditory verbal hallucinations and childhood sexual abuse. Clinical Psychology Review 31, 983992.
Morrison, AP, Haddock, G (1997). Cognitive factors in source monitoring and auditory hallucinations. Psychological Medicine 27, 669679.
Offen, L, Waller, G, Thomas, G (2003). Is reported childhood sexual abuse associated with the psychopathological characteristics of patients who experience auditory hallucinations? Child Abuse & Neglect 27, 919927.
Perry, BD (1994). Neurobiological sequelae of childhood trauma: PTSD in children. In Catecholamines in Post-Traumatic Stress-Disorder (ed. Murberg, M.), pp. 233255. American Psychiatric Press: Washington, DC.
Read, J (1997). Child abuse and psychosis: a literature review and implications for professional practice. Professional Psychology: Research and Practice 28, 448456.
Read, J, Argyle, N (1999). Hallucinations, delusions and thought disorder among adult psychiatric in patients with a history of child abuse. Psychiatric Services 50, 14671472.
Read, J, Fraser, A (1998). Abuse histories of psychiatric inpatients: to ask or not to ask. Psychiatric Services 49, 355359.
Read, J, Perry, B, Boskowitz, A, Connolly, J (2001). The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry 64, 319345.
Read, J, van Os, J, Morrison, AP, Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330350.
Ross, CA, Anderson, G, Clark, P (1994). Childhood abuse and positive symptoms of schizophrenia. Hospital & Community Psychiatry 45, 489491.
Sansonnet-Hayden, H, Haley, G, Marriage, K, Fine, S (1987). Sexual abuse and psychopathology in hospitalized adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 26, 753757.
Sommer, IE, Daalman, K, Rietkerk, T, Diederen, KM, Bakker, S, Wijkstra, J, Boks, MPM (2010). Healthy individuals with auditory verbal hallucinations; who are they? Psychiatric assessments of a selected sample of 103 subjects. Schizophrenia Bulletin 36, 633641.
van Lutterveld, R, Oranje, B, Kemner, C, Abramovic, L, Willems, AE, Boks, MP, Glenthøj, BY, Kahn, RS, Sommer, IE (2010). Increased psychophysiological parameters of attention in non-psychotic individuals with auditory verbal hallucinations. Schizophrenia Research 121, 153159.
Varese, F, Barkus, E, Bentall, RP (2011). Dissociation mediates the relationship between childhood trauma and hallucination-proneness. Psychological Medicine. Published online: 6 September 2011. doi:10.1017/S0033291711001826.
Walker, EF, DiForio, D (1997). Schizophrenia: a neural diathesis–stress model. Psychological Review 104, 667685.
Waters, FAV, Badcock, JC, Maybery, MT, Michie, PT (2003). Inhibition in schizophrenia: association with auditory hallucinations. Schizophrenia Research 62, 275280.


Childhood trauma and auditory verbal hallucinations

  • K. Daalman (a1), K. M. J. Diederen (a1), E. M. Derks (a1), R. van Lutterveld (a1), R. S. Kahn (a1) and Iris E. C. Sommer (a1)...


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