Stefan Andersson

For whatever it is worth my own attempt to understand why "up to 25 percent of patients with schizophrenia have polydipsia" (exessive fluid intake): A hungry animal with access to water may if an operant behavior is rewarded with food, but in too small amounts to satisfy its hunger, eventually develop polydipsia Will some people who hear their own thoughts as alien voices develop polydipsia (excessive fluid intake) because an operant behavior like alien covert speech is rewarded with information without entirely satisfying the need to access information? A behavior which operates on the environment to generate the voices you hear can be rewarded with information without entirely satifying the need to access information because you are able to reveal verbal illusion (1) or because bottom-up sensory signals affect the out come of competition between response tendencies (2)... 1.) To listen because you experience the need to access a verbal message may result in that you are able to reveal a verbal illusion and it is much harder to hear the voices you are trying to hear... 2.) How informative is a loose association? Quote: Fluid-electolyte balance is regulated within a narrow range and disturbances in this system are unusual in animals and humans. Studies from the preneuroleptic era to date suggest that up to 25 percent of patients with schizophrenia have polydipsia, suggesting that it is related to the pathophysiology of the psychoses. Polydipsia and the related phenomenon of hyponatremia cause considerable mortality an morbidity... Source: Schizophr Bull (1996) 22 (3): 455-464. Problems and Progress in the Diagnosis and Treatment of Polydipsia and Huponatremia by Cherian Verghese, José de Leon and Richard C. Josiassen http://schizophreniabulletin.oxfordjournals.org/content/22/3/455.short

Feel free to comment on a comment by Phil Corlett 8 july 2013 Quote: "Researchers across our field (even those relatively less interested in the brain) are deeply concerned with causalityfrom those geneticists or epidemiologists assessing the relationships between genes or cannabis exposure and illness onset to those phenomenologists concerned with how patients describe their thoughts and actions as lacking causal agency. For the most part, all of our observations are correlational. Anything more causal, with a few exceptions (Corlett et al., 2009), would entail ethical concerns. Causality is particularly problematic for those of us concerned with the neuronal mechanisms of symptom generation. Are the neural signals we observe with functional neuroimaging of patients with psychotic symptoms, for example, a cause of those symptoms or a consequence of having distressing and distracting experiences in the scanner?" Source: Schizophrenia research forum http://www.schizophreniaforum.org/pap/annotation.asp?powID=169761#

I use a brainwave feedback device to improve my ability to relax and concentrate. ( Two states which reduces the number of voices I hear... ) " Ask the right question..." 2.) What if each and every one of us are able to use covert speech to generate the perception of an external voice "that retain certain acoustic features that were present in the original signal" when we need to restore and better distinguish a verbal message Quote: "These findings indicate that motor circuits controlling production of speech sounds also contribute to their perception. Mapping acoustically highly variable speech sounds onto less variable motor representations may facilitate their phonemic categorization and be important for robust speech perception." Source: The Journal of Neuroscience, August 5, 2009, Motor representations of articulators contribute to categorical perception of speech sounds. Möttönen, Riikka and Watkins, Kate E http://www.jneurosci.org/cgi/content/full/29/31/9819 3.) Can the gestures you are about to produce during covert speech like the gestures you intend to produce during overt speech determine what you expect to hear and can a top-down sensory expectation like this be used to select (attend) all features matching the sensory consequence you are about to produce when you are motivated to access a verbal message 4.) Are you able to hear the sensory consequence of covert speech in integration with what you were able to select with a corresponding top-down sensory expectation 5.) How are people able to hear their own thoughts out loud in response to un-patterned noise of a very low volume (what normally is unattended and below awareness) 6.) Is Treisman´s attenuation model correct in its claim that "paying attention to a message means increasing its subjective loudness" 7.) Can a previous exposure to a tone enable the perception of the same tone at a lower volume than otherwise would have been possible (Hemisfärernas musik, s.53, Jan Fagius) because you expect to hear the tone you were exposed to and are able to use what you expect to hear to select (pay attention to) all features matching the tone you were exposed to To try to further confirm the assumption that memories guided my attention towards external sounds I first recorded a couple of notes coming from a violin in a certain sequence and after that I played them all together with white noise to see if I could single them out with the help of a short term memory. This actually worked and I heard the "melody" from the beginning of the tape over and over again. http://www.freewebs.com/stefan661/ 8.) Can excessive attentional focus on all features matching a top-down sensory expectation substantially increase the subjective loudness of what you are able to select (peripheral features not otherwise brought to awareness) when you are trying to hear the voice you are about to produce and will the subjective loudness of what you are able to select determine the subjective loudness of the voice you are about to produce I would like to ad that many of the voices I hear in response to environmental or tinnitus like sounds of a very low volume are heard without reaching the loudness with which a voice can be heard more objectively. 9.) Is it harder to reveal a verbal illusion in response to un-patterned noise below a certain threshold and will this sometimes result in a tendency to interpret environmental or tinnitus-like sounds of a very low volume To be able to reveal a verbal illusion in response to un-patterned noise above a certain threshold, but totally lack the ability to reveal a verbal illusion in response to un-patterned noise of a much lower volume may result in a tendency to expect to hear a verbal message in response un-patterned noise bellow a certain threshold and to expect to hear a verbal message in response to un-patterned noise bellow a certain threshold can be assumed to motivate a highly context dependent behavior which normally satisfies the need to restore a verbal message! Incentive motivational signals ("a type of motivationally-biased attention") may shift the allocation of processing resources while they increase the subjective loudness of what you are able to select when you are trying to hear the voice you are about to produce! The ability to interpret environmental or tinnitus-like sounds of a very low volume may depend on that you lack the ability to inhibit a verbal response and with a short delay hear the sensory consequence of covert speech in integration with what you were able to select with a corresponding top-down sensory expectation! Ford and colleagues suggest that patients with auditory hallucinations may have excessive attentional focus toward internally generated events and because of this overinterpret the kind of internal noise (spontaneous sensory activity) people normally ignore. Quote: Recent advances in the neurosciences provide clues to why patients report an auditory experience in the absence of any perceptual input. Spontaneous activity in the early sensory cortices may in fact form the basis for the original signal. Early neuronal computation systems are known to interpret this activity and engage in decision-making processes to determine whether a percept has been detected. A brain system that is abnormally tuned in to internal acoustic experiences may therefore report an auditory perception in the absence of any external sound. Ford and colleagues recently suggested that patients with auditory hallucinations may have excessive attentional focus toward internally generated eventsthe brains of persons who have auditory hallucinations may therefore be overinterpreting spontaneous sensory activity that is largely ignored in healthy brains (My remarks: The voices you hear in integration with all features matching a corresponding top-down sensory expectation will in response to certain sounds include acoustic features which characterize what you are able to hear more objectively and to sometimes be able to reveal a verbal illusion by locating the source of some environmental sounds can like when you are able to silence a voice by blocking what you are able to hear more objectively make it very easy to understand that you are able to interpret external stimuli. However to block what I hear with my fingers can only give a temporary relief from the voices I hear and I am also like expected able to hear my own thoughts in integration with the tinnitus sounds I hear (become more aware of) during silence.) Source: Auditory Hallucinations in Psychiatric Illness from the march 2010 issue of Psychiatric Times by Flavie Waters http://www.psychiatrictimes.com/cme/display/article/10168/1534546

Some things are possible to understand... To with an act of will synchronize covert speech by reading or thinking something syllable by syllable when I listen to a recorded sound played in intervals will generate the perception of an external voice "that retain certain acoustic features that were present in the original signal" (what I experience as "my own voice" can also be generated in response to more continuous tinnitus like or environmental sounds of a very low volume) and to without an act of will be able to synchronize covert speech with the real environmental sounds I hear can be assumed to generate the alien voices I sometimes hear in response to a distorted maybe distant voice! Quote: "In schizophrenia, functional hallucinations are defined as those that occur when a patient simultaneously receives a real stimulus in the perceptual field concerned (e.g., hallucinated voices heard simultaneously with—and specific to—the real sound of running water)... ...Another hallucinated voice occurred simultaneously with actual speech uttered by television announcers. The semantic content was the same as that of the "engine voice," but the "television voice" sounded human, exactly like the real voice of the television announcer who was speaking at the same time... ...In this patient, we observed a direct relationship between the timbre, prosody, and pitch of real environmental sounds and simultaneously perceived auditory hallucinations... ...This case suggests a further hypothesis: normal activation in the auditory system, which corresponds to neural encoding of natural-sound object and location characteristics, may be misinterpreted, leading to the false perception of functional auditory hallucinations that retain certain acoustic features that were present in the original signal..." Source: Letter to the Editor, Characteristics of Functional Auditory Hallucinations by Michael D. Hunter, M.R.C.Psych., and Peter W.R. Woodruff, Ph.D., M.R.C.P., M.R.c.Psych. Sheffield, U.K. Am J Psychiatry 161:923, May 2004 http://ajp.psychiatryonline.org/cgi/content/full/161/5/923 Each and every one of us are in response to a distorted verbal message able to restore an entire syllable and some people are syllable by syllable able to hear their own thoughts as alien voices in response to non-verbal environmental sounds corresponding to the sounds Warren and Warren used in their attempt to "isolate and clarify some fundamental processes that normally lead to accuracy of perception and appropriate interpretation of ambiguous sources"... Quote: "...These failures of perception are studied because they isolate and clarify some fundamental processes that normally lead to accuracy of perception and appropriate interpretation of ambiguous sources... ...Moreover, phonemic restorations were not limited to single speech sounds. The entire syllable “gis” in “legislatures” was heard clearly when it was replaced by an extraneous sound of the same duration... ...PHONEMIC RESTORATION is an illusion that shows the importance of context determining what sound is heard..." Source: Warren, R.M., & Warren, R.P. (1970). Auditory illusions and confusions. Scientific American, 223, 30-36. http://step.psy.cmu.edu/articles/WarrenWarren70.pdf To expect to access a verbal message in response to a slightly distorted maybe distant voice can be assumed to motivate a highly context dependent behaviour which makes it possible to restore and better distinguish a verbal message and to more frequently reward a behaviour which generates the exposure to stimulus (more ambiguous non-verbal environmental sounds) – stimulus (the sensory consequence of what I refer to as alien covert speech) contingencies can be assumed to establish a tendency to interpret what people normally ignore! (What you learn to expect or predict in response to a signal that consistently precedes a reinforcer can motivate an operant behaviour which has been established and fine tuned because it satisfies the need to access what you learn to expect! The ability to reveal a verbal illusion while you are trying to hear the voice you are about to produce may prevent this from happening by blocking the voice you are about to produce...) I assume that people more often expect to access a verbal message in response to non-verbal environmental sounds like the pitch and timbre of a distorted maybe distant voice than in response to environmental sounds with no connection to a verbal message (not coexisting with or corresponding to a distorted verbal message) and early on in the prodromal fase of this illness often experence the insidious voices I am able to hear subjectively in response to a distorted maybe distant voice. (I succeeded to simulate the circumstances needed to induce verbal illusions like these in one of my attempts to understand this better. This was done with the help of a soundfile with a lot of white noise used to mask distant voices talking in the background. An objective perception was hereby prevented, but I could still hear them talk and in real life you only need to hear a couple of words to start and fuel false beliefs... Common sense should in my opinion always be given a fair chance and M.D Hunter is a scientist who gives a more diversified and clear picture of verbal auditory hallucinations!) Quote: "A tendency to extract spurious, message-like meaning from meaningless noise was assessed as a risk factor leading to shizophrenia-spectrum disorders by assessing word length of speech illusions elicited by multispeaker babble in 43 people with prodromal symptoms..." Source: Extracting spurious messages from noise and risk of schizophrenia-spectrum disorders in a prodromal population written in British journal of psychiatry (2007), 191, 355-356 by Ralph E. Hoffman and his colleagues http://bjp.rcpsych.org/cgi/content/full/191/4/355 Quote: “Recently, it has been proposed that exaggerated top-down processing may generate spontaneous perceptual output, and that this may constitute a cognitive predisposition toward hallucinations... ...We conclude that aberrant top-down processing, particularly in the form of strong semantic expectations, may contribute to the experience of auditory-verbal hallucinations.” (My remarks: To expect to access a verbal message in response to a slightly distorted maybe distant voice can be assumed to motivate a highly context dependent behaviour which makes it possible to restore and better distinguish a verbal message and to frequently be forced to restore a verbal message may generate a tendency to expect to hear a verbal message in response to what people normally ignore...) Source: Schizophrenia Bulletin (2010) 36 (1): 151-156. Semantic Expectations Can Induce False Perceptions in Hallucination-Prone Individuals by Ans Vercammen and André Aleman http://schizophreniabulletin.oxfordjournals.org/content/36/1/151.full

My attempts to understand this illness started of several years ago in lingforum.com Post subject: Speech perception and some symptoms of schizophrenia http://www.lingforum.com/forum/viewtopic.php?t=512

Hi davidivad, to assume that auditory hallucinations can be triggered due to the exposure to stimulus - stimulus contingencies like these seem to be a rock solid idea to me...

"SCHIZOPHRENIA" (an integration disorder) - the price we pay for language? Professor Tim Crow's theory suggests that schizophrenia is the price we pay for language and I wonder if the exposure to stimulus (non-verbal) - stimulus (verbal) contingencies (classical conditioning) when you with a short delay are able to restore a verbal message or interpret what subjectively seems to be a verbal message can have such a profound effect that some people develop a mental illness. Quote:"...classical conditioning is far more subtle and relevant to complex human cognitive-emotional behavior than one might first realize..." (p. 4) Source: The Imbalanced Brain: From Normal Behavior To Schizophrenia (2000) by Stephen Grossberg http://www.cns.bu.edu/Profiles/Grossberg/Gro.BioPsy2000.pdf -------SUMMARY------- The event we call perception: Some people who hear their own thoughts as alien voices in response to non-verbal environmental sounds are able to generate the perception of an external voice "that retain certain acoustic features that were present in the original signal" and what if each and every one of us are able to use covert speech to generate the perception of an external voice "that retain certain acoustic features that were present in the original signal" when we need to restore and better distinguish a verbal message? Can the gestures you are about to produce during covert speech like the gestures you intend to produce during overt speech be used to determine (subliminally prime) what you expect to hear and can a top-down sensory expectation like this be used to select all features matching the sensory consequence you are about to produce? People who are able to generate the perception of an external voice "that retain certain acoustic features that were present in the original signal" may hear the sensory consequence of covert speech in integration with what they were able to select with a corresponding top-down sensory expectation and I am convinced that Alvin M. Liberman more than 50 years ago was correct in his assumption that the articulatory movements and their sensory effects mediate between the acoustic stimulus and the event we call perception... Alien covert speech must somehow operate on the environment in order to generate the event we call speech perception and the lost ability to generate an act of will with which you are able to consciously control covert speech with regards to a certain goal must be as essential to our ability to restore and better distinguish a verbal message as it can be devastating to people with an integration disorder referred to as schizophrenia. People who are trying to hear the voice they are about to produce may lose their ability to control covert speech because they are forced to monitor the production of the voice they are about to produce while a corresponding top-down sensory expectation in competition for limited attentional resources selects all features matching the voice they are trying to hear and to lose the ability to generate an act of will with which you are able to consciously control covert speech may serve the purpose of not letting an act of will interfere with the ability to select the gestures you need to use in response to a verbal message. Incentive motivational signals ("a type of motivationally-biased attention") may shift the allocation of processing resources from what generates the ability to consciously control covert speech (a self-monitoring or corollary discharge mechanism) to what you are able to attend with a corresponding top-down sensory expectation and the gesture you need to use (the one with the most equivalent sensory consequence you are able to produce) can be selected when what you are able to attend with a corresponding top-down sensory expectation (a competing task), more than what you are able to attend with any other to a lesser extent matching top-down sensory expectation, suppress the ability to control covert speech! (Demanding indecisiveness in response to more ambiguous stimuli (a slightly distorted verbal message) may serve the purpose of sensitizing all the gestures you select between in response to bottom-up sensory signals and the context you are exposed to and experience...) To lose the ability to generate an act of will with which you are able to consciously control covert speech is to more or less lose the ability to inhibit the gesture you are about to produce and to lose the ability to generate discharges corresponding "to nothing less than the experience of will or intention" is to lose the ability to attenuate ex- and reafference (all features matching the sensory consequence you are about to produce and the sensory consequence you produce)! People may hear their own thoughts as alien voices because bottom-up sensory signals suppress their ability to generate an act of will and some people who hear their own thoughts as alien voices in response to non-verbal environmental sounds are able to generate the perception of an external voice "that retain certain acoustic features that were present in the original signal"... What if each and every one of us are able to use covert speech to generate the perception of an external voice "that retain certain acoustic features that were present in the original signal" when we need to restore and better distinguish a verbal message? Can a mechanism which affects the outcome of competition between response tendencies generate the event we call perception in all of our senses (sight, hearing, touch, taste and smell)? From normal behavior to schizophrenia: To frequently reward a behavior which generates the exposure to stimulus (non-verbal) - stimulus (verbal) contingencies when you with a short delay are able to restore a verbal message or interpret what subjectively seems to be a verbal message can establish or maintain a tendency to interpret what people normally ignore! Any signal that consistently precedes a meal, such as a clock indicating that it is time for dinner or an appetizer, may cause us to feel hungrier than before the signal because we learn to expect a meal in response to CS and non-verbal environmental sounds that consistently precedes a verbal illusion (information) can like any signal that consistently precedes a meal become a conditioned reinforcer that can activate a drive representation D. What you learn to expect in response to a signal that consistently precedes a reinforcer can motivate an operant behavior which has been established and fine tuned because it satisfies the need to access what you learn to expect... What can increase the exposure to stimulus (non-verbal) - stimulus (verbal) contingencies like these? What will make it necessary to restore a verbal message (the exposure to noise and some hearing impairments), what will increase the exposure to more ambiguous voices (some urban environments), what may increase the need to access a verbal message (sensory deprivation, traumatic events, solitude or whatever gives you the sense of not belonging in a social context) and what will diminish our ability to generate an act of will with which we are able to consciously control covert speech with regards to a certain goal (sleep deprivation and stress can impair our ability to inhibit a verbal response and this may generate the event we call perception in response to more ambiguous stimuli). Can the exposure to stimulus (non-verbal) - stimulus (verbal) contingencies (classical conditioning) like these have such a profound effect that some people develop a mental illness? "Non-clinical populations usually experience voices with a neutral or even positive emotional content" while those who are diagnosed with schizophrenia more often experience voices expressed with a negative emotional content! I have tried to understand why some people do rather well while others are diagnosed with a mental illness in the light of the assumption that people who experience voices expressed with a neutral or even positive emotional content are trying to hear the voice they are about to produce while those who experience voices expressed with a negative emotional content are trying to avoid the voice they are about to produce by paying more attention to what they are able to hear more objectively. (To selectively be able to avoid some voices expressed with a negative emotional content by paying more attention to what you are able to hear more objectively may eventually generate a more unpleasant voice hearing experience, disorganization and negative symptoms...) People who consistently avoid the event they fear will continue to expect a fearfull event (phobia) and people who selectively are able to avoid some of the voices they hear by revealing a mismatch will continue to expect to hear the voices they were able to avoid! (A verbal illusion can be revealed when an increase in attention (incentive motivational signals) takes the sound you interpret out of its peripheral existence without generating a match between a top-down sensory expectation and bottom-up sensory signals!) To continue to expect to hear the voices you are able to avoid by revealing a verbal illusion may generate negative symptoms like poverty of speech, affective flattening and avolition (1a, 1b) and to continue to expect to hear the voices you are trying to avoid will generate the voices you are trying to avoid whenever you are unable to reveal a verbal illusion (2a, 2b). 1a.) People who reveal a mismatch between the voice they are about to produce and what they are able to hear more objectively are suddenly no longer motivated to attend all features matching the voice they are about to produce and this can improve their ability to inhibit a verbal response while the incentive to produce a verbal response which generates the event we call speech perception due to their ability to reveal a mismatch is lost. 1b.) People who previously in avoidance were able to reveal a verbal illusion may have lost the drive to produce a verbal response along with their ability to reveal a verbal illusion. 2a.) Disorganized speech/thinking in people who predominantly experience voices expressed with a negative emotional content emerge when all features matching a corresponding top-down sensory expectation are attended and in competition for limited attentional resources suppress their ability to inhibit a behavior which generates the event we call perception. The allocation of processing resources from what generates the ability to consciously control covert speech to what you are able to attend with a corresponding top-down sensory expectation must be greater when you are trying to avoid a voice with a negative emotional content than when you are trying to restore a verbal message or interpret non-verbal environmental or tinnitus like sounds with no connection to a verbal message (not coexisting with or corresponding to a distorted verbal message) and avoidance may therefore also generate a more disorganized behavior. 2b.) Some people who previously in avoidance were able to reveal a verbal illusion may hear their own thoughts as alien voices because they have lost the incentive they need to adequately monitor the production of a sensory consequence... (The gesture (and I mean whatever gesture) you are about to produce (covertly or overtly it does not matter) may eventually take on the value of what you in avoidance were able to reveal as irrelevant because it determines a top-down sensory expectation which according to previous events consistently generates a mismatch. What you are able to select with a top-down sensory expectation like this can be assumed to more easily suppress the ability to inhibit a verbal response.) The ability to consolidate and recall words can be impaired in patients with schizophrenia due to a tendency or previously present ability to reveal a verbal illusion, because they are forced to divide their attention between non-verbal irrelevant features and verbal more relevant information, because they are forced to simultaneously process ambiguous stimuli (demanding indecisiveness) and because bottom-up sensory signals affect the outcome of competition between response tendencies by suppressing the ability to generate an act of will (distractibility, loose associations and intrusion errors in memory tasks)! Positive symptoms in all of our other senses (visual hallucinations etc) emerge (or can be assumed to do so) when people frequently are able to reveal a verbal illusion and due to "unusual persistence of controlled information processing strategies" in what Grossberg refers to as a hypothesis testing cycle (mismatch -> arousal/novelty -> short term memory reset) fail to simultaneously block a neutral stimulus in compound with CS. A failure to block a neutral stimulus in compound with CS may generate the event we call perception in response more ambiguous stimuli and a tendency to interpret what people normally ignore can be maintained or established as the result of stimulus (ambiguous) - stimulus (informative) contingencies when you with a short delay are able to generate the event we call perception. ("The blocking phenomenon is one way that animals discriminate relevant stimuli from irrelevant stimuli." and a failure to block a neutral stimulus in compound with CS may influence the ability to filter out irrelevant stimuli!) Catatonic behaviors: Bottom-up sensory signals (what you are able to select in response to previously neutral ambiguous feedback) can affect the threshold for action selection by suppressing the ability to inhibit a response and this may generate aimless excess motor activity. However a movement can not be produced if bottom-up sensory signals continuously are suppressing the ability to inhibit the same response more than they suppress the ability to inhibit a new response. In other words a posture can be generated and maintained when what you are able to attend with a corresponding top-down sensory expectation (a competing task), more than what you are able to attend with any other to a lesser extent matching top-down sensory expectation, suppress the ability to inhibit a response. "Dopamine is released in order to achieve something good or to avoid something evil" and dopamine receptor antagonists are used to treat "schizophrenia"... Conditioned avoidance response (CAR) is a test with predictive validity for antipsychotic efficacy, but negative symptoms are very hard to treat and I wonder if this can be explained with the assumtion that negative symptoms predominantly depend on that you previously in avoidance were able to reveal a verbal illusion. An already stigmatized experience can be connected to an even more stigmatized illness, but most people who hear auditory hallucinations do not meet the diagnostic criteria for schizophrenia! The road to recovery: The ability to frequently reveal a mismatch will allow you to inhibit a verbal or non-verbal behavior which overtly or covertly generates the event we call perception in response to a previously neutral stimulus and the occurrences of a conditioned response (CR - when a conditioned reinforcer triggers the need to access a sensory consequence) will eventually decrease or disappear if a conditioned reinforcer (a previously neutral stimulus) due to the ability to reveal a mismatch no longer is paired with a primary reinforcer (information brought to awareness when the event we call perception is generated in response to a previously neutral stimulus), but only in people who frequently are able to reveal a mismatch while they are trying to attend the sensory consequence they are about to produce! (To change the context you are exposed to and experience may generate a more positive voice hearing experience and this may result in that some people regain the incentive they need to adequately monitor the production of a sensory consequence while it strengthens "a type of motivationally-biased attention" which improves their ability to reveal a verbal illusion... )