2026 ECNP Congress

PS04-4227

Auditory and visual distortions in schizophrenia: associations with positive symptoms and hallucination proneness across modalities

Judy Thompson — H. Dennis, M. Elacqua, M. Dougherty, Z. Pittman, E. Lalor, S. Silverstein · University of Rochester Medical Center, Psychiatry and Neuroscience, Rochester, United States

2026 ECNP Congress

Background

It is well-established that schizophrenia (SZ) is characterized by disturbances in perceptual processing, including in the auditory and visual modalities. In addition to the impairments documented by laboratory-based measures, phenomenological and case-study reports have long chronicled a wide variety of subjectively-reported perceptual anomalies in this condition. However, there are few quantitative studies of self-reported perceptual distortions in established psychotic disorders such as SZ. Thus, we sought to: 1) examine group differences in the frequency of self-reported auditory and visual distortions between SZ participants with and without auditory hallucinations; and 2) characterize the associations of auditory and visual distortions with positive symptoms and hallucination proneness across modalities in SZ.

Methods

Thus far, we have assessed 41 participants with SZ (specifically 22 with auditory hallucinations [AH+] and 19 without auditory hallucinations [AH-]), along with 46 healthy controls (HC), for this in-progress study. Data on self-reported auditory and visual distortions are being collected with the Audio-Visual Abnormalities Questionnaire (AVAQ), which assesses the frequency of a wide range of perceptual distortions experienced in the last year. Current symptom severity was measured with the Brief Psychiatric Rating Scale (BPRS), and lifetime hallucinatory experiences were assessed with the Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ), to index hallucination proneness. Group differences in subscale and total AVAQ scores were examined using Mann Whitney U tests, and associations of AVAQ scores with symptom severity and hallucination proneness were assessed using Spearman correlation analyses.

Results

As expected, auditory, visual, and total AVAQ scores were significantly higher in the SZ compared to healthy control group (all p < .001; Cohen’s d > 0.72). Within the SZ group, these AVAQ scores were significantly higher among AH+ compared to AH- participants (all p < .021; Cohen’s d > 0.75). Among SZ participants, higher AVAQ scores were significantly associated with more severe positive symptoms (all rs > .325, p < .041), whereas they were not significantly related to BPRS negative, disorganized, affective, or activation symptoms. Examination of individual BPRS positive symptoms indicated specific associations between higher AVAQ scores and more severe hallucinations (all rs > .383, p < .015). In both the SZ and HC groups, higher visual and total AVAQ scores were significantly associated with higher hallucination proneness across all modalities assessed, including olfactory, gustatory, and tactile (SZ: all rs > .613, p < .001; HC: all rs > .352, p < .026), as well as more frequent sensed presence experiences (SZ: all rs > .438, p < .007; HC: all rs > .323, p < .042).

Conclusions

These results are consistent with theoretical and empirical accounts that link perceptual distortions and positive symptoms in schizophrenia. Furthermore, they contribute novel information regarding associations between visual distortions and hallucinatory experiences across multiple modalities, including sensed presence experiences, in both SZ participants and HC.

References

No references