Abstract

Hallucinations are among the most impressive of psychopathological symptoms and may appear in all the sensory modalities. They are the most common symptom in schizophrenia, where patients usually experience auditory hallucinations, often hearing voices which speak to them in direct communication or in the form of running commentary. One of the major research strategies in psychopathology during the last years has become the neuropsychological reconstruction of psychopathological symptoms in order to detect basic “core” deficits of the different symptoms. Given the successful identification of such core deficits, they may then serve as heuristic tools to identify candidate brain regions of putative pathology. These brain sites in turn can be explored with respect to their impact for the pathogenesis of schizophrenia. Among these neuropsychological approaches, one of the most prominent concepts reconstructing schizophrenic symptomatology is the concept of a self-monitoring disturbance, based on the conceptual and empirical work of the group around Christopher Frith. Although this conceptualization is evidence-based and appears plausible, it does not fully explain the high degree of certainty or confidence with which schizophrenic patients usually judge the reality status of their hallucinations and the frequency with which the latter might occur. The concept of self-monitoring disturbance thus provides a necessary but not a sufficient theoretical account of how hallucinations are generated.