Abstract Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli that in individuals with schizophrenia very often feature distressing contents. AVH frequently interfere with social relationships or result in dangerous behaviours. We hypothesize that in schizophrenia several vulnerability factors, especially when a subject is engaged in real or represented interpersonal transactions, lead to the appearance of AVHs, and favour their self-perpetuation over time. We analyse the different psychological factors that, according to empirical studies and clinical experience with persons with schizophrenia, seem involved in the genesis of AVHs. Several vulnerability factors appear to interact with situational ones to trigger AVHs: a) a facilitation of neural transmission from the premotor regions to the perceptual ones; b) a difficulty attuning with others, c) interpersonal schemas, provoking emotional suffering, intrusive thoughts and rumination; d) metacognitive dysfunctions. Once AVHs have appeared, further factors promote their perpetuation over time: a) cognitive factors like ruminative processing on AVHs, b) metacognitive beliefs about AVHs. An integrated theoretical model of AVHs is described and ideas for its empirical testing are suggested.

中文翻译：

---

精神分裂症中听觉言语幻觉的主体间多因素模型

摘要 听觉言语幻觉 (AVHs) 是在没有适当刺激的情况下发生的类似感知的体验，精神分裂症患者通常具有令人痛苦的内容。AVH 经常干扰社会关系或导致危险行为。我们假设精神分裂症中的几个脆弱因素，特别是当一个主体从事真实的或代表的人际交易时，会导致 AVH 的出现，并有利于他们随着时间的推移自我延续。根据对精神分裂症患者的实证研究和临床经验，我们分析了不同的心理因素，这些因素似乎与 AVH 的发生有关。几个脆弱性因素似乎与情境因素相互作用以触发 AVH：a) 促进从运动前区到知觉区的神经传递；b) 难以与他人协调， c) 人际关系图式，引发情感痛苦、侵入性想法和沉思；d) 元认知功能障碍。一旦 AVH 出现，进一步的因素会随着时间的推移促进其持续存在：a) 认知因素，如对 AVH 的反刍处理，b) 关于 AVH 的元认知信念。描述了 AVH 的综合理论模型，并提出了其经验测试的想法。b) 关于 AVH 的元认知信念。描述了 AVH 的综合理论模型，并提出了其经验测试的想法。b) 关于 AVH 的元认知信念。描述了 AVH 的综合理论模型，并提出了其经验测试的想法。