The Effects of Sex and Age of Onset on Multimodal Hallucinations and Command Hallucinations in People with Schizophrenia and Schizophrenia-Spectrum Disorders

Date of Award


Degree Name

M.A. in Clinical Psychology


Department of Psychology


Julie Walsh-Messinger


This study assesses sex and age of onset of illness differences for two possible positive symptoms (i.e., multimodal and command hallucinations) of schizophreniaspectrum disorders that have not received extensive research despite their implications for the population experiencing them and the general population. Multimodal hallucinations are when an individual with psychosis experiences hallucinations in two or more sensory modalities (Toh et al., 2019). These hallucinations can be related or concurrent but do not have to be (Toh et al., 2019). Multimodal hallucinations are receiving increased attention and validation as awareness of their prevalence in the schizophrenia-spectrum population increases (McCarthy-Jones et al., 2017). Command hallucinations are a type of auditory hallucination where a voice tells the person having the hallucination what to do (Braham et al., 2004). These hallucinations occur with relative frequency (Braham et al., 2004) and can be related to self-harm (Rogers et al., 2002), harm of others (McNiel et al., 2000; Rogers et al., 2002), and severe personal distress (Ellet et al., 2017). Differences in sex and age of onset of illness were assessed because of the literature supporting their effects on other symptomology in schizophrenia-spectrum disorders. Patients in an inpatient schizophrenia research unit 3 were interviewed with three semi-structured interviews. This study did not find evidence of a relationship between sex or age of onset of illness and the number of hallucination sensory modalities reported. Additionally, sex and age of onset of illness did not appear to impact whether individuals in this sample had command hallucinations. Further research would be needed to determine whether these factors are important to multimodal and command hallucinations.


Clinical Psychology, Schizophrenia, schizophrenia-spectrum, multimodal hallucinations, command hallucinations, sex differences, age of onset

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