Mobile RDoC: Using Smartphone Technology to Understand Auditory Verbal Hallucinations

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Project Summary Auditory Verbal Hallucinations (AVH) occur in the context of a range of mental health conditions as well as in individuals who are otherwise considered healthy. AVH lead to significant distress, impairment, and need for care in some, but not others. The RDoC framework is ideally suited to better understand the phenomenology of AVH as they may be part of a continuum of psychotic experience ranging from “normal” to pathological. Building on the principles of the RDoC framework, the proposed project focuses on AVH as part of the broader construct of Auditory Perception and leverages an integrative multi-method paradigm leveraging measures from two RDoC units of analysis: Self-Report and Behavior. Our multidisciplinary investigative team proposes to use integrated mobile data collection techniques that we have piloted extensively (Ecological Momentary Assessment for self-report and automated multi-modal sensing to capture behavior) to study AVH experience and associated behaviors, as they occur in real-time/real-place in people with and without need for care. We propose to use innovative online and community-based participant recruitment strategies that we have piloted in relevant populations to enroll a clinically diverse sample of individuals with AVH. Participants will be provided with an integrated smartphone data collection system and will actively self-report AVH experiences and associated variables as they occur in real-time using EMA. Smartphones will also passively collect multi-modal behavioral sensing data continuously. We will combine both forms of data to examine the extent to which temporal relationships between self-reported AVH and behavioral measures vary across both groups. Specifically, we aim to: evaluate whether clinical status is associated with how AVH is experienced in real- time/real-place; examine relationships between demographic, functional, and immediate social/contextual factors and AVH; and test time-varying relationships posited in a cognitive model of psychosis between AVH appraisal, affect, and behavioral response. The study will advance our understanding of the phenomenology of AVH and move us closer to understanding why some develop impairment and need for care, while others do not. Findings may help inform the subsequent development of prevention strategies for subclinical populations so they do not progress in the psychotic trajectory, as well as inform more targeted treatments for individuals who already require treatment. If successful, the project will demonstrate the utility of applying the RDoC framework and integrated methodological approach in psychosis research.