Abstract

Auditory verbal hallucinations are among the most characteristic and clinically significant symptoms of psychotic disorders; however, the mechanisms underlying the formation of their content—particularly its hostile and threatening nature—remain insufficiently understood. The present article proposes a theoretical model that explains the aggressive and threatening content of auditory hallucinations through a mechanism of fear-driven misattribution of inner speech. According to the proposed concept, impairment in the recognition of authorship of inner speech leads to its perception as alien, thereby activating evolutionarily grounded threat-detection systems. The resulting fear is conceptualized not as a secondary emotional reaction, but as an active generative factor that shapes the content of perceived voices through subconscious simulation of potential danger. These simulations are experienced as external utterances, giving rise to a self-sustaining cycle of “alien voice – fear – hostile content.” The model integrates findings on the role of traumatic experience, individual differences in the thematic content of voices, and the sensory vividness of hallucinatory experiences. The proposed approach supports a continuum-based view of the boundary between norm and pathology and carries important clinical implications, particularly for psychotherapeutic interventions aimed at reducing fear and restoring a sense of authorship over internal experiences.