Adult report of childhood imaginary companions and adversity relates to concurrent prodromal psychosis symptoms

Paige E Davis,Lisa A.D Webster,Charles Fernyhough,Kevin Ralston,Susanna Kola-Palmer,Helen J Stain

doi:10.1016/j.psychres.2018.11.046

Abstract

Hallucination and dissociation have been found to be associated with imaginary friend play in childhood (CIC). Past studies have not investigated how this play relates to adult prodromal symptoms or how childhood adversity mediates the relationship. CIC play was examined in 278 participants, 18–24 years. CIC status predicted prodromal symptoms of hallucination only, whereas childhood adversity predicted all other symptoms. Mediation analysis found CIC's relation to hallucination symptoms was partially mediated by childhood adversity. Findings fit with views that CIC are a positive childhood experience which may convert to a negative developmental trajectory through the impact of childhood adversity.

Highlights

Childhood imaginary companion (CIC) play is a positive normative experience which has been found to relate to skills such as better theory of mind (Taylor and Carlson, 1997), emotional understanding (Giménez-Dasi et al, 2016) and mental state orientation (Davis et al, 2014) in children who create these entities
Of the 278 students, 224 reported on CIC status. 62 (22%) reported CIC play, with one removed because the CIC was described as a result of psychosis
Reporting concurrent prodromal symptoms of hallucination/perceptual abnormality was associated with self-report of CICs

Summary

Introduction

Childhood imaginary companion (CIC) play is a positive normative experience which has been found to relate to skills such as better theory of mind (Taylor and Carlson, 1997), emotional understanding (Giménez-Dasi et al, 2016) and mental state orientation (Davis et al, 2014) in children who create these entities. Children with imaginary companions have been found to score higher on early dissociation scales (Carlson et al, 2008), and to hear more words in an ambiguous voice stimuli aimed at simulating auditory hallucination-like experiences (Fernyhough et al, 2007). Our aim was to relate adult university students’ report of CIC play to the reporting of different prodromal symptoms (hallucination, perceptual abnormalities, negative symptoms), taking into account childhood adverse experiences. Childhood adversity paired with high imagination has been hypothesised to be a predisposing factor in dissociation as well as predictive of prodromal symptoms in adulthood (Carlson et al, 2008; Varese et al, 2012)

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