Abstract
Typically reported as vivid, multisensory experiences which may spontaneously resolve, hallucinations are present at high rates during childhood. The risk of associated psychopathology is a major cause of concern. On the one hand, the risk of developing further delusional ideation has been shown to be reduced by better theory of mind skills. On the other hand, ideas of reference, passivity phenomena, and misidentification syndrome have been shown to increase the risk of self-injury or heteroaggressive behaviors. Cognitive psychology and brain-imaging studies have advanced our knowledge of the mechanisms underlying these early-onset hallucinations. Notably, specific functional impairments have been associated with certain phenomenological characteristics of hallucinations in youths, including intrusiveness and the sense of reality. In this review, we provide an update of associated epidemiological and phenomenological factors (including sociocultural context, social adversity, and genetics, considered in relation to the psychosis continuum hypothesis), cognitive models, and neurophysiological findings concerning hallucinations in children and adolescents. Key issues that have interfered with progress are considered and recommendations for future studies are provided.
Highlights
Seeing, hearing, touching, smelling, or tasting constitute some of the earliest experiences of life, to which may be added experiences of internal origin such as emotions
Considering this framework, how do children apprehend their sensory environment, before the development of the meta-representational skills purported to be necessary in distinguishing reality from fantasy? At what age may hallucinations, defined as erroneous percepts in the absence of identifiable stimuli, initially be observed? Do they occur in drowsiness, wakefulness, or in more than one state? Are all of these experiences pathological, when considered in the context of typical child development?
It is commonly considered that hallucinations are difficult to assess in children before the acquisition of good language skills
Summary
Seeing, hearing, touching, smelling, or tasting constitute some of the earliest experiences of life, to which may be added experiences of internal origin such as emotions. Perception involves bottom-up sensory processing and inferential, top-down processes, leading to the optimal combination of new sensory inputs with prior knowledge. In this sense, recent neuroscientific progress converges with philosophical views stating that the physical world is only partially accessible to the subject and is always accessed through a strongly subjective prism. Recent neuroscientific progress converges with philosophical views stating that the physical world is only partially accessible to the subject and is always accessed through a strongly subjective prism Considering this framework, how do children apprehend their sensory environment, before the development of the meta-representational skills purported to be necessary in distinguishing reality from fantasy? The purpose of this article is to systematically review studies on childhood and adolescent hallucinations and attempt to synthesize the main results, emphasize the problems that have interfered with progress, and make recommendations for future research
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