Schizophr Bull
February 1, 2019
Elizabeth Pienkos, Anne Giersch, Marie Hansen et al.
93 citations
Hallucinations are often studied as isolated symptoms, but this review argues that they emerge from a broader set of changes in cognition, perception, selfhood, time, interpersonal experience, and embodiment. The authors suggest that grouping different hallucinatory experiences under a single definition may obscure meaningful differences in their causes and subjective qualities. They review phenomenological and neurocognitive theories and the role of trauma, proposing that hallucinations are an equifinal outcome of multiple genetic, neurocognitive, subjective, and social processes. Future research should incorporate a wider range of experiential alterations, and clinical practice should use phenomenologically responsive techniques and develop targeted therapies.
The lancet. Psychiatry
February 1, 2026
Rosa Ritunnano, Jeannette Littlemore, Barnaby Nelson et al.
8 citations
Delusions in first-episode psychosis are not isolated symptoms but emerge from a global shift in how a person experiences self and world, shaped by early negative emotions like shame. In a qualitative study of ten adults, persecutory, reference, and grandiose or religious themes were common and overlapping. Narrative interviews revealed that recurrent shame, anger, and fear, along with efforts to avoid or immerse in these emotions, preceded delusions. Three emotional transformation patterns were identified: from embodied shame to invincibility, from meaninglessness to love and hope, and feeling cut off in a simulation. Delusions reflect an embodied, temporal process where bodily experiences link to extreme appraisals, such as being a bad person or connected to God. Interventions should target the lived body and social environments for emotional regulation.
Cognitive Neuropsychiatry
January 1, 2022
Sam Wilkinson, Huw Green, Stephanie Hare et al.
8 citations
Philosophy contributes to hallucinations research in three distinct ways. Phenomenology provides a sophisticated, critical understanding of the lived experience of hallucinations. Philosophy of cognitive science enables big-picture theorizing, synthesis of ideas, and critical engagement with new paradigms. Philosophy of science and psychiatry raises theoretically informed questions about diagnosis and categorization. These contributions reflect philosophy's methodological variety and its relevance to hallucinations researchers.
Psychology and psychotherapy
March 1, 2025
Charlotte Aynsworth, Felicity Waite, Samuel Sargeant et al.
4 citations
Among people with psychosis, visions most often depict people who behave and appear real, making them indistinguishable from actual perception. In interviews with twelve participants, three key features emerged: the content of visions is typically people; these people act coherently, often speaking or touching the observer; and the visions possess a compelling authenticity. This combination explains why visions are so absorbing and distressing, and the framework of Content, Coherence, and Quality offers clinicians a practical way to explore these experiences.
BJPsych Open
September 1, 2024
Hannah Gofton, Henrietta Rodriguez, Trinity Sheridan-Guest et al.
3 citations
Thought interference and auditory-verbal hallucinations (AVHs) in childhood and adolescence are associated with suicidal thoughts and behaviors and with clinically significant delusions of control and AVHs at age 24. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), the study assessed these experiences at ages 11–16 and outcomes at age 24. Substance use-induced psychotic-like experiences mediated a large proportion of the relationship between early psychotic-like experiences and later suicidality. The authors conclude that mental health interventions for children and adolescents should account for specific psychotic-like experiences to enable early detection.
Schizophrenia Bulletin
April 10, 2026
Cherise Rosen, Liping Tong, Julia G. Lebovitz et al.
Depersonalization (DP) and derealization (DR) are alterations in sense of self and lifeworld that often co-occur in psychosis. Over 20 years, the Chicago Longitudinal Study examined these phenomena across psychiatric categories. DP was broadly distributed across diagnoses, while DR showed greater specificity to schizophrenia. Network analyses revealed three foundational constructs in schizophrenia: alteration in sense of self/lifeworld, multisensory experiences, and bodily experiences; bodily and multisensory alterations were foundational in affective-psychosis. Self-disturbance emerged as foundational only in schizophrenia. The findings support reframing DP and DR as points on a continuum of attenuated alterations in sense of self and lifeworld, representing a fundamental self-disturbance in existential feeling.
Lancet Psychiatry
May 1, 2022
R. Ritunnano, Joshua J. Kleinman, Danniella Whyte Oshodi et al.
Delusions in psychosis are best understood as highly individual and complex phenomena arising from a dynamic interplay of biological, personal, social, and cultural processes. A systematic review and qualitative synthesis of 24 studies representing 373 help-seeking individuals with psychosis identified three key themes: a radical shift in the lived world dominated by intense emotions; a process of doubting, losing, and rediscovering oneself within delusional realities; and a search for meaning, belonging, and coherence beyond mere dysfunction. The findings propose an Emergence Model of Delusion, suggesting that effective clinical care should account for the subjective experience and meaning of delusions, which may also address power imbalances and epistemic injustices in mental health.