Comparing the characteristics of hallucinations and mental imagery: a large cross-sectional study in the general population.
Guillaume Pepin, Hélène Lœvenbruck, Alan Chauvin, Camille Jacquet, Jean-Baptiste Eichenlaub, Catherine Bortolon
Consciousness and Cognition 2026 DOI: 10.1016/j.concog.2025.103974 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Preregistered Peer reviewed |
|---|---|
| Sample size | 1,951 |
| Population | French-speaking adults |
| Topics | Philosophy of mind |
| Keywords | Continuum of experience Hallucinations Inner experience Mental imagery Psychosis |
| Key findings | Involuntary mental imagery is more frequent, vivid, and self-generated than hallucinations, while hallucinations are more distressing and externally attributed, supporting a shared experiential continuum with distinct phenomenological profiles. |
Abstract
Hallucinations (HAs), the perceptual experiences that occur without external stimuli, are classically associated with psychiatric disorders, but also occur in the general population. Involuntary mental imagery (IMI), the spontaneous occurrence of visual or auditory mental content, shares several features with HAs. The continuum hypothesis suggests that these phenomena exist on a spectrum ranging from benign to clinically significant experiences. However, the precise boundaries of these phenomena remain under-explored. This pre-registered cross-sectional study focusing on the experiential continuum, involved 1,951 French-speaking adults who completed an online questionnaire assessing the frequency and characteristics of their HAs and IMI experiences. These experiences could include hearing music or voices, or seeing shadows. Participants rated ten phenomenologically-informed dimensions, including vividness, emotional valence, controllability, distress, agency, and perceived location. Associations were tested using Spearman correlations and Wilcoxon tests with Bonferroni correction. IMIs were significantly more frequent than HAs and were rated as more vivid, emotionally positive, and self-generated. In contrast, HAs were associated with greater distress and external attribution. Moderate to strong correlations between HAs and IMIs on most dimensions support the hypothesis of a shared experiential continuum. However, the fact that confidence and agency cannot be fully separated from controllability raises questions about cognitive models of self-monitoring and metacognition. These findings provide empirical evidence for both convergence and divergence in the phenomenological profiles of HAs and IMIs. Refining these distinctions could enhance theoretical models of hallucinatory experiences and facilitate the early identification and prevention of distressing internal phenomena in individuals at risk.
Comparable studies
Other cross-sectional and survey studies on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Survey of entity encounter experiences occasioned by inhaled N,N-dimethyltryptamine: Phenomenology, interpretation, and enduring effects. People who had a memorable entity encounter after taking N,N-dimethyltryptamine | 2020 | Survey | n = 2,561 |
| Future directions in meditation research: Recommendations for expanding the field of contemplative science Meditators | 2018 | Cross-sectional online survey | n = 1,120 |
| The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams | 2014 | Online survey | n = 684 |
| The neurophenomenology of early psychosis: An integrative empirical study. Ultra-high risk for psychosis patients, first episode psychosis patients, and healthy... | 2019 | Cross-sectional | n = 123 |
| Spontaneous Spiritual Awakenings: Phenomenology, Altered States, Individual Differences, and Well-Being People reporting their most powerful Spontaneous Spiritual or Kundalini Awakening | 2021 | Mixed within and between-participants self-report survey design | n = 152 |
Citations in the library
Cites 10
- Auditory verbal hallucinations and continuum models of psychosis: A systematic review of the healthy voice-hearer literature Clinical Psychology Review November 1, 2016
- Visual hallucinations in psychosis: What do people actually see? Psychology and Psychotherapy Theory Research and Practice March 1, 2025
- The brief mind wandering three-factor scale (BMW-3) October 16, 2023
- Unconscious mental imagery. Philosophical transactions of the Royal Society of London. Series B, Biological sciences December 14, 2020
- Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes. Schizophrenia Bulletin November 21, 2016
and 5 more in the library