Childhood hallucinations are surprisingly common - but why?
小児期の幻覚は驚くほど一般的ですが、なぜでしょうか? 多くの子供たちは声を聞いたり、ビジョンを見たりします。 通常は何も心配する必要はありませんが...(English) Childhood hallucinations are surprisingly common - but why? Many children hear voices or have visions. Usually, there is nothing to worry about...
Childhood hallucinations are surprisingly common - but why?
1)
Childhood has long been touted as a time for fantasy. But recent research has shown that another form of unreality - hallucinations - is more common in children than we previously thought.
For years, children's reports of seeing, hearing and experiencing things that weren't there were considered part of the same invented world - an 'overactive imagination', a 'fantasy world'.
The Alice in Wonderland approach, perhaps. But once it was recognised that hallucinations in children could be reliably identified, science began to look at why these illusory experiences are many times more common in our early years.
2)
Hallucinations often reflect a bizarre, blurred version of our reality, and because play is an everyday reality for children, the content can seem similar.
Both can include eccentric characters and strange scenarios and inspire curious behaviour. One child described seeing a wolf in the house; another said that "yahoos" lived there and ate all his medicine.
This could be a child's imagination, but real hallucinations have a different flavour. "In play and fantasy, children are imagining things," says Elena Garralda, professor of child and adolescent psychiatry at Imperial College London.
"They do not have the perceptual experience of seeing and hearing." Another key difference, says Garralda, is that "hallucinations feel imposed, and children have no direct control over them".
3)
Recent studies have produced some surprising statistics about how common they are. A UK study found that almost two-thirds of children reported having at least one "psychotic-like experience" in their lives, including unchangeable and unrealistic beliefs and fears.
Focusing on hallucinations alone, a review of research found that 17% of 9-12-year-olds have these experiences at any one time.
The number halves in teenagers and then drops again in adults.
This type of research focuses on selected experiences because they can occur in adult mental health problems, such as hearing voices, which are only a tiny part of the possible range of hallucinations; these figures are likely to be a low estimate.
4)
Interestingly, hallucinations become less common as we move into adulthood.
Because very young children are harder to test and have not been studied as extensively, it's unclear whether we start in a more hallucinatory world that becomes more stable with age or whether middle childhood is a peak time for unreal experiences.
Despite its reputation for causing emotional chaos, puberty could be a stabilising force on our perceptions.
5)
Let's take a breather at this point - a sanity check, if you will - because many people get worried when they think about the possibility of their child hallucinating.
These numbers don't mean a child who hallucinates is sick or unwell. In most cases, children's hallucinations disappear within a few days or weeks and are nothing to worry about.
Childhood hallucinations are often triggered by life stress, poor sleep and periods of low mood, which disappear when the problematic situations end. However, it may be time to seek professional help if the hallucinations are distressing or persistent.
6)
Renaud Jardri has seen many children with hallucinations in his clinical practice. He also researches the subject as a Child and Adolescent Psychiatry Professor at the University of Lille School of Medicine.
The criteria, he says, for judging whether a child needs professional help are whether the hallucinations are "frequent, complex, distressing and causing impairment". For Jardri, hallucinations associated with positive emotions that don't interfere with the child's friendships and family life are usually benign.
7)
In rare cases, medical problems may be the cause. Epilepsy can cause hallucinations, as can sleep disorders that affect consciousness and force the dream world to invade waking hours.
For reasons that aren't entirely clear, severe psychosis, represented by diagnoses such as schizophrenia, is extremely rare in young children.
But when it does occur, the hallucinations can be striking and frightening.
The six-year-old who described having yahoos inside him was one of those rare cases; he heard them talking to him all the time, feared being poisoned, believed he could cast spells, smelled 'bugs' in the tap water and saw non-existent tracks in the snow.
This is a far cry from the more common fear of "monsters under the bed" or isolated hallucinations that fade over time.
8)
Then some imaginary friends are not hallucinations but vivid fantasies that have been the subject of much adult hand-wringing over the years.
They have therefore been surprisingly well researched, and I am delighted to live in a world of natural, imaginary friends as if Roald Dahl were alive and funding a research institute.
It turns out that children with imaginary friends tend to have better social skills and more developed language skills than children without imaginary friends.
Nor, the research shows, are these imaginary companions compensated for the lack of real friends. They seem to reflect a child's brain working overtime, expending excess energy, enjoying the limits of imagination and playing with the possibilities of the social world.
Childhood hallucinations are surprisingly common – but why?
Add info No1)
Prevalence and correlates of auditory vocal hallucinations in middle childhood
Abstract
Background
Hearing voices occurs in middle childhood, but little is known about the prevalence, aetiology and immediate consequences.
Aims
To investigate the prevalence, developmental risk factors and behavioural correlates of auditory vocal hallucinations in 7- and 8-year-olds.
Method
Auditory vocal hallucinations were assessed with the Auditory Vocal Hallucination Rating Scale in 3870 children. Prospectively recorded data on pre- and perinatal complications, early development and current problem behaviour were analysed in children with auditory vocal hallucinations and matched controls.
Results
The 1-year prevalence of auditory vocal hallucinations was 9%, with substantial suffering and problem behaviour reported in 15% of those affected. Prevalence was higher in rural areas, but auditory verbal hallucinations were more severe and had a more significant functional impact in the urban environment. There was little evidence for associations with developmental variables.
Conclusions
Auditory vocal hallucinations in 7- and 8-year-olds are prevalent but mostly of limited functional impact. Nevertheless, there may be continuity with more severe psychotic outcomes given the profound suffering in a subgroup of children, and there is evidence for a poorer prognosis in an urban environment.
Future research
Auditory vocal hallucinations in young children are prevalent, but most children experience no or only mild subjective burden. Nevertheless, there may be a degree of continuity with more severe psychotic outcomes in children who suffer severely, in children hearing third-person voices and in children scoring in the clinical range of the CBCL. Therefore, this cohort will be followed into adulthood to study the course of hallucinatory experiences and the possible relationship with behavioural problems and to determine the predictive value of auditory vocal hallucinations for later psychiatric disorders.
Add info No2)
Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357982/
In 2014, Jardri and colleagues1 synthesised research results on childhood and adolescent hallucinations as part of the International Consortium on Hallucination Research (ICHR) working group and provided practical recommendations for future research.
Social and Cultural Factors
Trauma and adverse life events are associated with hallucinations in a bidirectional dose-response relationship. Trauma is also related to the persistence of hallucinations. However, most children and adolescents experiencing maltreatment do not develop hallucinations, and not every child or adolescent with hallucinations has experienced adverse life events. However, these studies suggest that children exposed to a current or past traumatic event(s) are more vulnerable to voices' presence and potential persistence. Moreover, discontinuing adverse life events predicts discontinuation of hallucinations,50 providing an opportunity for targeted intervention strategies, such as programs against bullying.
Hallucinations are typically understood differently when comparing European and African samples. However, there are sparse studies of cultural factors in hallucinations involving children and adolescents. Adriaanse et al. examined the prevalence and impact of PE in a large community sample of ethnic minority and majority youth in the Netherlands. They found that minority children had a 2- to 3-fold higher prevalence of PE with high impact than Dutch peers. In addition, religious beliefs and experiences may also influence prevalence estimates. For example, one study found that moderately religious adolescents were more likely to report and develop hallucinations than nonreligious adolescents. It was speculated that religious rituals and activities could have been adopted to appraise or cope with their hallucinations. These findings point to the need to assess ethnic and cultural context when constructing intervention strategies for young people.