TY - JOUR
T1 - Hallucinations Beyond Voices
T2 - A Conceptual Review of the Phenomenology of Altered Perception in Psychosis
AU - Pienkos, Elizabeth
AU - Giersch, Anne
AU - Hansen, Marie
AU - Humpston, Clara
AU - McCarthy-Jones, Simon
AU - Mishara, Aaron
AU - Nelson, Barnaby
AU - Park, Sohee
AU - Raballo, Andrea
AU - Sharma, Rajiv
AU - Thomas, Neil
AU - Rosen, Cherise
N1 - © The Author(s) 2019
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Recent psychiatric research and treatment initiatives have tended to move away from traditional diagnostic categories and have focused instead on transdiagnostic phenomena, such as hallucinations. However, this emphasis on isolated experiences may artificially limit the definition of such phenomena and ignore the rich, complex, and dynamic changes occurring simultaneously in other domains of experience. This article reviews the literature on a range of experiential features associated with psychosis, with a focus on their relevance for hallucinations. Phenomenological research on changes in cognition, perception, selfhood and reality, temporality, interpersonal experience, and embodiment are discussed, along with their implications for traditional conceptualizations of hallucinations. We then discuss several phenomenological and neurocognitive theories, as well as the potential impact of trauma on these phenomena. Hallucinations are suggested to be an equifinal outcome of multiple genetic, neurocognitive, subjective, and social processes; by grouping them together under a single, operationalizable definition, meaningful differences in etiology and phenomenology may be ignored. It is suggested that future research efforts strive to incorporate a broader range of experiential alterations, potentially expanding on traditional definitions of hallucinations. Relevance for clinical practice, including emphasizing phenomenologically responsive techniques and developing targeted new therapies, is discussed.
AB - Recent psychiatric research and treatment initiatives have tended to move away from traditional diagnostic categories and have focused instead on transdiagnostic phenomena, such as hallucinations. However, this emphasis on isolated experiences may artificially limit the definition of such phenomena and ignore the rich, complex, and dynamic changes occurring simultaneously in other domains of experience. This article reviews the literature on a range of experiential features associated with psychosis, with a focus on their relevance for hallucinations. Phenomenological research on changes in cognition, perception, selfhood and reality, temporality, interpersonal experience, and embodiment are discussed, along with their implications for traditional conceptualizations of hallucinations. We then discuss several phenomenological and neurocognitive theories, as well as the potential impact of trauma on these phenomena. Hallucinations are suggested to be an equifinal outcome of multiple genetic, neurocognitive, subjective, and social processes; by grouping them together under a single, operationalizable definition, meaningful differences in etiology and phenomenology may be ignored. It is suggested that future research efforts strive to incorporate a broader range of experiential alterations, potentially expanding on traditional definitions of hallucinations. Relevance for clinical practice, including emphasizing phenomenologically responsive techniques and developing targeted new therapies, is discussed.
KW - Hallucinations/etiology
KW - Humans
KW - Models, Theoretical
KW - Psychotic Disorders/complications
KW - Schizophrenia/complications
U2 - 10.1093/schbul/sby057
DO - 10.1093/schbul/sby057
M3 - Review article
C2 - 30715544
SN - 0586-7614
VL - 45
SP - S67-S77
JO - Schizophrenia bulletin
JF - Schizophrenia bulletin
IS - 45 Suppl 1
ER -