Imaginary Companions, Inner Speech, and Auditory Verbal Hallucinations: What Are the Relations?

Abstract

Interacting with imaginary companions (ICs) is now considered a natural part of childhood for many children, and has been associated with a range of positive developmental outcomes. Recent research has explored how the phenomenon of ICs in childhood and adulthood relates to the more unusual experience of hearing voices (or auditory verbal hallucinations, AVH). Specifically, parallels have been drawn between the varied phenomenology of the two kinds of experience, including the issues of quasi-perceptual vividness and autonomy/control. One line of research has explored how ICs might arise through the internalization of linguistically mediated social exchanges to form dialogic inner speech. We present data from two studies on the relation between ICs in childhood and adulthood and the experience of inner speech. In the first, a large community sample of adults ( N = 1,472) completed online the new Varieties of Inner Speech – Revised (VISQ-R) questionnaire ( Alderson-Day et al., 2018 ) on the phenomenology of inner speech, in addition to providing data on ICs and AVH. The results showed differences in inner speech phenomenology in individuals with a history of ICs, with higher scores on the Dialogic, Evaluative, and Other Voices subscales of the VISQ-R. In the second study, a smaller community sample of adults ( N = 48) completed an auditory signal detection task as well as providing data on ICs and AVH. In addition to scoring higher on AVH proneness, individuals with a history of ICs showed reduced sensitivity to detecting speech in white noise as well as a bias toward detecting it. The latter finding mirrored a pattern previously found in both clinical and nonclinical individuals with AVH. These findings are consistent with the view that ICs represent a hallucination-like experience in childhood and adulthood which shows meaningful developmental relations with the experience of inner speech.

Susceptibility to auditory hallucinations is associated with spontaneous but not directed modulation of top-down expectations for speech.

“…Specifically, there is evidence to suggest that having an IC as a child is associated with both elevated hallucination-proneness and bias in auditory signal detection skills as an adult (Fernyhough et al, 2019). In addition, children with ICs are more likely to hear words amidst jumbled speech, which is similar in many ways to effects seen for SWS (Fernyhough et al, 2007).…”

“…This suggested that d' change and hallucination-proneness were nevertheless unrelated, despite the effect of IC status. (Fernyhough et al, 2019).…”

“…shows the distribution of hallucination-proneness scores as collected by the LSHS-A. The mean score of 9.40 places this sample as having a mean level of hallucinationproneness comparable to other samples with childhood histories of ICs, and slightly higher than large samples without any IC history (M = 8.76;Fernyhough et al, 2019). As would be expected, participants with an IC in the present sample had significantly higher LSHS-A scores (IC M(SD) = 10.55 (2.89); No IC M(SD) = 8.74 (2.41); t = -2.48, df = 37.86, p = .02, d…”

“…Exclusion criteria were identical to Experiment 1. Within the 60, it was possible to recruit 22 people with a history of having imaginary companions as children, of whom 14 were able to provide parental verification of their childhood ICa validation step considered good practice in IC research (Fernyhough et al, 2007(Fernyhough et al, , 2019.…”

“…Experiment 2 (n = 60), run partly in parallel, used an alternative measure specific to AVH-proneness, a version of the Launay-Slade Hallucination Scale-Revised (Bentall & Slade, 1985b;Morrison et al, 2000). It also included participants intentionally recruited to expand the potential range of individual differences in hallucination-proneness (specifically, people with a history of imaginary companions; Fernyhough et al, 2019), and an added condition which sought to further prime potential templates for speech. In Experiment 3 (n = 99), we tested the same prediction but with a new stimulus, sine-vocoded speech (SVS).…”