Persisting Hallucinations following Childhood Sexual Abuse

Abstract

Hallucinations can persist for many years after childhood sexual abuse. If we recognise this, we will not mis-diagnose psychosis and we may treat with psychotherapy (talk). The hallucinations are distinct from hallucinations in schizophrenia though patients have frequently been given that diagnosis. They would generally be classified as pseudo-hallucinations. They are generally self-referential. They can involve all sensory modalities. Three case reports illustrate this link. Methods for interviewing and providing ongoing help are discussed. Issues in phenomenology and diagnosis are considered. Post-traumatic stress disorder is the best diagnostic fit, though psychotic depression may explain some cases. Freud's case of Frau P (1896) was an early report of this link.

Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder

“…Ellenson (1985) identi ed, in 40 women, a 'post incest syndrome', including hallucinations, which was 'exclusively associated with a history of childhood incest ' (p. 526). This was replicated in 10 other incest cases (Heins, Gray, & Tennant, 1990). In an inpatient study (Read & Argyle, 1999) all female incest survivors experienced hallucinations and were signi cantly more likely to do so than those subjected to extra-familial CSA.…”

“…Although auditory hallucinations were more than three times more common in incest cases (56% ) than non-incest CSA cases (17% ), this did not attain signi cance, X 2 (1) = 3.00, p = .083. The hypothesis that auditory hallucinations in incest survivors are found only when substance abuse is also present (Heins et al, 1990) was not con rmed by an earlier study (Read & Argyle, 1999) or by the current study, in which 10 of the 20 incest survivors with no documented substance abuse experienced auditory hallucinations.…”

“…Paranoid delusions and voices commenting, for instance, were present in about one third of incest cases. Previous ndings of a particularly strong relationship between incest and auditory hallucinations (Ellenson, 1985;Heins et al, 1990;Read & Argyle, 1999) received only tentative support from the current study. Although auditory hallucinations were more than three times more common in incest cases (56% ) than non-incest CSA cases (17% ), this did not attain signi cance, X 2 (1) = 3.00, p = .083.…”

The experience of childbirth for survivors of incest

“…Heins et al (1990) note that transition points in psychosexual development such as the birth of a child are risk periods for survivors of incest and Gelinas (1983) calls these 'developmental triggers'.…”

De la formulation de cas à la prévention de rechute : une thérapie cognitive systématique de la schizophrénie

“…Étant donné que des évé-nements de vie significatifs précèdent souvent le développement de psychoses, il est nécessaire de discuter des types de réactions psychologiques que les gens peuvent avoir lors de grands stress. Encore une fois, on remet au patient la littérature démontrant que les hallucinations étaient chose commune parmi les vétérans de la guerre du Vietnam (Wilcox et al, 1991), ou dans les cas d'abus sexuel (Heins et al, 1990). Cela permet aux patients de se sentir moins aliénés par leurs symptômes et accentue chez eux la possibilité d'en discuter plus ouvertement.…”