Hallucinatory Experiences in Nonpsychotic Children

What Do We Know About the Correlates and Underlying Causes of Auditory Hallucinations in Nonpsychotic Children and Adolescents, and What Are the Implications for Diagnosis and Treatment?

“…Famularo, Kinscherff and Fenton (1992), for example, found a strong association between auditory hallucinations and a history of maltreatment (more specifically, a diagnosis of PTSD), and reported that the hallucinations themselves seemed to be related to details of past traumatic events. Kotsopoulos et al (1987) had earlier reported a similar finding in relation to their subject children; namely, that "the hallucinations were coherent, made sense, and in some children were congruent with their life experiences and circumstances" (p.379). It was also the conclusion of Edelsohn, Rabinovich and Portnoy (2003) that the content of the hallucinations was often relevant in understanding the underlying psychopathology in the child's life and, in a later paper, Edelsohn (2006) provided two case vignettes that highlighted such a link between the contents of the hallucinations presented and the child's stressful life experiences.…”

“…Why some children experience auditory hallucinations while others who present with similar conditions do not, remains largely unexplained. However, it may be, as suggested by Mertin and O'Brien (2013), that hallucinating children are simply more vulnerable to adverse effects of high stress levels, or have poorer coping strategies (e.g., Kotsopoulos et al, 1987), than those children who do not hallucinate.…”

Non-psychotic auditory hallucinations in children and adolescents

“…Some voices were reported as threatening and unpleasant (2) as seen in Cases 9, 11 and 12. In the presence of low mood, stress and anxiety, the voices may urge aggressive action against others and warn of danger and possible harm (5,14). This was seen in Case 3.…”

“…However, auditory hallucinations in children and adolescents are relatively less significant diagnostically and a range of other mental health problems may produce this symptom. For example, auditory hallucinations have been described in children and adolescents with conduct and emotional disorders, difficulties in coping, bereavement, affective syndromes, migraine, anxiety and adjustment disorders (2,3,4,5). A study of non-psychotic hallucinations in children presenting to a psychiatric emergency service found that 34% were depressed, 22% had attention deficit hyperactivity disorder (ADHD) and 12% had a disruptive behaviour disorder (6).…”

“…Further, non-psychotic auditory hallucinations have been recognised as indicating high levels of arousal, arising from chronic stress. The evidence comes from significant rates of family disruption, dysfunction and domestic violence reported in these children (5,6,15). Other authors have hypothesised a neurological disturbance such as migraine and anxiety disorders associated with it as a cause, especially in the presence of a strong family history of both disorders (4).…”