Auditory Hallucinations in Irish school-children

later12

I read a really interesting article on RTE's news website today

http://www.rte.ie/news/2012/0412/over-20-of-children-report-hearing-voices.html

Researchers carried out psychiatric assessments of almost 2,500 children aged between 11 and 16 in Dublin.

They discovered that 21%-23% of younger adolescents, aged 11 to 13, had experienced auditory hallucinations.

Of this group, just over half were found to have a non-psychotic psychiatric disorder such as depression.

Just 7% of older adolescents aged 13 to 16 reported hearing voices - but almost 80% of those who did had a diagnosable psychological problem.

If you have an athens login or subscription you can access the paper on the British Journal of Psychiatry's web page. Here is the link to the article:

http://bjp.rcpsych.org/content/early/2012/03/28/bjp.bp.111.101543.full.pdf
From the paper:

Using two large population-based survey studies and two in-depth clinical interview studies, we have shown a number of important findings.

First, psychotic symptoms are prevalent in a wide range of non-psychotic psychopathologies.

Second, although psychotic symptoms are not pathognomonic of illness, the majority of young people in the community who report psychotic symptoms do have a diagnosable psychiatric disorder.

Third, psychotic symptoms index a particularly high risk of multiple pathology (having more than one DSM diagnosis).

Fourth, psychotic symptoms are reported more commonly in early than in middle adolescence.

Fifth, psychotic symptoms become increasingly predictive of diagnosable psychopathology with increasing age.

The paper also has an interesting comment on the crossover between psychosis and neurosis

The relevance of our findings extends beyond adolescent mental health; the finding that psychotic symptoms are highly prevalent in a range of (non-psychotic) disorders raises questions about traditional diagnostic boundaries. Although psychosis has conventionally been considered as separate from ‘neurotic’ dis- orders, a number of researchers have questioned the independence of the psychoses and non-psychotic psychopathology.39–41 The high prevalence of psychotic symptoms in a wide variety of non-psychotic disorders as demonstrated in the present research suggests that divisions between the neuroses and psychoses are not clear-cut.

These are some startling findings - or at least they appear startling to someone like me who is not particular familiar with research in this area. Would these results reflect findings of psychosis elsewhere? How reliable are these results? I hope the findings are taken on board by parents and educators of these children.

Opinions?

hotspur

later12 wrote: »

These are some startling findings - or at least they appear startling to someone like me who is not particular familiar with research in this area. Would these results reflect findings of psychosis elsewhere? How reliable are these results? I hope the findings are taken on board by parents and educators of these children.

Opinions?

I have read previous studies which have found surprisingly high levels of auditory hallucinations in the adult general population. Whatever else about the precise relationship between such experiences and significant psychological distress, it would appear that the prevalence of them is greater than our social narrative for them allows for.

If you go to something like the Mind, Body, Spirit festival you will find an entire room with people who experience such hallucinations to some degree, but who frame it within a special gift story. Go to a psychiatric ward and you will find people who frame it as pure pathology.

I'm not naive enough of a social constructionist to believe that the difference is purely, or even mainly, one of framing. Clearly for many the inability to unattend to a multitude background stimuli causes suffering. However I have found it interesting to reflect on how such framing may orientate the stance of a person with milder experiences of it towards their experience.

A special gift interpretation can lead to the experiences having meaning, as opposed to how Foucault once described an attitude towards psychiatric symptoms as being “An enigma without any truth except that which could reduce it”.

These people who become mediums, Tarot readers, spiritualists etc. have their abilities respected and admired among their sub-culture. They wish to develop them. They can result in joining social communities of alternative therapists, healers, and those with "extra-sensory powers". They can lead to employment opportunities.

Contrast that with the framing of such experiences as being pathological. Their experiences are to be ameliorated as unwanted phenomena. They are to be got rid of. They are to be psychiatric patients surrounded by mental health professionals and others who are suffering. They are sick. Their employment prospects are diminished.

To use an acceptance and commitment therapy metaphor which group do we think are the ones most likely to be disturbing themselves by pulling hard on the tug-of-war rope in a battle with their "symptoms"?

I don't mean any of this to come across as sounding like the anti-psychiatry idiots who over the years have ignored the reality that there are very many who are suffering profoundly precisely due to the biological extremity of their experiences.

But for the surprisingly large amount of people at the milder end I think it is very important that we broaden our cultural normative narrative in relation to such experiences. If not for the sake of destigmatising, then at least to be statistically accurate.

JuliusCaesar

Have you ever been walking down a street and thought you heard your name called out? Then you turned around and nobody was waving at you or even looking at you? That's an auditory hallucination, and most people have had this experience.

later12

hotspur wrote: »

Contrast that with the framing of such experiences as being pathological. Their experiences are to be ameliorated as unwanted phenomena. They are to be got rid of. They are to be psychiatric patients surrounded by mental health professionals and others who are suffering. They are sick. Their employment prospects are diminished.

In fairness to the authors, they do distinguish quite clearly between delusions/ hallucinations and psychotic disorders from the beginning of the paper and throughout. There is no broad condemnation of the children's health for having experienced auditory hallucinations at all.

However, what the authors do say, and what I find striking, is that " Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood."

The authors then go on to find that a majority of children who have experienced an auditory hallucination were observed to have at least one psychotic disorder. (57% in early adolescence, and 80% in mid-adolescence).

There was also a high risk of coexisting pathologies according to the authors.

I am not a psychiatrist, but I do have some experience of mental illness and I would have thought that early intervention is as important in psychiatry as it is in other fields of medicine.

Could the question that the researchers asked - ‘Have you ever heard voices or sounds that no one else can hear?’ - be a useful screening tool in monitoring the mental health of young people, given the apparent statistical relationship between psychotic sympotoms and mental health disorders that were observed in the study?

later12

JuliusCaesar wrote: »

Have you ever been walking down a street and thought you heard your name called out? Then you turned around and nobody was waving at you or even looking at you? That's an auditory hallucination, and most people have had this experience.

It's not unthinkable that someone would consider an experience like that as grounds for answering Yes to the question ‘Have you ever heard voices or sounds that no one else can hear?’, but I'd doubt most people would.

Examples like the one you give tend to be mis-heard or overheard yells or conversations as opposed to auditory hallucinations, as though out of thin air.

JuliusCaesar

later12 wrote: »

Examples like the one you give tend to be mis-heard or overheard yells or conversations as opposed to auditory hallucinations, as though out of thin air.

Except that 'voices'/auditory hallucinations aren't out of thin air - they are thoughts that the person has, which they misinterpret as external voices.

later12

JuliusCaesar wrote: »

Except that 'voices'/auditory hallucinations aren't out of thin air - they are thoughts that the person has, which they misinterpret as external voices.

Of course, but isn't that really just another way of saying what I just said? i.e. "as though out of thin air" i.e. not from the external environment.

Walking down the street and thinking you've heard someone call your name is not an auditory hallucination under the definition applied by the researchers if that sound comes from a source audible to others.

krd

JuliusCaesar wrote: »

Have you ever been walking down a street and thought you heard your name called out? Then you turned around and nobody was waving at you or even looking at you? That's an auditory hallucination, and most people have had this experience.

You're hearing, like your sight, recognises patterns. Mishearing a sound, as your name being, I don't think should be classed as an auditory hallucination.

Schizophrenics, sometimes get very loud and very clear voices speaking to them - even persistently....That is an auditory hallucination.


And...Julius....you haven't been mishearing anything. It is I, who has been following you down streets and calling your name...and when you look, I quickly turn away, and pretend I haven't. ....I'm trying to drive you mad.

JuliusCaesar

This is interesting:

Luhrmann has hypothesized that people going to services and prayer groups at evangelical churches have trained their minds to perceive God's voice. In the prayer classes she attended, she observed people experiencing what she calls a new "theory of mind."

"They learn to experience some of their thoughts as not being thoughts from them, but thoughts from God that they hear inside their mind," she says.

Sully777

JuliusCaesar wrote: »

Except that 'voices'/auditory hallucinations aren't out of thin air - they are thoughts that the person has, which they misinterpret as external voices.

A very good point.