Comparing the characteristics of hallucinations and mental imagery: a large cross-sectional study in the general population

DOI: 10.1016/j.concog.2025.103974

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Measurement & Assessment Involuntary Imagery Hyperphantasia

Pepin, G., Lœvenbruck, H., Chauvin, A., Jacquet, C., Eichenlaub, J.-B., & Bortolon, C. (2026). Comparing the characteristics of hallucinations and mental imagery: a large cross-sectional study in the general population. Consciousness and Cognition, 137, 103974. doi:10.1016/j.concog.2025.103974

Abstract

Hallucinations (HAs), the perceptual experiences that occur without external stimuli, are classically associated with psychiatric disorders, but also occur in the general population. Involuntary mental imagery (IMI), the spontaneous occurrence of visual or auditory mental content, shares several features with HAs. The continuum hypothesis suggests that these phenomena exist on a spectrum ranging from benign to clinically significant experiences. However, the precise boundaries of these phenomena remain under-explored. This pre-registered cross-sectional study focusing on the experiential continuum, involved 1,951 French-speaking adults who completed an online questionnaire assessing the frequency and characteristics of their HAs and IMI experiences. These experiences could include hearing music or voices, or seeing shadows. Participants rated ten phenomenologically-informed dimensions, including vividness, emotional valence, controllability, distress, agency, and perceived location. Associations were tested using Spearman correlations and Wilcoxon tests with Bonferroni correction. IMIs were significantly more frequent than HAs and were rated as more vivid, emotionally positive, and self-generated. In contrast, HAs were associated with greater distress and external attribution. Moderate to strong correlations between HAs and IMIs on most dimensions support the hypothesis of a shared experiential continuum. However, the fact that confidence and agency cannot be fully separated from controllability raises questions about cognitive models of self-monitoring and metacognition. These findings provide empirical evidence for both convergence and divergence in the phenomenological profiles of HAs and IMIs. Refining these distinctions could enhance theoretical models of hallucinatory experiences and facilitate the early identification and prevention of distressing internal phenomena in individuals at risk.

Authors

Guillaume Pepin1
Hélène Lœvenbruck3
Alan Chauvin3
Camille Jacquet1
Jean-Baptiste Eichenlaub1
Catherine Bortolon1

What This Study Is About

This study explores the relationship between involuntary mental imagery—thoughts or pictures that pop into your head unbidden—and hallucinations in the general population. Researchers wanted to know how common these experiences are and whether they share similar characteristics, such as how vivid or distressing they feel.

How They Studied It

The researchers surveyed 1,931 adults from the general public using detailed questionnaires. Participants were asked about the frequency and nature of their "inner experiences," specifically focusing on:

Involuntary Mental Imagery (IMI): Spontaneous mental images or sounds (like a song stuck in your head or a sudden memory).

Hallucinations (HAs): Seeing or hearing things that others cannot, which feel like they are coming from the outside world.

The team compared these experiences across several categories, including vividness (how clear they are), valence (how positive or negative they feel), and how much control the person felt they had over them.

What They Found

The study found that these experiences are surprisingly common: about 22% of people reported having at least one hallucination per month, while 45% experienced involuntary mental imagery.

Key differences included:

Vividness: Involuntary imagery was generally rated as more vivid and clear than hallucinations.

Emotion: Imagery tended to be more positive or neutral, whereas hallucinations were more likely to be negative or distressing.

Control: While both were hard to stop, people felt they had more "agency" or ownership over their involuntary imagery compared to hallucinations, which felt more "alien" or imposed.

Location: Hallucinations were more often perceived as coming from outside the body, while imagery felt internal.

What This Might Mean

The findings suggest that hallucinations and mental imagery are not completely different things, but rather exist on a "continuum" or spectrum of inner experience. Because many healthy people experience mild hallucinations, the study suggests that having these experiences doesn't necessarily mean someone has a medical condition. Instead, the level of distress and the feeling of losing control may be what distinguishes a typical experience from a clinical one.

One Interesting Detail

The researchers found that age was a significant factor: younger participants were much more likely to report frequent hallucinations and involuntary imagery than older participants, suggesting that our "inner world" might become less noisy as we age.

Comparing the characteristics of hallucinations and mental imagery: a large cross-sectional study in the general population

Abstract

Authors

Comparing the characteristics of hallucinations and mental imagery: a large cross-sectional study in the general population

Abstract

Authors

Comparing the characteristics of hallucinations and mental imagery: a large cross-sectional study in the general population

Abstract

Authors

Comparing the characteristics of hallucinations and mental imagery: a large cross-sectional study in the general population

Abstract

Authors

What This Study Is About

How They Studied It

What They Found

What This Might Mean

One Interesting Detail

What This Study Is About

How They Studied It

What They Found

What This Might Mean

One Interesting Detail

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