Other Investigational Approaches To Hallucinations

The descriptive and analytic framework employed in this article represents one approach to hallucinations. Others tend to be complementary, rather than exclusive, with their boundaries increasingly blurred as convergence and integration occur. The resulting interdisciplinary synthesis has enhanced our understanding of hallucinations. At the cognitive level of analysis, numerous mechanisms have been posited to play a role in the generation of hallucinations, with support derived from psychologic, electrophysiologic, and animal studies. Several theories focus on abnormalities in the processing of input or its comparison with past experience. These can be seen to dovetail with the sensory input, midbrain/thalamic, sensory cortical, and limbic/paralimbic disturbances described previously. Others focus on cognitive abnormalities that may give rise to deficits in the ability to discriminate between external and self-generated events. These theories, in turn, are related to frontal/executive disturbances. At the neurochemical level, much work has been done on the relation between disturbances in neurotransmitter systems, such as dopamine, serotonin, and glutamate, and hallucinations. This is clearly relevant to the limbic and midbrain/thalamic disturbances noted previously. At the computational level, neural networks models have been used to investigate links between posited cognitive or physiologic abnormalities and hallucinations, with intriguing results. At the social/psychological level, investigations and clinical observations suggest that personal, social, and cultural factors play a role in the development and content of hallucinations—a role likely to be mediated by limbic and cortical brain regions involved in learning and complex cognition.

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