ISSN 2043-8087
Journal of Experimental Psychopathology
 Volume 3, Issue 2, 274-296, 2012
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The Role of Mental Imagery in Aberrant Perception: A Neurobiological Perspective

Vincent van de Ven (a), David E. J Linden (b)
(a) Dept. of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
(b) MRC Centre for Neuropsychiatric Genetics and Genomics, Dept. of Psychological Medicine & Neurology, Cardiff University School of Medicine, Cardiff, UK.

Volume 3, Issue 2, 2012, Pages 274-296

A number of mental disorders comprise aberrant perceptions that are often described as possessing a perceptual quality approaching real-life sensory experience, while at the same time lacking a sensory correlate in the real world. Healthy individuals can also have perceptual experience without an external correlate when they engage in mental imagery. Aberrant perceptions differ from mental imagery in their lack of voluntary control and the sense of reality. Early theories suggested that increased imagery vividness could lead to aberrant perceptions in a number of clinical disorders. However, cognitive and neuroimaging studies do not endorse this view, and instead suggest that mental imagery comprises a functional architecture that is at least partly shared with memory and perception. Miscommunication or disconnection between brain areas or functional modules within this architecture may give rise to aberrant perceptions and their sense of reality. We describe the evidence for this view in relation to psychotic hallucinations in schizophrenia, hallucinations in neurodegenerative disorders and flashbacks of traumatic events in post-traumatic stress disorder. We suggest that an impaired neural architecture of imagery, rather than merely increased intensity or vividness of imagery, underlies aberrant perceptions. This view fits with neurobiological models of mental disorders that suggest that psychopathological symptoms arise from disrupted communication between brain areas.

Table of Contents
Clarification of key concepts
Theories and functions of mental imagery
 Mental imagery and information processing
 Neural correlates of mental imagery: Sensory vs. non-sensory accounts
Contribution of mental imagery to aberrant perceptual experiences
 Imagery, hallucinations and intrusive memories (flashbacks)
  Confusion of reality: Increased mental imagery vividness?
  Hallucinations and the forward model
  Neural substrates of imagery and hallucinations – commonalities and differences
  Imagery in Post-traumatic Stress Disorder (PTSD)
 Neurologic hallucinations: Filling-in missing or noisy afferent sensory inputs
Synthesis of mental imagery in psychopathology
List of abbreviations

Correspondence to
D. E. J. Linden, Dept. of Psychological Medicine & Neurology, Sir Henry Wellcome Building, Cardiff University School of Medicine, Cardiff CF144XN, UK.

hallucinations, schizophrenia, Charles-Bonnet syndrome, visual, auditory

Received 7 Apr 2011; Revised 12 Oct 2011; Accepted 13 Oct 2011; In Press 23 Apr 2012

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