A Cross-National Investigation of Hallucination-Like Experiences in 10 Countries: The E-CLECTIC Study

Abstract

Hallucination-like experiences (HLEs) are typically defined as sensory perceptions in the absence of external stimuli. Multidimensional tools, able to assess different facets of HLEs, are helpful for a better characterization of hallucination proneness and to investigate the cross-national variation in the frequencies of HLEs. The current study set out to establish the validity, factor structure, and measurement invariance of the Launay-Slade Hallucinations Scale-Extended (LSHS-E), a tool to assess HLEs. A total of 4419 respondents from 10 countries were enrolled. Network analyses between the LSHS-E and the 3 dimensions of the Community Assessment of Psychic Experiences (CAPE) were performed to assess convergent and divergent validity of the LSHS-E. Confirmatory factor analysis was used to test its measurement invariance. The best fit was a 4-factor model, which proved invariant by country and clinical status, indicating cross-national stability of the hallucination-proneness construct. Among the different components of hallucination-proneness, auditory-visual HLEs had the strongest association with the positive dimension of the CAPE, compared with the depression and negative dimensions. Participants who reported a diagnosis of a mental disorder scored higher on the 4 LSHS-E factors. Small effect size differences by country were found in the scores of the 4 LSHS-E factors even after taking into account the role of socio-demographic and clinical variables. Due to its good psychometric properties, the LSHS-E is a strong candidate tool for large investigations of HLEs.

Fig. 1.

Distribution of scores by item for the LSHS-E in the sample. The items are ranked according to the frequency of positive endorsement.

Fig. 2.

Network graph of the links among the 3 dimensions of the CAPE and the 4 factors of the LSHS-E in putatively healthy people (on the left) and in people who reported a diagnosis of a mental disorder (on the right). Colors correspond to different assessment tools (CAPE vs LSHS-E). Thickness of the lines is proportional to the estimated correlation coefficients, which are superimposed on the lines. Positive correlations are in “powder blue”; negative correlations are in “violet”.

Fig. 3.

Distribution of scores by countries for the 4 dimensions of the LSHS-E as estimated by CFA: Intrusive thoughts; Vivid daydreams; Multisensory HLEs; Auditory-Visual HLEs. Data are marginal means as estimated on the basis of the multivariate analyses of covariance (MANCOVA) taking into account the role of socio-demographic and clinical variables. Vertical segments represent 95% CI of the means.