Imaginary friends, voices and psychosis
This chapter explores child mental health professionals distinguish when childhood fantasy is an expected part of the child’s development and when it may be worth worrying about. It shows that a higher prevalence of a variety of psychotic symptoms in children with an intelligence quotient below 90 and in victims of bullying, particularly if the bullying was chronic and severe. There may be temperamental factors, such as easy suggestibility, determining which children report hearing voices. Many professionals working in mental health are trained to differentiate the normal from the abnormal. However, defining psychosis in children and young people can be fraught with difficulty. Simplistically, characteristic features of psychosis include delusions and hallucinations. Young children are often enchanted by stories and theatrical performances; most will readily engage in extended sessions of make-believe or fantasy play, by themselves or with others.