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Barnby JM, Park S, Baxter T, Rosen C, Brugger P, Alderson-Day B. The felt-presence experience: from cognition to the clinic. Lancet Psychiatry 2023; 10:352-362. [PMID: 36990104 DOI: 10.1016/s2215-0366(23)00034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 03/31/2023]
Abstract
The felt presence experience is the basic feeling that someone else is present in the immediate environment, without clear sensory evidence. Ranging from benevolent to distressing, personified to ambiguous, felt presence has been observed in neurological case studies and within psychosis and paranoia, associated with sleep paralysis and anxiety, and recorded within endurance sports and spiritualist communities. In this Review, we summarise the philosophical, phenomenological, clinical, and non-clinical correlates of felt presence, as well as current approaches that use psychometric, cognitive, and neurophysiological methods. We present current mechanistic explanations for felt presence, suggest a unifying cognitive framework for the phenomenon, and discuss outstanding questions for the field. Felt presence offers a sublime opportunity to understand the cognitive neuroscience of own-body awareness and social agency detection, as an intuitive, but poorly understood, experience in health and disorder.
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Affiliation(s)
- Joseph M Barnby
- Social Computation and Cognitive Representation Lab, Department of Psychology, Royal Holloway, University of London, London, UK.
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Tatiana Baxter
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Peter Brugger
- Neuropsychology Unit, Valens Rehabilitation Centre, Zurich, Switzerland; University Hospital of Psychiatry, Zurich, Switzerland
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Carruthers G. Confabulation or experience? Implications of out-of-body experiences for theories of consciousness. THEORY & PSYCHOLOGY 2018. [DOI: 10.1177/0959354317745590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Difficulties in distinguishing veridical reports of experience from confabulations have implications for theories of consciousness. I develop some of these implications through a consideration of out-of-body experiences (OBEs). Do these variations indicate individual variation in experience or are they post-hoc confabulations, stories told by subjects to themselves in an attempt to make sense of the core phenomenology? I argue that no existent or possible evidence would be sufficient to favour one hypothesis over the other. How such evidence is interpreted depends on prior commitments to one or other of these hypotheses or to a theory of consciousness that is not neutral as to these hypotheses. One of these types of theory, namely vehicle theories, has difficulty accommodating the existence of confabulations and so allows for only the elaborate phenomenology hypothesis. Because we cannot know that reports are not confabulations, vehicle theories are insufficient to explain OBEs.
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Castelnovo A, Cavallotti S, Gambini O, D'Agostino A. Post-bereavement hallucinatory experiences: A critical overview of population and clinical studies. J Affect Disord 2015; 186:266-74. [PMID: 26254619 DOI: 10.1016/j.jad.2015.07.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 06/29/2015] [Accepted: 07/28/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Removal of the "bereavement exclusion" criterion for major depression and proposed research criteria for persistent complex bereavement disorder in DSM-V pose new compelling issues regarding the adequacy of current nosographical boundaries. Post-bereavement hallucinatory experiences (PBHE) are abnormal sensory experiences that are frequently reported by bereaved individuals without a history of mental disorder. Given current uncertainty over the continuum of psychotic experiences in the general population, whether or not they should be considered pathological remains unclear. METHODS In order to systemize available knowledge, we reviewed the literature describing general population and clinical studies on PBHEs. Given the relatively low number of articles, all peer-reviewed, published studies in English were included. No study characteristics or publication date restrictions were imposed. RESULTS Overall, evidence suggests a strikingly high prevalence of PBHEs - ranging from 30% to 60% - among widowed subjects, giving consistence and legitimacy to these phenomena. LIMITATIONS Whereas general population studies had adequate sample size numbers, all studies in the bereaved population had a very small number of subjects. No consensus for method of evaluation exists in the literature, with some studies using a free interview method and others using semi-structured interviews. CONCLUSIONS The available literature appears to support an elevated frequency of PBHEs in bereaved individuals, but further research is needed to increase the reliability of these findings and refine the boundaries between physiological and pathological experiences.
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Affiliation(s)
- Anna Castelnovo
- Department of Health Sciences, Università degli Studi di Milano, Italy
| | - Simone Cavallotti
- Department of Health Sciences, Università degli Studi di Milano, Italy
| | - Orsola Gambini
- Department of Health Sciences, Università degli Studi di Milano, Italy
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Braithwaite JJ, Broglia E, Brincat O, Stapley L, Wilkins AJ, Takahashi C. Signs of increased cortical hyperexcitability selectively associated with spontaneous anomalous bodily experiences in a nonclinical population. Cogn Neuropsychiatry 2014; 18:549-73. [PMID: 23441857 DOI: 10.1080/13546805.2013.768176] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The current study examined the presence of cortical hyperexcitability, in nonclinical hallucinators, reporting different forms of anomalous bodily experiences (ABEs). Groups reporting visual out-of-body experiences and nonvisual sensed-presence experiences were examined. It was hypothesised that only those hallucinators whose experiences contained visual elements would show increased signs of visual cortical hyperexcitability. METHODS One hundred and eighty-two participants completed the "Pattern-glare task" (involving the viewing of striped gratings with spatial frequencies irritable to visual cortex)-a task known to reflect degrees of cortical hyperexcitability associated with hallucinatory/aura experiences in neurological samples. Participants also completed questionnaire measures of anomalous "temporal-lobe experience" and predisposition to anomalous visual experiences. RESULTS Those reporting increased levels of anomalous bodily experiences provided significantly elevated scores on measures of temporal-lobe experience. Only the visual OBE group reported significantly elevated levels of cortical hyperexcitability as assessed by the pattern-glare task. CONCLUSIONS Collectively, the results are consistent with there being an increased degree of background cortical hyperexcitability in the cortices of individuals predisposed to some ABE-type hallucinations, even in the nonclinical population. The present study also establishes the clinical utility of the pattern-glare task for examining signs of aberrant visual connectivity in relation to visual hallucinations.
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Affiliation(s)
- Jason J Braithwaite
- a Behavioural Brain Sciences Centre, School of Psychology , University of Birmingham , Birmingham , UK
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The seahorse, the almond, and the night-mare: elaborative encoding during sleep-paralysis hallucinations? Behav Brain Sci 2013; 36:618-9; discussion 634-59. [PMID: 24304759 DOI: 10.1017/s0140525x13001325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Llewellyn's proposal that rapid eye movement (REM) dreaming reflects elaborative encoding mediated by the hippocampus ("seahorse") offers an interesting perspective for understanding hallucinations accompanying sleep paralysis (SP; "night-mare"). SP arises from anomalous intrusion of REM processes into waking consciousness, including threat-detection systems mediated by the amygdala ("almond"). Unique aspects of SP hallucinations offer additional prospects for investigation of Llewellyn's theory of elaborative encoding.
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Leu-Semenescu S, De Cock VC, Le Masson VD, Debs R, Lavault S, Roze E, Vidailhet M, Arnulf I. Hallucinations in narcolepsy with and without cataplexy: contrasts with Parkinson's disease. Sleep Med 2011; 12:497-504. [PMID: 21486708 DOI: 10.1016/j.sleep.2011.03.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2010] [Revised: 03/01/2011] [Accepted: 03/04/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Narcolepsy and Parkinson's disease (PD) are associated with hallucinations, excessive daytime sleepiness, REM sleep behavior disorder (RBD), as well as complete (narcolepsy with cataplexy) vs. partial (PD, narcolepsy without cataplexy) hypocretin-1 deficiency. OBJECTIVE To compare the hallucinations associated with narcolepsy to those of PD. METHODS One hundred patients with narcolepsy (with and without cataplexy) and 100 patients with PD were consecutively interviewed about their hallucinations (frequency, phenomenology, insight into unreality and association with sleep) as well as their risk factors. RESULTS Hallucinations occurred more frequently and with more motor and multimodal aspects in narcolepsy with cataplexy (59%) than in narcolepsy without cataplexy (28%) and PD (26%). Compared to PD, the hallucinations in narcolepsy were less frequently of the passage/presence type (passage: brief visions of a person or animal passing sideways; presence: perception that a living character or an animal is behind or near the subject, without the subject actually seeing, hearing or touching it), more frequently auditory and more often associated with sleep. However, in 40% of the patients with narcolepsy and 54% of the patients with PD, the hallucinations occurred while the patients were wide awake. Patients with cataplexy had reduced immediate insight into the unreality of their hallucinations compared to patients with PD, but the delusions were exceptional (2%), transient and based on hallucinations in both groups. The risk factors for hallucinations were sleep paralysis and RBD in narcolepsy and motor disability and sleepiness in PD. CONCLUSIONS The multimodal, dreamlike aspect of hallucinations in narcolepsy with cataplexy could transiently impair the patients' insight. The high frequency of these hallucinations (compared to those in narcolepsy without cataplexy or PD) suggests that complete (more than partial) hypocretin-1 deficiency promotes hallucinations.
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Affiliation(s)
- Smaranda Leu-Semenescu
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris 6 University, Paris, France.
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The body unbound: Vestibular–motor hallucinations and out-of-body experiences. Cortex 2009; 45:201-15. [DOI: 10.1016/j.cortex.2007.05.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Revised: 04/10/2007] [Accepted: 05/31/2007] [Indexed: 11/30/2022]
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Abrams MP, Mulligan AD, Carleton RN, Asmundson GJG. Prevalence and correlates of sleep paralysis in adults reporting childhood sexual abuse. J Anxiety Disord 2008; 22:1535-41. [PMID: 18436428 DOI: 10.1016/j.janxdis.2008.03.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2007] [Revised: 03/03/2008] [Accepted: 03/05/2008] [Indexed: 11/19/2022]
Abstract
Sleep paralysis (SP) occurs when rapid eye movement (REM) activity and concomitant paralysis of the skeletal muscles persist as an individual awakens and becomes conscious of his/her surroundings. SP is often accompanied by frightening hallucinations that some researchers suggest may be confounded with memories of childhood sexual abuse (CSA; [McNally, R. J., & Clancy, S. A. (2005). Sleep paralysis in adults reporting repressed, recovered, or continuous memories of childhood sexual abuse. Journal of Anxiety Disorders, 19, 595-602]). The purpose of this study was to evaluate relationships between CSA and SP. Based on self-report, participants (n=263) were categorized into three CSA groups: confirmed, unconfirmed, or no history of CSA. Relative to participants reporting no CSA history, those reporting CSA reported more frequent and more distressing episodes of SP. Post hoc analyses revealed that participants with clinically significant post-traumatic symptoms (irrespective of CSA history) also reported more frequent and more distressing episodes of SP. Significant correlations were found among SP indices and measures of post-traumatic symptoms, depression, dissociation, and absorption. Implications and future research directions are discussed.
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The transliminal brain at rest: baseline EEG, unusual experiences, and access to unconscious mental activity. Cortex 2008; 44:1353-63. [PMID: 18814870 DOI: 10.1016/j.cortex.2007.08.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Revised: 08/02/2007] [Accepted: 08/07/2007] [Indexed: 11/30/2022]
Abstract
Transliminality reflects individual differences in the threshold at which unconscious processes or external stimuli enter into consciousness. Individuals high in transliminality possess characteristics such as magical ideation, belief in the paranormal, and creative personality traits, and also report the occurrence of manic/mystic experiences. The goal of the present research was to determine if resting brain activity differs for individuals high versus low in transliminality. We compared baseline EEG recordings (eyes-closed) between individuals high versus low in transliminality, assessed using The Revised Transliminality Scale of Lange et al. (2000). Identifying reliable differences at rest between high- and low-transliminality individuals would support a predisposition for transliminality-related traits. Individuals high in transliminality exhibited lower alpha, beta, and gamma power than individuals low in transliminality over left posterior association cortex and lower high alpha, low beta, and gamma power over the right superior temporal region. In contrast, when compared to individuals low in transliminality, individuals high in transliminality exhibited greater gamma power over the frontal-midline region. These results are consistent with prior research reporting reductions in left temporal/parietal activity, as well as the desynchronization of right temporal activity in schizotypy and related schizophrenia spectrum disorders. Further, differences between high- and low-transliminality groups extend existing theories linking altered hemispheric asymmetries in brain activity to a predisposition toward schizophrenia, paranormal beliefs, and unusual experiences.
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Nielsen T. Felt presence: paranoid delusion or hallucinatory social imagery? Conscious Cogn 2007; 16:975-83; discussion 984-91. [PMID: 17434323 DOI: 10.1016/j.concog.2007.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Accepted: 02/04/2007] [Indexed: 11/16/2022]
Abstract
Cheyne and Girard characterize felt presence (FP) during sleep paralysis attacks as a pre-hallucinatory expression of a threat-activated vigilance system. While their results may be consistent with this interpretation, they are nonetheless correlational and do not address a parsimonious alternative explanation. This alternative stipulates that FP is a purely spatial, hallucinatory form of a common cognitive phenomenon-social imagery-that is often, but not necessarily, linked with threat and fear and that may induce distress among susceptible individuals. The occurrence of both fearful and non-fearful FPs in a multiplicity of situations other than sleep paralysis attacks supports the notion that FPs are hallucinatory variants of social imagery and that they are not necessarily bound to threat-activated vigilance. Evidence linking FPs with anxiety disorders supports the notion that the distress they evoke may be mediated by a more general affective distress personality factor. To illustrate the predominantly spatial character of FP hallucinations, similarities between FP and phantom limbs are summarized and the possibility that these two phenomena are parallel expressions (self- vs. other-presence) of a mirror neuron system is considered.
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Affiliation(s)
- Tore Nielsen
- Dream & Nightmare Laboratory, Sacré-Coeur Hospital, Montreal, Canada
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Cheyne JA, Girard TA. Paranoid delusions and threatening hallucinations: a prospective study of sleep paralysis experiences. Conscious Cogn 2007; 16:959-74. [PMID: 17337212 DOI: 10.1016/j.concog.2007.01.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Revised: 01/07/2007] [Accepted: 01/09/2007] [Indexed: 11/19/2022]
Abstract
Previously we reported a three-factor structure for hallucinations accompanying sleep paralysis (SP). These earlier analyses were, however, based on retrospective accounts. In a prospective study, 383 individuals reported individual episodes online providing further evidence for the three-factor structure as well as clearer conceptually meaningful relations among factors than retrospective studies. In addition, reports of individual episodes permitted a more fine-grained analysis of the internal structure of factors to assess predictions based on the hypothesis that a sensed or felt presence (FP) is a core experience affecting other SP hallucinations. Results were generally consistent with this hypothesis. In particular, associations among, and temporal stability of, sensory hallucinations were largely explained by their common association with FP. The findings are consistent with REM initiation of a threat activated vigilance system with pervasive effects on the SP experience and suggest a potential model for the thematic organization of nightmares and dreams more generally.
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Affiliation(s)
- J Allan Cheyne
- Department of Psychology, University of Waterloo, 200 University Avenue, Waterloo, Ont., Canada
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Girard TA, Martius DLMA, Cheyne JA. Mental representation of space: Insights from an oblique distribution of hallucinations. Neuropsychologia 2007; 45:1257-69. [PMID: 17113114 DOI: 10.1016/j.neuropsychologia.2006.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Revised: 10/10/2006] [Accepted: 10/13/2006] [Indexed: 11/27/2022]
Abstract
Three-dimensional spatial distributions of hypnagogic and hypnopompic hallucinations associated with sleep paralysis were used to investigate the internal representation of space. Left-right asymmetries in human preferences and abilities are well established. Parallel effects are also observed as lower-upper asymmetries. These parallels could reflect common underlying mechanisms or additive effects of independently evolved horizontal and vertical asymmetries. This study adds to the growing literature on multidimensional spatial biases in a context free from the influence of task-related factors. We present evidence of an oblique bias in the projection of both sensory and motor hallucinations toward lower-left and especially upper-right external space exceeding that accounted for by an additive model of separate horizontal and vertical biases. These observations are consistent with theories regarding a systematic functional relation of hemispheric with ventral and dorsal cerebral organization.
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Affiliation(s)
- Todd A Girard
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 Canada.
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Previc FH. The role of the extrapersonal brain systems in religious activity. Conscious Cogn 2006; 15:500-39. [PMID: 16439158 DOI: 10.1016/j.concog.2005.09.009] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2004] [Revised: 08/09/2005] [Accepted: 09/21/2005] [Indexed: 11/28/2022]
Abstract
The neuropsychology of religious activity in normal and selected clinical populations is reviewed. Religious activity includes beliefs, experiences, and practice. Neuropsychological and functional imaging findings, many of which have derived from studies of experienced meditators, point to a ventral cortical axis for religious behavior, involving primarily the ventromedial temporal and frontal regions. Neuropharmacological studies generally point to dopaminergic activation as the leading neurochemical feature associated with religious activity. The ventral dopaminergic pathways involved in religious behavior most closely align with the action-extrapersonal system in the model of 3-D perceptual-motor interactions proposed by . These pathways are biased toward distant (especially upper) space and also mediate related extrapersonally dominated brain functions such as dreaming and hallucinations. Hyperreligiosity is a major feature of mania, obsessive-compulsive disorder, schizophrenia, temporal-lobe epilepsy and related disorders, in which the ventromedial dopaminergic systems are highly activated and exaggerated attentional or goal-directed behavior toward extrapersonal space occurs. The evolution of religion is linked to an expansion of dopaminergic systems in humans, brought about by changes in diet and other physiological influences.
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Affiliation(s)
- Fred H Previc
- Northrop Grumman Information Technology, San Antonio, TX 78229, USA.
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Cheyne JA. Sleep paralysis episode frequency and number, types, and structure of associated hallucinations. J Sleep Res 2005; 14:319-24. [PMID: 16120108 DOI: 10.1111/j.1365-2869.2005.00477.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sleep paralysis (SP) episodes are often accompanied by vivid hallucinoid experiences that have been found to fall into three major categories thought to be organized according to intrinsic rapid eye movement (REM) processes. Prior research has, however, combined data for individuals with varying degrees of experience with SP episodes, rendering interpretations of the source of this structure ambiguous. The present study of 5799 current SP experients compares the nature and structure of the hallucinations of novice SP experients with those reporting varying numbers of episodes. Both qualitative and quantitative differences were found in reported hallucinations as a function of episode frequency, although the underlying three-factor structure of the hallucinoid experiences was highly similar for all groups. Novice experients' reports were, however, characterized by clearer differentiation of factors, likely because of a tendency of experienced SP experients to conflate experiences across episodes. Age and age of onset of SP episodes were associated with differences in the variety and types of hallucinations but not their underlying structure. Earlier onset of SP episodes was also associated with more frequent episodes. The results are consistent with the hypothesis that the basic form and patterning of hallucinatory experiences is a result of intrinsic processes, independent of prior experience, likely associated with underlying REM neurophysiology.
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Affiliation(s)
- J A Cheyne
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
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