ArticlePDF Available

Abstract and Figures

Little is known about the personality characteristics of those who have experienced a “Near-Death Experience” (NDE). One interesting candidate is fantasy proneness. We studied this trait in individuals who developed NDEs in the presence (i.e., classical NDEs) or absence (i.e., NDEs-like) of a life-threatening situation. We surveyed a total of 228 individuals. From those, 108 qualified as NDE experiencers (i.e., Greyson NDE scale total score ≥ 7): 51 had their NDEs in the context of a life-threatening situation; 57 had their NDEs not related to a life-threatening situation. From those who did not meet the criteria to be considered “experiencers”, 20 had their NDE in the absence of a life-threatening situation; 50 had faced death but did not recall a NDE and finally, 50 were healthy people without a history of life threat and/or NDE. All participants completed a measure of NDE intensity (the Greyson NDE scale) and a measure of fantasy proneness (the Creative Experiences Questionnaire). People reporting NDEs-like scored higher on fantasy proneness than those reporting classical NDEs, individuals whose experiences did not meet the NDE criteria and matched controls. By contrast, individuals reporting classical NDEs showed similar engagement in fantasy as matched controls. The reported intensity of the experiences was positively correlated with engagement in fantasy. Our findings support the view that strong engagement in fantasy by individuals recalling NDEs-like might make these persons more likely to report such subjective experiences when exposed to suitable physiological and/or psychological conditions (e.g., meditation, syncope).
Content may be subject to copyright.
ORIGINAL RESEARCH
published: 07 June 2018
doi: 10.3389/fpsyt.2018.00190
Frontiers in Psychiatry | www.frontiersin.org 1June 2018 | Volume 9 | Article 190
Edited by:
Roumen Kirov,
Institute of Neurobiology (BAS),
Bulgaria
Reviewed by:
Jean-Pierre Jourdan,
International Association for
Near-Death Studies, France
Francesca Pistoia,
University of L’Aquila, Italy
*Correspondence:
Charlotte Martial
cmartial@uliege.be;
coma@chu.ulg.ac.be
Specialty section:
This article was submitted to
Psychopathology,
a section of the journal
Frontiers in Psychiatry
Received: 21 February 2018
Accepted: 23 April 2018
Published: 07 June 2018
Citation:
Martial C, Cassol H,
Charland-Verville V, Merckelbach H
and Laureys S (2018) Fantasy
Proneness Correlates With the
Intensity of Near-Death Experience.
Front. Psychiatry 9:190.
doi: 10.3389/fpsyt.2018.00190
Fantasy Proneness Correlates With
the Intensity of Near-Death
Experience
Charlotte Martial 1
*, Héléna Cassol 1, Vanessa Charland-Verville 1, Harald Merckelbach 2
and Steven Laureys 1
1Coma Science Group, GIGA-Consciousness and Neurology Department, University and University Hospital of Liège, Liège,
Belgium, 2Forensic Psychology Section, Maastricht University, Maastricht, Netherlands
Little is known about the personality characteristics of those who have experienced a
“Near-Death Experience” (NDE). One interesting candidate is fantasy proneness. We
studied this trait in individuals who developed NDEs in the presence (i.e., classical
NDEs) or absence (i.e., NDEs-like) of a life-threatening situation. We surveyed a total
of 228 individuals. From those, 108 qualified as NDE experiencers (i.e., Greyson NDE
scale total score 7): 51 had their NDEs in the context of a life-threatening situation;
57 had their NDEs not related to a life-threatening situation. From those who did not
meet the criteria to be considered “experiencers,” 20 had their NDE in the absence of a
life-threatening situation; 50 had faced death but did not recall a NDE and finally, 50 were
healthy people without a history of life threat and/or NDE. All participants completed a
measure of NDE intensity (the Greyson NDE scale) and a measure of fantasy proneness
(the Creative Experiences Questionnaire). People reporting NDEs-like scored higher on
fantasy proneness than those reporting classical NDEs, individuals whose experiences
did not meet the NDE criteria and matched controls. By contrast, individuals reporting
classical NDEs did not show different engagement in fantasy as matched controls.
The reported intensity of the experiences was positively correlated with engagement in
fantasy. Our findings support the view that strong engagement in fantasy by individuals
recalling NDEs-like might make these persons more likely to report such subjective
experiences when exposed to suitable physiological and/or psychological conditions
(e.g., meditation, syncope).
Keywords: fantasy proneness, near-death experience, experiencer, near-death experience-like, creativity
INTRODUCTION
When facing a life-threatening situation—or, at least, a situation perceived as such, some people will
later report having lived various phenomenological experiences (e.g., seeing a bright light and/or
a dark tunnel, out-of-body experiences, encountering deceased relatives) that are intriguing by
their paranormal appearance or are surprising by their extra-ordinary aspect (1). These distinct
perceptual experiences are commonly referred to as “Near-Death Experiences” (NDEs). To explain
NDEs and their phenomenal content, three main non-mutually exclusive explanatory models have
Martial et al. Fantasy Proneness in Near-Death Experiencers
been proposed (2,3). Spiritual theories assume a “dualistic”
approach toward the mind-brain relationship (4),
neurobiological approaches suggest that specific brain networks
and functions might underlie NDEs (5,6), whereas psychological
theories have advocated that NDEs are the result of a dissociative
defense mechanism in response to extreme danger (7). To
facilitate the identification of NDEs and to assess core content
components and their intensity, researchers have used the
Greyson NDE scale (the Greyson NDE scale; (8)]. Yet, looking
at the empirical evidence [see (9) for review], the possible causes
and conditions under which NDEs appear remain unclear.
Intriguingly, similar phenomenological experiences termed
“NDEs-like” (i.e., containing a comparable phenomenological
content and intensity) have been reported in situations where
there was no genuine threat to the individuals’ life (10,11), such
as during a meditative state (12) or intense grief and anxiety
(13). Gabbard and Twemlow (14) argued that the expectancy of
an impending death or the strong belief of one’s death felt at
that moment, rather than the actual proximity of death, would
suffice to trigger NDEs. However, given that some NDEs-like do
not include any perceived threat to life, not all experiences in
this category can be explained by the expectancy or the belief
in an impending death (11). Although enigmatic, the NDE-like
phenomenon has been the subject of very few empirical studies
(10,11,14).
The current paper focuses on fantasy proneness (15) as one
potential variable that may shape people’s reports of NDEs and
NDEs-like. Fantasy proneness refers to a habitual engagement in
imaginative activities (16). Each individual has (to some extent)
imaginative capacities and can report a range of experiences that
are more or less related to imagination [e.g., daydreaming; (17)].
Yet, even within non-psychiatric samples, fantasy can distort
perception and memory thereby leading to reality monitoring
errors (17).
Cognitive researchers have argued that we constantly
use information gathered through the senses (“bottom-
up” processing) but we also construct meaning about our
environment (and our interactions with it) by using information
we have already stored in memory (“top-down” processing).
Indeed, our brain is constantly trying to make sense of the
world around us and the information it receives by using this
general dynamic process of two-way flow of information (18).
In the case of NDEs, the phenomenal content would reflect
individuals’ attempts to make sense of the ambiguous perceptive
feature of NDEs in circumstances (i.e., during altered state
of consciousness) that enhance such ambiguous bottom-up
information (9,19). Related to this perspective are theories that
emphasize depersonalization and other dissociative symptoms.
When facing a life-threatening or aversive situation, a person
may feel disconnected from the external world and focus
attention on internally oriented fantasies (7,15,20). Yet, this
account assumes that the eliciting event was threatening and it is
not clear how it would explain NDEs-like phenomena.
Although many humans are exposed to life-threatening
situations (i.e., a severe brain injury) or have the feeling that they
have been close to death at some point in their life, only a limited
number of persons recall identifiable “classical” NDEs [i.e., (21,
22)]. Similarly, an important question is why some individuals
experience NDEs-like phenomena, when others do not, although
they have been exposed to physiological and/or psychological
conditions that are known to be associated with NDEs-like
(e.g., meditation, syncope). People reporting “classical” NDEs
(i.e., with a context of a life-threatening situation) do not seem
to show any deficits in global cognitive functioning (21), but
Martial et al. (23) observed less optimal source monitoring
abilities and heightened illusory recollections in this population.
In addition, Greyson (24) found that experiencers report more
dissociative symptoms than people who had come close to death
without subsequently developing NDEs. As fantasy proneness is
strongly related to dissociative symptoms and source monitoring
breakdown (25), these findings suggest that people with NDEs
score higher on fantasy proneness than those without NDEs. An
unpublished conference presentation found stronger imaginative
activities [as indexed by the Inventory of Childhood Memories
and Imaginings; (26)] in experiencers reporting classical NDEs
compared with those reporting an event that brought them
near to death but did not feel that they had a NDE or with
healthy subjects (Council and Greyson, unpublished data, 1985).
By contrast, using the Childhood Experience Inventory, Ring
and Rosing (27) did not find more pronounced imaginative
involvement in people reporting NDEs. These conflicting
findings may be due to the different instruments that the authors
employed to measure fantasy proneness.
With this in mind, the present study aimed to assess fantasy
engagement in experiencers reporting NDEs [i.e., the memory
scored 7 or above on the Greyson NDE scale; (8)] (1) in and
(2) outside the context of an actual threat to life (i.e., NDEs-
like); (3) in individuals reported having had a NDE without a
life-threatening situation but not qualified as experiencers [i.e.,
the memory scored below the cutoff score of 7 on [the Greyson
NDE scale; (8)]; (4) in matched control participants who had
been exposed to a life-threatening situation but did not report
any kind of NDE; and finally (5) matched control participants
who had neither faced a life threatening situation, nor had
any NDEs. To this end, the Creative Experiences Questionnaire
[CEQ; (16)] was administered to all groups. We also looked into
the association between fantasy proneness (i.e., CEQ total score)
and self-reported intensity of NDEs [i.e., Greyson NDE scale total
score; (8)].
MATERIALS AND METHODS
Participants
Subjects were recruited from among individuals who contacted
us to share their experience. Initially, they were recruited
via the International Associations for Near-Death Studies
(IANDS France and Flanders) and the Coma Science Group
(GIGA-Consciousness, University and University Hospital
of Liège, Belgium). Control participants were recruited via
announcements by the Coma Science Group. The study was
approved by the ethics committee of the Faculty of Medicine of
the University of Liège.
The total sample consisted of 128 people who claimed to
have experienced a NDE. Reported experiences were assessed
according to the Greyson NDE scale (8). Fifty-one participants
(40%) described experiences that met the accepted criteria of
Frontiers in Psychiatry | www.frontiersin.org 2June 2018 | Volume 9 | Article 190
Martial et al. Fantasy Proneness in Near-Death Experiencers
NDEs [i.e., Greyson NDE scale total score 7/32; (8)] in the
context of a life-threatening situation (“NDErs/LTS” group).
Fifty-seven (44%) described experiences that also met the
accepted criteria of NDEs [i.e., Greyson NDE scale total score
7/32; (8)] but in the absence of a life-threatening situation
(“NDErs/non-LTS” group). Twenty (16%) described experiences
in the absence of a life-threatening context but that did not meet
the accepted criteria of NDEs (i.e., Greyson NDE scale total score
<7/32; (8); “non-NDErs/non-LTS” group). We recruited a cohort
of 100 control participants: 50 people who had come close to
death at some point in their lives but did not recall a NDE
(“controls/LTS” group) and 50 healthy people who had never
reported to have experienced NDEs (“controls/non-LTS” group).
Completion of the anonymous questionnaire was voluntary and
written informed consent was obtained from all participants
enrolled in the study.
Measures
Participants were invited to participate in a study on creativity.
To that end, they were mailed a questionnaire including the
Creative Experiences Questionnaire [CEQ; (16)] and items
of socio-demographic (gender, age) and clinical (time since
experiences, presence of life-threatening event) data. To gauge
the presence of a life-threatening event (i.e., a severe brain
injury), we asked participants whether they had gone through
a period of coma and whether they had stayed in intensive
care. The term “fantasy proneness” was not used either in the
explanatory letter or in the questionnaire itself. The CEQ (16) is
a self-report instrument which is a measure of fantasy proneness
including 25 true/false items. A total score is derived from the
sum of all the true responses and referred to as a validated index
of propensity toward fantasy [higher scores indicate higher levels
of fantasy proneness; (16)]. Illustrative items are: “As a child,
I had my own make believe friend or animal,” “Many of my
fantasies have a realistic intensity,” and “When I imagine I have
eaten rotten food, I really get nauseous.”
The Greyson NDE scale is a validated 16-item multiple-
choice tool used to obtain a standardized identification of NDEs
with a validated cut-off score of 7 (8). For each item, scores
are arranged on an ordinal scale ranging from 0 to 2. This
scale also permits the intensity of the NDE to be quantified
(i.e., total score ranging from 0 to 32), because it considers
both the number of experienced dimensions (i.e., item marked
0=“not present” or present) and the gradation of intensity in
the scoring provided (i.e., 1 =“mildly or ambiguously present”
and 2 =“definitively present”). The instrument includes four
subscales: cognitive, affective, paranormal, and transcendental
components. Participants whose experience did not meet the
accepted criteria [i.e., total score <7/32; (8)] were included in the
“non-NDErs/non-LTS” group (see below).
Analyses
Pearson’s χ2tests were used to assess frequency distributions.
One-way ANOVAs and t-tests were performed to compare age,
age at experience, time since experience, and reported intensity
of the NDE within groups. Pairwise planned comparisons were
then conducted to determine which groups differed significantly
from each other. The distribution of CEQ total scores was
skewed. For this reason, non-parametric tests were used. Thus,
group differences regarding the CEQ were evaluated with the
Kruskal–Wallis test. Next, we performed post-hoc comparisons
using Bonferroni-corrected (p<0.01) Mann–Whitney U-tests
to examine possible differences across groups. Spearman’s
rank-order correlations were computed to examine associative
strength between CEQ total scores and Greyson NDE scale total
scores and subscale scores. All participants who reported having
experienced a NDE were included, also those who obtained
a score of <7 on the Greyson NDE scale. In addition, we
calculated Spearman rank-order correlations between CEQ and
Greyson NDE total scores for each of the two experiencer groups
separately. Finally, we used Fisher’s r-to-ztransformation to test
the significance of the difference between these two correlation
coefficients. To avoid type I errors, Bonferroni adjustments
(p<0.007) were applied.
RESULTS
The five groups did not significantly differ with regard to gender
and age distributions (see Table 1). Experiencers groups and the
non-NDErs group did not differ either for age at experience or
for time elapsed since the experience.
As to the intensity (i.e., Greyson NDE scale total score) of
reported NDEs, NDErs/LTS (mean total score =16 ±5), and
NDErs/non-LTS (mean total score =15 ±6) groups did not
score differently [t(106) =0.25, d=0.20, p=0.79].
TABLE 1 | Demographic data of subsamples.
Demographics NDErs Non-NDErs non-LTS
(n=20)
Controls pη2
LTS (n=51) non-LTS (n=57) LTS (n=50) non-LTS (n=50)
Gender–female 27 (53%) 36 (63%) 11 (55%) 32 (64%) 29 (58%) 0.76
Age 57 ±13 57 ±14 62 ±14 53 ±11 55 ±12 0.11 0.03
Mean in years ±SD
Age at experience 35 ±17 28 ±16 35 ±20 29 ±13 0.14 0.03
Mean in years ±SD
Time since experience 22 ±16 28 ±17 27 ±20 24 ±12 0.16 0.03
Mean in years ±SD
NDErs, near-death experiencers; LTS, life-threatening situation; SD, standard deviation.
Frontiers in Psychiatry | www.frontiersin.org 3June 2018 | Volume 9 | Article 190
Martial et al. Fantasy Proneness in Near-Death Experiencers
TABLE 2 | CEQ total scores of subsamples (on the first line: total scores summing all items; on the second line: total scores excluding the three items overlapping with the
Greyson NDE scale items).
Scale NDErs Non-NDErs non-LTS
(n=20)
Controls p d
LTS (n=51) non-LTS (n=57) LTS (n=50) non-LTS (n=50)
CEQ total score 7 (5-11) 11 (7-13) 7 (4-8) 6 (3-9) 6 (2.5–8) <0.0001 0.85
Median (IQR)
CEQ total score (excluding item
21, 23, and 25)
Median (IQR)
7 (4–9.5) 9 (5-12) 6 (4-7) 5 (3-8) 6 (2-8)
NDErs, near-death experiencers; LTS, life-threatening situation; IQR, inter-quartile range.
Total CEQ scores were significantly different between groups
(see Table 2; see Supplementary Material for endorsement
percentages for each CEQ item across subsamples). The
NDErs/non-LTS group obtained significantly higher CEQ total
scores than the NDErs/LTS (p<0.005, d=0.56), non-
NDErs/non-LTS (p<0.001, d=0.83), and control/non-LTS
(p<0.0001, d=1.2) groups. By contrast, CEQ total scores
of NDErs/LTS and controls/LTS groups were not significantly
different (p=0.019, d=0.47). Finally, non-NDErs/non-LTS and
control/non-LTS groups did not obtain different CEQ total scores
(p=0.39, d=0.21).
Among individuals who claimed to have had a NDE
(whether or not they reached the cut-off of 7/32 on the
Greyson NDE scale; i.e., NDErs/LTS, NDErs/non-LTS, and non-
NDErs/non-LTS groups), Greyson NDE scale total scores were
positively correlated with total CEQ scores (see Table 3). To
investigate whether the correlational result observed in this
analysis effectively reflects an association between experiencers’
investment in fantasy and the reported intensity of the NDE, we
performed a Spearman’s rank-order correlation between Greyson
NDE scale and CEQ total scores but without including the three
CEQ items (item 21, 23, and 25) showing some overlaps with
certain items of the Greyson NDE scale. We observed a similar
significant positive correlation (Spearman r=0.26; p<0.005;
see Table 2 for raw median CEQ scores without the three items).
Total CEQ scores were also positively correlated with affective,
paranormal and transcendental subscale scores but not with
cognitive subscale scores (Table 3). Looking at the subsamples,
for the NDErs/non-LTS group only, we found a significant
positive correlation (Spearman r=0.33; p<0.007) between
Greyson NDE scale total scores and total CEQ scores. By
contrast, in the NDErs/LTS group, the correlation between both
total scores did not attain significance (Spearman r=0.28;
p=0.054). Nevertheless, the Fisher’s ztest showed that the two
associations were not significantly different (z=0.28; p=0.39).
DISCUSSION
The sample of individuals who reported NDEs-like scored
higher on self-reported measures of fantasy proneness than
matched control individuals who had never experienced NDEs
and individuals who had reported similar experiences that did
not meet NDEs criteria. Interestingly, although both groups of
experiencers did not differ in terms of intensities of experience
[as also reported in previous studies; (10)], experiencers recalling
NDEs-like showed a greater engagement in fantasy than those
with classical NDEs. Thus, compared with control participants
who exhibited moderate fantasy engagement [in line with
previous non-clinical population studies; (16,28)], the CEQ
scores of individuals who reported NDEs-like is suggestive of
heightened fantasy proneness levels.
The retrospective and correlational design of this study does
not permit conclusions to be made about the casual pathway; that
is, whether NDEs-like occur more frequently in individuals with
(previously established) high engagement in fantasy or whether
such experiences encourage fantasy proneness in individuals
who were previously not prone to fantasy. Yet it is reasonable
to hypothesize that high engagement in fantasy, as a habitual
tendency, makes people more likely to report subjective NDEs-
like when exposed to certain physiological and/or psychological
conditions (e.g., meditation, syncope). Indeed, some items of the
CEQ allude to retrospective recall of childhood experiences (16),
supporting the idea of an enduring predisposition toward fantasy
in those who score relatively high on the CEQ. It can then be
assumed that the core experience of a NDE would be common
to all experiencers and physiologically determined. However,
top-down mechanisms would then interact by influencing
mnesic details of the content and the interpretation thereof.
Any unusual sensations—potentially engendered by a disrupted
brain—or “fantasy guesses” (29) could then be integrated into
the individual’s model of reality, which could account for some
elements perceived during NDEs.
By contrast, we found no indication that individuals
with classical NDEs are more fantasy prone than matched
controls, including individuals who had come close to
death without having NDEs. Given the sample size in
the current study, we believe that there is little reason to
believe that a NDE per se is the result of fantasy prone
fabrication.
Interestingly, we found an association between experiencers’
investment in fantasy and imagination and the reported intensity
of the NDE. More specifically, individuals’ engagement in fantasy
were correlated with affective, paranormal, and transcendental
NDE features [as assessed by the Greyson NDE subscale scores;
(8)], but not with their cognitive features. Yet, the correlational
analyses performed within each of the two experiencers’ groups
revealed differential patterns depending on whether (or not)
a threat to the individual’s life was experienced. That is, the
Frontiers in Psychiatry | www.frontiersin.org 4June 2018 | Volume 9 | Article 190
Martial et al. Fantasy Proneness in Near-Death Experiencers
TABLE 3 | Spearman rank correlations between CEQ total score and Greyson
NDE scale scores and subscale scores for the total sample (n=128).
CEQ total score p
GREYSON NDE SCALE
Total score 0.32 <0.0005
SUBSCALE SCORES
Cognitive 0.22 0.015
Affective 0.27 <0.007
Paranormal 0.26 <0.007
Transcendental 0.28 <0.007
more individuals described intense NDEs in the absence of
a life-threatening situation, the higher they scored on fantasy
proneness, whereas there was no significant correlation between
the intensity of the NDE and an engagement in fantasy
for experiencers reporting classical NDEs. Nevertheless, when
comparing the two correlation coefficients obtained in the
two experiencers’ groups, we did not observe difference in
the strength of association between the engagement in fantasy
and the intensity of the NDE. Again, these correlations (or
their absence) do not imply any form of causality (or the
absence thereof). Still, another hypothesis is that when no
life-threatening situation was present, the reported intensity
of the experience depends on how strongly the individual is
involved in fantasy and imaginative processes. In the extant
literature, functional neuroimaging studies have demonstrated
that spontaneous thoughts [accompanied by a disengagement
from the external environment; (30)] are constrained by the
organization of our neurocognitive system even though they
arise independently of external input (31). While it appears that
subjective NDEs are intensively experienced by the experiencers’
inner world and that variation in spontaneous thoughts is (at
least partly) constrained by the network organization of the
brain (31), further studies should investigate structural and
functional connectivity profiles using neuroimaging techniques
in people who have recalled NDEs and people who do not.
Moreover, whether classical NDEs and NDEs-like phenomena
are underpinned by similar neural mechanisms remains an
unanswered question.
The present findings warrant follow-up investigation.
Specifically, it is important to look into factors (e.g., reality
monitoring failures) involved in fantasy proneness that may
generate NDEs-like. One possibility might be that individuals
with NDEs-like are more “open to experiences,” a personality trait
of the Five-Factor Model (32). It is likely that the experiencers
recalling NDEs-like are unusually sensitive to internal states
and possess a special propensity to pick up certain perceptual
elements that other individuals are blind to. This formulation is
consistent with the notion of a “NDE-prone personality,” defined
as “the capacity to shift into states of consciousness that afford
access to non-ordinary realities coupled with strong tendencies
toward psychological absorption” (27). In line with this, fantasy
prone individuals’ lives appear to be experientially richer (33)
and as a consequence, their fantasies are “as real as real” (15).
This is consistent with Thonnard et al.’s (34) results showing
that experiencers usually report a sense of “hyper-reality”
regarding their experiences (due to extremely vivid
memories).
Alternatively, the reality monitoring model (35) could provide
a framework for understanding why some individuals may
report NDEs-like accounts. The CEQ (16) used in this study
specifically assesses the frequency in which individuals engage
in fantasy and their difficulties in distinguishing fantasy and
reality. Thus, it may be the case that these experiences arise
as a consequence of source-monitoring errors, whereby inner
thoughts and feelings are wrongly interpreted as memories of
events that occurred in reality. Fantasy proneness goes along
with lenient criteria and is closely related to suboptimal reality
monitoring (35,36). Thus, extreme internal focus in individuals
could, in some cases, result in memories of subjective experiences
meeting the identification criteria of NDEs but occurring without
a life-threatening situation (i.e., NDEs-like).
In addition to potential influences of top-down mechanisms
in the emergence of NDEs-like, it would be interesting
to investigate top-down influences in the meaning, form,
and content of the experience itself. In keeping with the
reconstructive view described above, the NDE experiencers’
religiosity and cultural background have been suggested to
influence the NDEs’ content and the features (29,37,38).
However, most of the conducted studies are case studies and
surveys are mainly conducted in Western cultures, thus limiting
the generalizability and the conclusions that can be drawn.
Translated versions of the Greyson NDE scale are now available
[e.g., see for the Italian version: (39)], thereby facilitating future
cross-cultural studies.
In line with the present findings and as previously stressed
(11), NDEs-like phenomena call for a reappraisal of the (more
general) NDE phenomenon. The label itself—NDE—does not
appear to adequately describe the diversity of experiences (3,6).
Because there is no clear universal definition of NDEs, an implicit
consensus between investigators has emerged where NDEs were
defined in terms of their commonalities (40). However, while
similar phenomenal content has been described for various states
of consciousness [e.g., trance states, general anesthesia; (10,11)],
it appears that the classic features of the NDE phenomenon
are not associated exclusively with actual confrontation with
life-threatening circumstances. We believe that NDE research
might benefit from employing a more fine-grained classification.
Finally, we think that it is also important for NDE experiencers
themselves. Indeed, the NDE label per se might contribute to
the reluctance of people with NDEs-like phenomena to talk
openly about their experience: some of them might consider their
experiences as deviant because they were not in a critical context
of impending death.
Our study has several methodological constraints. First,
participants enrolled in the study were mostly self-selected
and might not be representative due to a possible selection
bias. Importantly, the personality construct of fantasy proneness
itself could have biased the recruitment. Indeed, fantasy prone
individuals might be less reluctant to share their experience as
they could be more accustomed to dealing with non-ordinary
experiences. Second, our study was cross-sectional and relied
Frontiers in Psychiatry | www.frontiersin.org 5June 2018 | Volume 9 | Article 190
Martial et al. Fantasy Proneness in Near-Death Experiencers
on self-report measures. Third, it should be point out the
lack of medical information regarding the presence of a life-
threatening event. Finally, one can ask to what extent there
is an overlap between the items of the two scales and to
what extent they assess the same construct. While it can be
observed that there is a part of overlap between certain items,
the primary difference between the two scales is in resolution:
the CEQ focuses on lifetime experiences whereas the Greyson
NDE scale focuses on one major event. Indeed, the latter focuses
on the content of a specific type of experience (i.e., classical
NDE or NDE-like) and its intensity at a phenomenological
level, while the CEQ assesses a more broadly personality trait.
Importantly, we further realized the correlation analysis without
including the items showing an overlap with some items of
the Greyson NDE scale and we still observed a significant
positive correlation (see the Results section). This suggests
that even in removing the critical items, we still observed an
association between experiencers’ engagement in fantasy and the
reported intensity of the experience. Except the present study,
no research has previously looked at the link between fantasy
proneness and the occurrence of NDEs-like. The association
may have important ramifications for studies addressing the
phenomenon of NDEs-like and may open new theoretical
perspectives.
To date, it is not clear whether NDEs are a randomly occurring
phenomenon or whether some specific psychological factors
play an important role in their generation (or recall). Although
much has been learned regarding the NDE phenomenon
per se, considerably less research has been directed at
exploring the psychological mechanisms that might lead to
the occurrence of such memories. Fantasy proneness (15) may
constitute a psychological predisposition for the occurrence
of NDEs-like. Because NDEs can subsequently induce life-
changing consequences on the experiencers’ set of values and
attitudes toward death (22), further understanding of their
cognitive functioning remains an important focus for clinical
research.
ETHICS STATEMENT
This study was carried out in accordance with the
recommendations of the ethics committee of the Faculty of
Medicine of the University of Liège with written informed
consent from all subjects. All subjects gave written informed
consent in accordance with the Declaration of Helsinki. The
protocol was approved by the ethics committee of the Faculty of
Medicine of the University of Liège.
AUTHOR CONTRIBUTIONS
CM and SL designed the protocol. CM, HC, and VC-V obtained
the data. CM analyzed the data; CM, HC, HM, and SL:
interpreted data. All authors contributed to the writing of the
manuscript. CM and SL were the main investigators. All authors
were involved in editing the paper and approved the final text.
FUNDING
This work was supported by the University and University
Hospital of Liège, Belgian National Funds for Scientific
Research (FNRS), French Speaking Community Concerted
Research Action (ARC - 06/11 - 340), NSERC discovery
grant, Human Brain Project (EU-H2020-fetflagship-hbp-sga1-
ga720270), Luminous project (EU-H2020-fetopen-ga686764),
IAP research network P7/06 of Belgian Government (Belgian
Science Policy), BIAL Foundation, the European Commission,
James McDonnell Foundation, Mind Science Foundation,
European space agency (ESA), Public Utility Foundation
Université Européenne du Travail and Fondazione Europea di
Ricerca Biomedical.
ACKNOWLEDGMENTS
The authors would like to thank our subjects for contributing
their time to participate in this study and the International
Associations for Near-Death Studies (IANDS France and
Flanders) and particularly J.-P. Jourdan and G. Vander Linden
who helped with near-death experiencers recruitment.
SUPPLEMENTARY MATERIAL
The Supplementary Material for this article can be found
online at: https://www.frontiersin.org/articles/10.3389/fpsyt.
2018.00190/full#supplementary-material
REFERENCES
1. Ring K. Life at Death: A Scientific Investigation of the Near-Death Experience.
NewYork, NY: Coward, McCann and Geoghegan (1980).
2. Agrillo C. Near-death experience: out-of-body and out-of-brain? Rev Gen
Psychol. (2011) 15:1–10. doi: 10.1037/a0021992
3. French CC. Near-death experiences in cardiac arrest survivors. Prog Brain Res.
(2005). 150:351–67. doi: 10.1016/S0079-6123(05)50025-6
4. Zeman A. What in the world is consciousness? Prog
Brain Res. (2005) 150:1–10. doi: 10.1016/S0079-6123(05)
50001-3
5. Borjigin J, Lee U, Liu T, Dinesh P, Huff S, Klarr D, et al. Surge
of neurophysiological coherence and connectivity in the dying brain.
Proc Natl Acad Sci U.S.A. (2013) 110:14432–7. doi: 10.1073/pnas.1308
285110
6. Lake J. The near-death experience: a testable neural model. Psychol Conscious
(2017) 4:115–34. doi: 10.1037/cns0000099
7. Noyes R, Kletti R. Depersonalization in the face of life-
threatening danger: a description (1976). Psychiatry 39:19–27.
doi: 10.1080/00332747.1976.11023873
8. Greyson B. The near-death experience scale. Construction,
reliability, and validity. J Nerv Ment Dis. (1983). 171:369–75.
doi: 10.1097/00005053-198306000-00007
9. Blanke O, Dieguez S. Leaving body and life behind: out-of-body and
near-death experience In: Laureys S, Tononi G. editors. The Neurology of
Consciousness. London: Academic Publishers (2009). p. 303–25.
10. Charland-Verville V, Jourdan JP, Thonnard M, Ledoux D, Donneau AF,
Questermont E, et al. Near-death experiences in non-life-threatening events
and coma of different etiologies. Front Hum Neurosci. (2014). 8:203.
doi: 10.3389/fnhum.2014.00203
Frontiers in Psychiatry | www.frontiersin.org 6June 2018 | Volume 9 | Article 190
Martial et al. Fantasy Proneness in Near-Death Experiencers
11. Facco E, Agrillo C. Near-death-like experiences without life-threatening
conditions or brain disorders: a hypothesis from a case report. Front Psychol.
(2012). 3:490. doi: 10.3389/fpsyg.2012.00490
12. Beauregard M, Courtemanche J, Paquette V. Brain activity in near-death
experiencers during a meditative state. Resuscitation (2009). 80:1006–10.
doi: 10.1016/j.resuscitation.2009.05.006
13. Kelly EW. Near-death experiences with reports of meeting deceased people.
(2001). Death Stud. (2001). 25:229–49. doi: 10.1080/07481180125967
14. Gabbard G, Twemlow S. Do “near-death experiences” occur only near-death?-
Revisited. J Near Death Stud. (1991). 10:41–47.
15. Wilson SC, BarberTX. The fantasy-prone personality: implications for
understanding imagery, hypnosis, and parapsychological phenomena. In:
Sheikh AA editor. Imagery: Current Theory, Research, and Application. New
York, NY: Wiley (1983a). p. 340–87.
16. Merckelbach H, Horselenberg R, Muris P. The Creative Experiences
Questionnaire (CEQ): a brief self-report measure of fantasy proneness. Pers
Individ Dif. (2001) 31:987–95. doi: 10.1016/S0191-8869(00)00201-4
17. Aleman A, De Haan EHF Fantasy proneness, mental imagery
and reality monitoring. Pers Individ Dif. (2004). 36:1747–54.
doi: 10.1016/j.paid.2003.07.011
18. Huitt W. The Information Processing Approach to Cognition.Educational
Psychology Interactive. Valdosta, GA: Valdosta State University. (2003).
19. Mobbs D, Watt C. There is nothing paranormal about near-death experiences:
how neuroscience can explain seeing bright lights, meeting the dead, or
being convinced you are one of them. Trends Cogn Sci. (2011) 15, 447–9.
doi: 10.1016/j.tics.2011.07.010
20. Ring K. The Omega Project: Near-Death Experiences, UFO Encounters, and
Mind at Large. NewYork, NY: William Morrow (1992).
21. Greyson B. Incidence and correlates of near-death experiences
in a cardiac care unit. Gen Hosp Psychiaty (2003) 25:269–76.
doi: 10.1016/S0163-8343(03)00042-2
22. van Lommel P, van Wees R, Meyers V, Elfferich I. Near-death experience in
survivors of cardiac arrest: a prospective study in the Netherlands. Lancet
(2001) 358, 2039–2045. doi: 10.1016/S0140-6736(01)07100-8
23. Martial C, Charland-Verville V, Dehon H, and Laureys S. False
memory susceptibility in coma survivors with and without a near-death
experience. Psychol Res. (2017). doi: 10.1007/s00426-017-0855-9. [Epub ahead
of print].
24. Greyson B. Dissociation in people who have near-death experiences: out
of their bodies or out of their minds? Lancet (2000) 3255:460–463.
doi: 10.1016/S0140-6736(00)82013-9
25. Merckelbach H, Muris P, Horselenberg R, Stougie S. Dissociative experiences,
response bias, and fantasy proneness in college students. Pers Individ Dif.
(2000) 28:49–58. doi: 10.1016/S0191-8869(99)00079-3
26. Wilson SC, Barber TX. The Memory, Imagination and Creativity Schedule.
Framingham, MA: The Medfield Foundation (1983b).
27. Ring K, Rosing CJ. The omega project: an empirical study of the NDE prone
personality. J Near Death Stud. (1992) 8:211–39. doi: 10.1007/BF01074276
28. Merckelbach H, Muris P, Rassin E. Fantasy proneness and cognitive failures
as correlates of dissociative experiences. Pers Individ Dif. (1999). 26:961–7.
doi: 10.1016/S0191-8869(98)00193-7
29. Blackmore S. Dying to Live: Science and Near-Death Experience. London:
Grafton. (1993).
30. Smallwood J, Beach E, Schooler JW, Going AWOL in the brain: mind
wandering reduces cortical analysis of external events. J Cognitive Neurosci.
(2008) 20:458–69. doi: 10.1162/jocn.2008.20037
31. Karapanagiotidis T, Bernhardt BC, Jefferies E, et al. Tracking
thoughts: Exploring the neural architecture of mental time
travel during mind-wandering. Neuroimage(2017) 147:272–81.
doi: 10.1016/j.neuroimage.2016.12.031
32. McCrae RR, Costa PT. Validation of the five-factor model of personality
across instruments and observers. J Pers Soc Psychol. (1987) 52:81–90.
doi: 10.1037/0022-3514.52.1.81
33. Rothmann S, Coetzer E. The big five personality dimensions and job
performance. SA J Ind Psychol (2003) 29:68–74. doi: 10.4102/sajip.v29i1.88
34. Thonnard M, Charland-Verville V, Brédart S, Dehon H, Ledoux D,
Laureys S.. Characteristics of near-death experiences memories as compared
to real and imagined events memories. PLoS ONE (2013) 8:e57620.
doi: 10.1371/journal.pone.0057620
35. Johnson MK, Raye CL. Reality monitoring. Psychol Rev (1981) 88:67–85.
doi: 10.1037/0033-295X.88.1.67
36. Aleman A, Böcker KBE, De Haan EHF. Disposition toward hallucination and
subjective versus objective imagery in normal subjects. Pers Individ Dif. (1999)
27:707–14. doi: 10.1016/S0191-8869(98)00270-0
37. Belanti J, Perera M, Jagadheesan K. Phenomenology of near-death
experiences: a cross-cultural perspective. Transcult Psychiatry (2008) 45:121–
33. doi: 10.1177/1363461507088001
38. Pasricha S, Stevenson I. Near-death experiences in India. J Nerv Ment Dis.
(1986). 174:165–70. doi: 10.1097/00005053-198603000-00007
39. Pistoia F, Mattiacci G, Sarà M, Padua L, Macchi C, Sacco S. Development of
the Italian version of the near-death experience scale. Front Hum Neurosci.
(2018). 12:45. doi: 10.3389/fnhum.2018.00045
40. Greyson B. Defining near-death experiences. Mortality (1999) 4:7–20.
doi: 10.1080/713685958
Conflict of Interest Statement: The authors declare that the research was
conducted in the absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.
Copyright © 2018 Martial, Cassol, Charland-Verville, Merckelbach and Laureys.
This is an open-access article distributed under the terms of the Creative Commons
Attribution License (CC BY). The use, distribution or reproduction in other forums
is permitted, provided the original author(s) and the copyright owner are credited
and that the original publication in this journal is cited, in accordance with accepted
academic practice. No use, distribution or reproduction is permitted which does not
comply with these terms.
Frontiers in Psychiatry | www.frontiersin.org 7June 2018 | Volume 9 | Article 190
... In addition, those with NDEs more easily experience common and non-pathological dissociation states, such as daydreaming or becoming so absorbed in a task that the individual is unaware of what is happening in the room [104]. They are also more prone to fantasy [50]. These findings suggest that NDE experiencers are particularly sensitive to their internal states and that they possess a special propensity to pick up certain perceptual elements that other individuals do not see or hear. ...
... and personality traits correlate with the emergence and the richness of NDEs (Box 2). Continuously, we use information gathered through our senses (bottom-up processing) and we also construct meaning about our environment (and our interactions with it) by using information we have already stored in memory (top-down processing) [49,50]. The NDE phenomenology may reflect individuals' attempts to make sense of the ambiguous perceptive features in critical circumstances [44,[50][51][52]. ...
... Continuously, we use information gathered through our senses (bottom-up processing) and we also construct meaning about our environment (and our interactions with it) by using information we have already stored in memory (top-down processing) [49,50]. The NDE phenomenology may reflect individuals' attempts to make sense of the ambiguous perceptive features in critical circumstances [44,[50][51][52]. NDEs have also been conceived as a type of depersonalization (i.e., a sense of the self as unreal or lacking agency) inducing an altered sensation in one's sense of identity [53]. ...
Article
Full-text available
Forty-five years ago, the first evidence of near-death experience (NDE) during comatose state was provided, setting the stage for a new paradigm for studying the neural basis of consciousness in unresponsive states. At present, the state of consciousness associated with NDEs remains an open question. In the common view, consciousness is said to disappear in a coma with the brain shutting down, but this is an oversimplification. We argue that a novel framework distinguishing awareness, wakefulness, and connectedness is needed to comprehend the phenomenon. Classical NDEs correspond to internal awareness experienced in unresponsive conditions, thereby corresponding to an episode of disconnected consciousness. Our proposal suggests new directions for NDE research, and more broadly, consciousness science.
... To date, no theory has been able to fully account for the whole NDE phenomenon. However, several hypotheses have been formulated regarding the role of psychological factors, notably higher dissociative symptoms and fantasy proneness in people who have lived these experiences (so-called NDE experiencers or NDErs;Greyson 2000b;Martial et al. 2018), as well as neuropsychological mechanisms (Jansen 1990;Timmermann et al. 2018). ...
... Considering that the richness of the experience appears to be associated with NDErs' traits (e.g. fantasy proneness; Martial et al. 2018), future studies should investigate to what extent NDE richness might also influence their interpretation and integration into the life story. ...
... We observed that both groups of experiences did not differ in terms of richness of the experience. This is consistent with our previous studies (e.g., [6,7,39]). Moreover, no difference was observed between their experience of ego dissolution and inflation. ...
Article
Full-text available
Many people who have had a near-death experience (NDE) describe, as part of it, a disturbed sense of having a “distinct self”. However, no empirical studies have been conducted to explore the frequency or intensity of these effects. We surveyed 100 NDE experiencers (Near-Death-Experience Content [NDE-C] scale total score ≥27/80). Eighty participants had their NDEs in life-threatening situations and 20 had theirs not related to life-threatening situations. Participants completed the Ego-Dissolution Inventory (EDI) and the Ego-Inflation Inventory (EII) to assess the experience of ego dissolution and inflation potentially experienced during their NDE, respectively. They also completed the Nature-Relatedness Scale (NR-6) which measures the trait-like construct of one’s self-identification with nature. Based on prior hypotheses, ratings of specific NDE-C items pertaining to out-of-body experiences and a sense of unity were used for correlational analyses. We found higher EDI total scores compared with EII total scores in our sample. Total scores of the NDE-C scale were positively correlated with EDI total scores and, although less strongly, the EII and NR-6 scores. EDI total scores were also positively correlated with the intensity of OBE and a sense of unity. This study suggests that the experience of dissolved ego-boundaries is a common feature of NDEs.
... It should also be pointed out that the time that has elapsed since the NDEs was relatively long and may have introduced inaccuracies in participants' recall of their experiences. Although the experience was subsequently recalled with vividness and details (Martial et al., 2017a;Moore & Greyson, 2017;Thonnard et al., 2013), several factors may have influenced memory accuracy such as memory performance and personality traits (Martial et al., 2017c;Martial et al., 2018). In addition, no study has assessed the psychometric properties of the French version of the NDE scale used in Study 1. Finally, we should stress that the new scale might not reflect the NDE in all its richness and intensity since the scale is comprised solely of closed questions. ...
Article
Full-text available
As interest grows in near-death experiences (NDEs), it is increasingly important to accurately identify them to facilitate empirical research and reproducibility among assessors. We aimed (1) to reassess the psychometric properties of the NDE scale developed by Greyson (1983) and (2) to validate the Near-Death Experience Content (NDE-C) scale that quantifies NDEs in a more complete way. Internal consistency, construct and concurrent validity analyses were performed on the NDE scale. Based on those results and the most recent empirical evidence, we then developed a new 20-item scale. Internal consistency, explanatory and confirmatory factor, concurrent and discriminant validity analyses were conducted. Results revealed (1) a series of weaknesses in the NDE scale, (2) a 5-factor structure covering relevant dimensions and the very good psychometric properties of the NDE-C scale, including very good internal consistency (Cronbach α=0.85) and concurrent validity (correlations above 0.76). This new reliable scale should facilitate future research.
... This is in line with Lynn et al. (2014), who reviewed evidence indicating that the overlap between fantasy proneness and dissociation cannot be accounted for entirely in terms of self-reported trauma. Rogers and Lowrie (2016; see also Rogers et al., 2007), Bigelsen and Schupak (2011), and Martial et al. (2018) provide further examples of a disconnect between fantasy proneness and trauma. All in all, these findings support the alternative idea that there are non-traumatic routes to fantasy proneness such as genetic predisposition (Ott, Reuter, Hennig, & Vaitl, 2005), parental encouragement of creativity (Rhue & Lynn, 1988), or boredom (Bigelsen, Lehrfeld, Jopp, & Somer, 2016). ...
Article
Full-text available
We reviewed articles that appeared between 2000 and 2018 and that addressed fantasy proneness as measured by the Creative Experiences Questionnaire (CEQ) or the Inventory of Childhood Memories and Imaginings (ICMI). We searched Google Scholar to identify relevant articles and used the Hunter-Schmidt method to meta-analyze the correlates of fantasy proneness. We identified 132 articles describing 139 samples that together included 24,007 research participants. Effect sizes were large (r’s > .50) for hallucinatory experiences, magical ideation, perceptual aberration, dissociation, and excessive daydreaming. Contrary to the popular idea that childhood trauma is a prominent precursor of fantasy proneness, we found that the effect sizes for self-reported trauma, were small, as was also the case for depression, anxiety, and memory illusions (r’s < .30). Strides in this research area can be made when future studies move beyond the fantasy proneness-trauma link to test causal models regarding the antecedents of maladaptive fantasizing
... These subjective experiences contain some typical and recurrent features such as the vision of a bright light, outof-body experiences (OBEs) or coming to a border or a point of no return (Greyson, 1983;Martial et al., 2017a;Cassol et al., 2018). Long regarded as taboo and out of reach for science, the scientific study of the phenomenon emerged only four decades ago but recently led to an increasing number of empirical research (e.g., Van Lommel et al., 2001;Palmieri et al., 2014;Martial et al., 2018Martial et al., , 2019a. NDEs are of particular clinical relevance given their frequency of appearance (i.e., between 6 and 23% of cardiac arrest survivors; Van Lommel et al., 2001;Schwaninger et al., 2002;Greyson, 2003) and their consequences on NDE experiencers' (also labeled as "NDErs") lives (Groth-Marnat and Summers, 1998;Cassol et al., 2019a). ...
Article
Full-text available
Memories of near-death experiences (NDEs) are recalled as “realer” than memories of other real or imagined events. Given their rich phenomenology, emotionality and consequentiality, it was hypothesized that they could meet some aspects of the definition of flashbulb memories. We aimed to identify and compare the episodic and non-episodic information provided in verbal recollections of NDE, flashbulb, and control autobiographical memories. The phenomenological characteristics and centrality of the memories were also compared. Twenty-five participants who had lived a NDE in a life-threatening situation were interviewed and completed the Memory Characteristics Questionnaires as well as the Centrality of Event Scale for their NDE, a flashbulb and another autobiographical memory used as control. Overall, transcribed NDE verbal recollections included a higher overall amount of details and more internal/episodic information than control autobiographical and flashbulb memories. Moreover, flashbulb memories were associated to a lower intensity of feelings while remembering and a lower personal importance, and are less reactivated and less susceptible to be remembered from a first person perspective compared to NDE and control autobiographical memories. Finally, NDE memories are the most central memories to experiencers’ identity, followed by control autobiographical and then by flashbulb memories. These findings corroborate previous studies highlighting the impact and uniqueness of NDE memories.
... Furthermore, individuals who have, on separate occasions, experienced both hallucinations and an NDE describe the experiences and associated imagery as being quite different (Sartori, Badham, & Fenwick, 2006). A more recent study indicated that compared to individuals who were categorized as having an NDE-like experience, those who had an NDE as indicated by the sum of their responses on the NDE Scale, scored lower on fantasy proneness but showed no difference to matched controls (Martial, Cassol, Charland-Verville, Merckelbach, & Laureys, 2018), indicating a tendency to engage in fantasy is also not reliably associated with NDE occurrence. ...
Chapter
Near-death experiences (NDEs) have been reported across time and cultures and more recently with increased frequency, in part due to improved survival rates from near-fatal encounters. As anomalous psychological phenomena often occurring in near-death situations, NDEs represent a radical departure from everyday normative experiences and are typically characterized by their transcendence of space, time, and perceptual boundaries. Although consensus regarding a definition of NDEs is yet to be achieved, less disputed is the profound impact such experiences effect in the lives of those who have them, particularly in regard to notions of religiosity and spirituality. This chapter will consider NDEs and their influence. After defining NDEs, considering causal explanations, and identifying cultural and motivational factors influencing the social reporting of NDEs, the chapter will explore the impact of NDEs on religious faith and spirituality and provide some explanatory propositions for reflection.
... Alternatively, is it a real experience of sped-up AM functioning? The CLR may be also seen as an example of false memories, similar to dream memories or memories of stressful events [10,11]. ...
Article
Full-text available
The compressed life review (CLR) is a mnemonic illusion of having “your entire life flashing before your eyes”. This research was guided by concerns over the retrospective methodology used in CLR studies. To depart from this methodology, I considered the long-term working memory (WM), “concentric”, and “activation-based” models of memory. A novel theoretically rooted laboratory-based experimental technique aimed to elicit the CLR-like experience with no risk to healthy participants was developed. It consists of listening to superimposed audio recordings of previously trained verbal cues to an individually composed set of self-defining memories (SDMs). The technique evoked a self-reported CLR-like experience in 10 out of 20 participants. A significant similarity in eye movement patterns between a single SDM condition and a choir of SDM conditions in self-reported CLR experiencers was confirmed. In both conditions, stimuli caused relative visual immobilization, in contrast to listening to a single neutral phrase, and a choir of neutral phrases that led to active visual exploration. The data suggest that CLR-like phenomenology may be successfully induced by triggering short-term access to the verbally cued SDMs and may be associated with specific patterns of visual activity that are not reportedly involved with deliberate autobiographical retrieval.
... We found a prevalence of 10% using the same criteria in our previous crowdsourcing online survey on NDE and REM intrusion (Kondziella, Dreier & Olsen, 2019), indicating that this prevalence is quite robust. Unlike most previous reports in which NDE were almost always associated with peace and well-being (Thonnard et al., 2013;Charland-Verville et al., 2014;Martial et al., 2017Martial et al., , 2018Cassol et al., 2018), we confirmed recent findings that many people find their NDE unpleasant (Charland-Verville et al., 2015;Kondziella, Dreier & Olsen, 2019;Cassol et al., 2019). However, experiences with the cut-off score of ≥7 GNDES points were reported more often as pleasant (49%) than experiences with a lower score (13%). ...
Article
Full-text available
Background Near-death experiences (NDE) occur with imminent death and in situations of stress and danger but are poorly understood. Evidence suggests that NDE are associated with rapid eye movement (REM) sleep intrusion, a feature of narcolepsy. Previous studies further found REM abnormalities and an increased frequency of dream-enacting behavior in migraine patients, as well as an association between migraine with aura and narcolepsy. We therefore investigated if NDE are more common in people with migraine aura. Methods We recruited 1,037 laypeople from 35 countries and five continents, without any filters except for English language and age ≥18 years, via a crowdsourcing platform. Reports were validated using the Greyson NDE Scale. Results Eighty-one of 1,037 participants had NDE (7.8%; CI [6.3–9.7%]). There were no significant associations between NDE and age ( p > 0.6, t -test independent samples) or gender ( p > 0.9, Chi-square test). The only significant association was between NDE and migraine aura: 48 (6.1%) of 783 subjects without migraine aura and 33 (13.0%) of 254 subjects with migraine aura had NDE ( p < 0.001, odds ratio (OR) = 2.29). In multiple logistic regression analysis, migraine aura remained significant after adjustment for age ( p < 0.001, OR = 2.31), gender ( p < 0.001, OR = 2.33), or both ( p < 0.001, OR = 2.33). Conclusions In our sample, migraine aura was a predictor of NDE. This indirectly supports the association between NDE and REM intrusion and might have implications for the understanding of NDE, because a variant of spreading depolarization (SD), terminal SD, occurs in humans at the end of life, while a short-lasting variant of SD is considered the pathophysiological correlate of migraine aura.
Chapter
The word ‘consciousness’ indicates several partially overlapping meanings, with the intended one depending on the context. Dictionaries tend to limit ‘consciousness’ to ‘awareness’, and that may range from perception of a sensory stimulus to self-awareness, i.e. the mind knowing it exists. Neuroscientists have made some progress in the search for the ‘neural correlate of consciousness’, although the networks that give rise to self-awareness have yet to be identified. There are three normal states of consciousness: in the awake state there is awareness of oneself and of the outside world; in dreams there is awareness of oneself, but this is disconnected from the outside world; in dreamless sleep awareness also occurs, but less often, and it is usually not remembered later.
Article
Full-text available
Near-death experiences (NDEs) have been defined as any conscious perceptual experience occurring in individuals pronounced clinically dead or who came very close to physical death. They are frequently reported by patients surviving a critical injury and, intriguingly, they show common features across different populations. The tool traditionally used to assess NDEs is the NDE Scale, which is available in the original English version. The aim of this study was to develop the Italian version of the NDE Scale and to assess its reliability in a specific clinical setting. A process of translation of the original scale was performed in different stages in order to obtain a fully comprehensible and accurate Italian translation. Later, the scale was administered to a convenience sample of patients who had experienced a condition of coma and were, at the time of assessment, fully conscious and able to provide information as requested by the scale. Inter-rater and test–retest reliability, assessed by the weighted Cohen’s kappa (Kw), were estimated. A convenience sample of 20 subjects [mean age ± standard deviation (SD) 51.6 ± 17.1, median time from injury 3.5 months, interquartile range (IQR) 2–10] was included in the study. Inter-rater [Kw 0.77 (95% CI 0.67–0.87)] and test–retest reliability [Kw 0.96 (95% CI 0.91–1.00)] showed good to excellent values for the total scores of the Italian NDE Scale and for subanalyses of each single cluster of the scale. An Italian Version of the NDE Scale is now available to investigate the frequency of NDE, the causes for NDE heterogeneity across different life-threatening conditions, and the possible neural mechanisms underlying NDE phenomenology.
Article
Full-text available
It has been postulated that memories of near-death experiences (NDEs) could be (at least in part) reconstructions based on experiencers’ (NDErs) previous knowledge and could be built as a result of the individual’s attempt to interpret the confusing experience. From the point of view of the experiencer, NDE memories are perceived as being unrivalled memories due to its associated rich phenomenology. However, the scientific literature devoted to the cognitive functioning of NDErs in general, and their memory performance in particular, is rather limited. This study examined NDErs’ susceptibility to false memories using the Deese–Roediger–McDermott (DRM) paradigm. We included 20 NDErs who reported having had their experience in the context of a life-threatening event (Greyson NDE scale total score ≥7/32) and 20 volunteers (matched for age, gender, education level and time since brain insult) who reported a life-threatening event but without a NDE. Both groups were presented with DRM lists for a recall task during which they were asked to assign “Remember/Know/Guess” judgments to any recalled response. In addition, they were later asked to complete a post-recall test designed to obtain estimates of activation and monitoring of critical lures. Results demonstrated that NDErs and volunteers were equally likely to produce false memories but that NDErs recalled them more frequently associated with compelling illusory recollection. Of particular interest, analyses of activation and monitoring estimates suggest that NDErs and volunteers groups were equally likely to think of critical lures but source monitoring was less successful in NDErs compared to volunteers.
Article
Full-text available
Near-death experiences (NDEs) have been described consistently since antiquity and more rigorously in recent years. Investigation into their mechanisms and effects has been impeded by the lack of quantitative measures of the NDE and its components. From an initial pool of 80 manifestations characteristic of NDEs, a 33-item scaled-response preliminary questionnaire was developed, which was completed by knowledgeable subjects describing their 74 NDEs. Items with significant item-total score correlations that could be grouped into clinically meaningful clusters constituted the final 16-item NDE Scale. The scale was found to have high internal consistency, split-half reliability, and test-retest reliability; was highly correlated with Ring's Weighted Core Experience Index; and differentiated those who unequivocally claimed to have had NDEs from those with qualified or questionable claims. This reliable, valid, and easily administered scale is clinically useful in differentiating NDEs from organic brain syndromes and nonspecific stress responses, and can standardize further research into mechanisms and effects of NDEs.
Article
Full-text available
Background: Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. Methods: This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., "NDE-like" experience) or after a pathological coma (i.e., "real NDE") and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. Results: From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between "NDE-like" (n = 50) and "real NDE" (n = 140) groups, nor within the "real NDE" group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89-93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. Conclusions: It appears that "real NDEs" after coma of different etiologies are similar to "NDE-like" experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers.
Article
The capacity to imagine situations that have already happened or fictitious events that may take place in the future is known as mental time travel (MTT). Studies have shown that MTT is an important aspect of spontaneous thought, yet we lack a clear understanding of how the neurocognitive architecture of the brain constrains this element of human cognition. Previous functional magnetic resonance imaging (MRI) studies have shown that MTT involves the coordination between multiple regions that include mesiotemporal structures such as the hippocampus, as well as prefrontal and parietal regions commonly associated with the default mode network (DMN). The current study used a multimodal neuroimaging approach to identify the structural and functional brain organisation that underlies individual differences in the capacity to spontaneously engage in MTT. Using regionally unconstrained diffusion tractography analysis, we found increased diffusion anisotropy in right lateralised temporo-limbic, corticospinal, inferior fronto-occipital tracts in participants who reported greater MTT. Probabilistic connectivity mapping revealed a significantly higher connection probability of the right hippocampus with these tracts. Resting-state functional MRI connectivity analysis using the right hippocampus as a seed region revealed greater functional coupling to the anterior regions of the DMN with increasing levels of MTT. These findings demonstrate that the interactions between the hippocampus and regions of the cortex underlie the capacity to engage in MTT, and support contemporary theoretical accounts that suggest that the integration of the hippocampus with the DMN provides the neurocognitive landscape that allows us to imagine distant times and places.
Article
The near-death experience (NDE) raises important unanswered questions about changes in brain activity that take place in the moments before death, as well as in dreams and altered states in which similar experiences are reported to occur. The fact that NDEs take place in response to both life-threatening trauma and nonlife-threatening situations, suggests that multiple mechanisms underlie NDE phenomenology. In this paper, the NDE is considered in the context of recent advances in neuroscience, including the default mode network DMN and ?connectomics? theory. Findings of animal and human studies support that a surge of highly coherent electrical activity takes place in the brain moments before cessation of cardiac function. Starting from these findings, I propose a multifactorial model in which disparate physiological and psychological factors activate dynamically interconnected networks, resulting in phenomenal content retrospectively interpreted as NDEs. I develop 3 variations of a general model based on the assumption that networks can be activated as a single event, serially, or in parallel with other networks. Mechanisms postulated for the models differ with respect to the relative order of network dynamics involved. The phenomenal content of a unique NDE and its recall are constrained by multiple physiological factors that modulate neural network activity and affect encoding and decoding of information in cortical and subcortical brain regions. In conclusion, I propose a longitudinal research program using sophisticated electroencephalographic (EEG) and functional brain-imaging techniques and advanced data analysis methods.
Article
Few scientists have taken seriously the interpretation of near-death experiences (NDEs) as evidence for survival after death, even though most people having such an experience have become convinced that they will survive death and several features of NDEs are at least suggestive of survival. This article compares survival and some nonsurvival interpretations of NDEs in light of one feature suggestive of survival, that of reports of having seen deceased persons during the NDE. Several features of 74 NDEs involving such reports were compared with those of 200 NDEs not involving such reports. Although some of the findings could support either a survival or a nonsurvival interpretation, several other findings may weaken the Primary nonsurvival hypothesis, that of expectation. Additionally, the convergence of several features suggesting survival and the convergence of features that require multiple kinds of alternative explanations, in individual cases as well as in large groups of cases, warrant our considering the survival hypothesis of NDEs more seriously than most scientists currently do.
Chapter
Out-of-body experiences (OBEs) and near-death experiences (NDEs) are complex phenomena that have fascinated mankind from time immemorial. OBEs are defined as experiences in which a person seems to be awake and sees his body and the world from a disembodied location outside his physical body. Recent neurological and neuroscientific research suggests that OBEs are the result of disturbed bodily multisensory integration, primarily in right temporo-parietal cortex. NDEs are more loosely defined, and refer to a set of subjective phenomena, often including an OBE, that are triggered by a life-threatening situation. Although a number of different theories have been proposed about the putative brain processes underlying NDEs, neurologists and cognitive neuroscientists have, so far, paid little attention to these phenomena, although several experimental investigations based on principles from cognitive neuroscience are possible. This might be understandable but is unfortunate, because the neuroscientific study of NDEs could provide insights into the functional and neural mechanisms of beliefs, concepts, personality, spirituality, magical thinking, and the self. Based on previous medical and psychological research in cardiac arrest patients with NDEs, we sketch a neurological framework for the study of the so-called NDEs.