A new study challenges the idea that heightened sensitivity increases the risk of hallucinations or other psychosis-related symptoms. Published in Psychological Reports, the research found that traits linked to being a Highly Sensitive Person do not cause more anomalous perceptual experiences. In fact, when psychosis-prone traits were present, high sensitivity seemed to act as a protective buffer—reducing rather than increasing the likelihood of reporting unusual perceptual phenomena like hallucinations or altered sensory experiences.
Many people report experiences that seem out of the ordinary—hearing voices, sensing unseen presences, or having unusually vivid perceptions. These “anomalous perceived phenomena” are often associated with psychotic disorders, but they can also occur in people who are not clinically ill. At the same time, people with Highly Sensitive Person traits—those who are emotionally responsive, attuned to subtleties in their environment, and easily overstimulated—have been thought to be more vulnerable to distress or mental illness, including psychosis. Yet the connection between high sensitivity and these unusual perceptual experiences has remained unclear.
To address this, the researchers—Álex Escolà-Gascón and colleagues from institutions across Spain and the UK—developed a new model that combines existing theories of temperament, sensitivity, and psychosis. Their goal was to understand how these traits interact and to test whether high sensitivity increases or decreases the risk of experiencing anomalous perceptions. They called this new framework the Integrated Temperamental-Sensitivity Theory of Anomalous Experience (ITSTAE).
The researchers collected survey data from 1,215 Spanish-speaking adults between the ages of 21 and 55. Participants lived in Madrid, Barcelona, or Valencia and completed a series of psychological questionnaires online. These included a temperament inventory assessing traits like emotional reactivity, persistence, sensory sensitivity, and activity level along with a validated scale measuring Highly Sensitive Person traits, including ease of overstimulation and sensitivity to aesthetics or subtle stimuli.
The participants also completed a measure of psychosis-like traits known as the Psychosis Continuum Model, which includes positive symptoms such as hallucinations, negative symptoms like emotional flatness, and depressive symptoms along with an assessment of anomalous perceived phenomena, covering visual, auditory, tactile, olfactory, and bodily sensations not tied to real external stimuli.
As expected, the researchers found that psychosis-prone traits were strongly associated with higher levels of anomalous perceptual experiences. This supports the idea that some individuals are more likely than others to have hallucination-like perceptions, even in non-clinical populations.
However, Highly Sensitive Person traits did not increase the risk of these experiences. In fact, when psychosis-prone traits were taken into account, individuals with higher levels of sensitivity reported fewer anomalous experiences. The relationship reversed: sensitivity became a suppressor, not a risk factor. This counterintuitive finding suggests that while psychosis-like traits may increase susceptibility to altered perceptions, high sensitivity appears to dampen that effect.
This pattern was not apparent when psychosis traits were excluded from the analysis. Without controlling for psychosis-prone characteristics, there was no significant link between Highly Sensitive Person traits and anomalous experiences. Only when psychosis-like traits were considered did the protective effect of sensitivity become clear.
Moreover, when all three components—temperament, psychosis traits, and Highly Sensitive Person traits—were included in the analysis, the model significantly improved in predicting who would report anomalous experiences. The addition of psychosis-related traits raised the explained variance in anomalous experiences from 47.1% to 61.4%, showing that the interaction among these traits offers a more accurate picture than any one alone.
The researchers also confirmed that high sensitivity and psychosis-prone traits are conceptually and statistically distinct. Using a method called Multitrait-Multimethod analysis, they demonstrated that while the two constructs may overlap in some symptoms, they represent different psychological dimensions.
What the findings suggest
The study’s findings offer a new perspective on sensitivity and mental health. Instead of viewing Highly Sensitive People as fragile or at higher risk for hallucinations and delusions, the researchers propose that sensitivity may actually function as a cognitive shield—helping people filter or regulate how they process unusual perceptions.
This insight runs counter to psychiatric reductionism, which tends to interpret any perceptual anomaly as a symptom of mental illness. The new findings support a more nuanced view, in which altered perceptions are not automatically signs of pathology, especially in people with a temperament marked by high sensitivity.
The authors argue that the ITSTAE model could help clinicians better distinguish between benign perceptual quirks and symptoms that reflect real clinical risk. For example, someone with Highly Sensitive Person traits who occasionally experiences vivid perceptions may not be at risk for a psychotic disorder—especially if their sensitivity helps them regulate these experiences. On the other hand, someone with both high psychosis-prone traits and low sensitivity might be more vulnerable.
This model may also help reduce the stigma around both sensitivity and anomalous experiences. Not every unusual perception is a warning sign, and not every sensitive person is on the verge of a breakdown. Recognizing the complexity of these traits could improve psychological assessments and inform more personalized approaches to mental health.
The researchers note several limitations. The study relied on self-report questionnaires and used a correlational design, which means that causal relationships cannot be confirmed. Experimental studies and longitudinal research would be needed to determine whether sensitivity truly buffers psychotic symptoms over time.
The sample also included only non-clinical participants, meaning the results may not generalize to people already diagnosed with psychotic disorders. Clinical samples would be needed to explore whether sensitivity plays a similar role in those populations. In addition, the study focused on a relatively narrow set of temperament dimensions and did not include variables like extraversion, which could also influence how people experience or report anomalous perceptions.
Future research could explore how depressive or negative psychotic symptoms interact with Highly Sensitive Person traits, since the current study focused mainly on positive symptoms like hallucinations. It’s possible that highly sensitive individuals are more vulnerable to depression or social withdrawal, even if they are less prone to hallucinations. Investigating these questions could lead to a more complete picture of how sensitivity shapes mental health.
The study, “Who Has Anomalous Experiences Today? Evidence for the Highly Sensitive Person Paradox,” was authored by Álex Escolà-Gascón, Christopher C. French, Neil Dagnall, Andrew Denovan, and Alejandro Rujano.