Defining and ‘diagnosing’ aphantasia: condition or individual difference

Research into the newly-coined ‘condition’ of ‘aphantasia’, an individual difference involving the self-reported absence of voluntary visual imagery, has taken off in recent years, and more and more people are ‘self-diagnosing’ as aphantasic. Yet, there is no consensus on whether aphantasia should really be described as a ‘condition’, and there is no battery of psychometric instruments to detect or ‘diagnose’ aphantasia. Instead, researchers currently rely on the Vividness of Visual Imagery Questionnaire (VVIQ) to ‘diagnose’ aphantasia. We review here fundamental and methodological problems affecting aphantasia research stemming from an inadequate focus on how we should define aphantasia, whether aphantasia is a pathological condition, and the extensive use of VVIQ as a ‘diagnostic test’ for aphantasia. Firstly, we draw attention to ‘literature blindness’ for visual imagery research from the 1960s–1990s concerning individual differences in visual imagery vividness. Secondly, despite aphantasia being defined as a ‘condition’ where voluntary visual imagery is absent as indicated by the lowest score on the VVIQ, aphantasia studies inconsistently employ samples comprised of a mixture of participants with no visual imagery and low visual imagery, and we argue that this hinders the uncovering of the underlying cause of aphantasia. Thirdly, the scores used to designate the boundary between aphantasia and non-aphantasia are arbitrary and differ between studies, compromising the possibility for cross-study comparison of results. Fourthly, the problems of ‘diagnosing’ aphantasia are not limited to the academic sphere, as one can ‘self-diagnose’ online, for example by using the variant-VVIQ on the Aphantasia Network website. However, the variant-VVIQ departs from the original in ways likely to impact validity and accuracy, which could lead people to falsely believe they have been ‘diagnosed’ with aphantasia by a scientifically-validated measure. Fifthly, we discuss the hypothesis that people who believe they have been ‘diagnosed’ with aphantasia might be vulnerable to health anxiety, distress, and stigma. We conclude with a discussion about some fundamental aspects of how to classify a disorder, and suggest the need for a new psychometric measure of aphantasia