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Back to Psychiatry Diseases
Formal thought disorder
In psychiatry, thought disorder or formal thought disorder is a term
used to describe a symptom of psychotic mental illness.
It describes a persistent underlying disturbance to conscious thought
and is classified largely by its effects on speech and writing. Affected
persons may show pressure of speech (speaking incessantly and quickly),
derailment or flight of ideas (switching topic mid-sentence or
inappropriately), thought blocking, rhyming or punning or 'word salad'
when individual words may be intact but speech is incoherent.
Subtypes in detail
Pressure of speech
An increase in the amount of spontaneous speech compared to what is
considered customary.
Distractible speech
During mid speech, the subject is changed in response to a stimulus.
e.g. "Then I left San Francisco and moved to... where did you get that
tie ?"
Tangentiality
Replying to questions in an oblique, tangential or irrelevant manner.
e.g. "What city are you from ?", "Well, that's a hard question. I'm from
Iowa. I really don't know where my relatives came from, so I don't know
if I'm Irish or French".
Derailment
Ideas slip off the track on to another which is obliquely related or
unrelated. e.g. "The next day when I'd be going out you know, I took
control, like uh, I put bleach on my hair in California".
Incoherence (word salad)
Speech that is unintelligible due to the fact that, though the
individual words are real words, the manner in which they are strung
together results in incoherent gibberish, e.g. the question "Why do
people believe in God?" elicits a response like "Because make a twirl in
life, my box is broken help me blue elephant. Isn't lettuce brave? I
like electrons, hello."
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Illogicality
Conclusions are reached that do not follow logically (non sequiturs or
faulty inductive inferences).
Clanging
Sounds rather than meaningful relationships appear to govern words. e.g.
"I'm not trying to make noise. I'm trying to make sense. If you can't
make sense out of nonsense, well, have fun".
Neologisms
New word formations. e.g. "I got so angry I picked up a dish and threw
it at the geshinker".
Word approximations
Old words used in a new and unconventional way. e.g. "His boss was a
seeover".
Circumstantiality
Speech that is very delayed at reaching its goal. Excessive long
windedness.
Loss of goal
Failure to show a chain of thought to a natural conclusion.
Perseveraton
Persistent repetition of words or ideas. e.g. "I'll think I'll put on my
hat, my hat, my hat, my hat, my hat, my hat, my hat, my hat..."
Echolalia
Echoing of other people's speech e.g. "Can we talk for a few minutes ?",
"Talk for a few minutes".
Blocking
Interruption of train of speech before completed.
Stilted speech
Speech excessively stilted and formal. e.g. "The attorney comported
himself indecorously".
Self-reference
Patient repeatedly and inappropriately refers back to self. e.g. "What's
the time?", "It's 7 o'clock. That's my problem".
Phonemic paraphasia
Mispronounciation; syllables out of sequence. e.g. "I slipped on the
lice broke my arm".
Semantic paraphasia
Substitution of inappropriate word. e.g. "I slipped on the coat, on the
ice I mean, and broke my book".
Diagnostic issues
The concept of thought disorder has been criticized as being based on
circular or incoherent definitions. For example, thought disorder is
inferred from disordered speech, however it is assumed that disordered
speech arises because of disordered thought. Similarly the definition of
'Incoherence' (word salad) is that speech is incoherent.
This article is licensed under the GNU Free Documentation License. It uses material from the
Wikipedia
article "Formal thought disorder".
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