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In psychiatry, thought disorder or formal thought disorder is a term used to describe a pattern of disordered language use that is presumed to reflect disordered thinking. It is usually considered a symptom of psychotic mental illness, although it occasionally appears in other conditions.
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, punning, or 'word salad' when individual words may be intact but speech is incoherent.
Eugen Bleuler, who named schizophrenia, held that its defining characteristic was a disorder of the thinking process. It is important to note however that the delusions and hallucinations of psychosis could also be considered as disorders of thought, but that the term formal thought disorder applies specifically to the presumed disruption in the flow of conscious verbal thought that is inferred from spoken language. This is typically what is referred to when the strictly less accurate, more commonly used but abbreviated term, 'thought disorder', is used.
Additional recommended knowledge
Specific subtypes in detail
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.
Furthermore, although thought disorder is typically associated with psychosis, similar phenomena can appear in different disorders, potentially leading to misdiagnosis.
For example, people with Asperger syndrome often are noted for having a highly pedantic way of speaking, using language far more formal and structured than the situation normally would be thought to call for. Language abnormalities in Asperger Syndrome include literalness, substitutions, monotonous speech, repetition (echolalia), staccato speech, narrow focus on the details and obsessive questions. A tendency to misdirect the conversation toward the person's obsessional interest could be mistaken for evidence of associative loosening. A comparison between autism and schizophrenia showed that they did not differ in degree of affective blunting, and that people with autism showed poverty of speech, poverty of content of speech and perseveration. However, the autism group showed much less derailment and illogicality, due to their often obsessive focus on special topics of interests.
Many people with Asperger syndrome also make idiosyncratic use of words, including coinages and unusual juxtapositions. This can develop into a rare gift for humor (especially puns, wordplay, doggerel, satire) or writing. Tony Attwood refers to a particular child's skill at inventing expressions, e.g. "tidying down" (the opposite of tidying up) or "broken" (when referring to a baby brother who cannot walk or talk) (Attwood, 82). Another noted behavioral characteristic that may be present is echolalia, which causes the subject to repeat words, or parts of words, when they speak, like an echo, or palilalia repeating one's own words (Attwood, 109).
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Thought_disorder". A list of authors is available in Wikipedia.|