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 is also known as knight's move thinking referring to the nonlinear way a knight moves in chess. Psychiatrist redirects here. ... Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration... This article does not cite its references or sources. ... The knight moves in an L shape. ... Chess is a recreational and competitive game for two players. ...

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. This article or section does not cite its references or sources. ... Scribe Writing Writing, in its most common sense, is the preservation and the preserved text on a medium, with the use of signs or symbols. ... A rhyme is a repetition of identical or similar terminal sounds in two or more different words (i. ... It has been suggested that dajare be merged into this article or section. ... In context of e-mail spamming, see also Word salad (computer science). ...

Eugen Bleuler, who named schizophrenia, held that its defining characteristic was a disorder of the thinking process.^[1] 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. Eugene Bleuler (b. ... A delusion is commonly defined as a false belief, and is used in everyday language to describe a belief that is either false, fanciful or derived from deception. ... A hallucination is a false sensory perception in the absence of an external stimulus, as distinct from an illusion, which is a misperception of an external stimulus. ... Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration...

Specific subtypes in detail

Nancy C. Andreasen^[2] has given the following definitions. Nancy C. Andreasen, M.D., Ph. ...

• 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:

Q: "What city are you from?"
A: "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". Pressure of speech is a tendency to speak rapidly and frenziedly, as if motivated by an urgency not apparent to the listener. ...

• 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 he makes a twirl in life, my box is broken help me blue elephant. Isn't lettuce brave? I like electrons. Hello, beautiful."
• Illogicality - Conclusions are reached that do not follow logically (non sequiturs or faulty inductive inferences). e.g. "Do you think this will fit in that box?" draws a reply like "well duh, its brown, isn’t it?"
• 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. e.g. "What is your name?" "Well, sometimes when people ask me that I have to think about whether or not I will answer because some people think its an odd name even though I don’t really because my mom gave it to me and I think my dad helped but its as good a name as any in my opinion but yeah it's Tom."
• Loss of goal - Failure to show a chain of thought to a natural conclusion.
• Perseveration - 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..."
• 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 - Mispronunciation; 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".

In context of e-mail spamming, see also Word salad (computer science). ... In psychology and psychiatry, clanging is a form of speech pattern where thinking is driven by word sounds. ... A neologism is a word, term, or phrase which has been recently created (coined) — often to apply to new concepts, or to reshape older terms in newer language form. ... Look up perseverate in Wiktionary, the free dictionary. ... Echolalia is the repetition or echoing of verbal utterances made by another person. ...

Diagnostic issues

The concept of thought disorder has been criticized as being based on circular or incoherent definitions^[3]. 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, staccato speech, narrow focus on the details and obsessive questions.[1] A tendency to misdirect the conversation towards the persons obsessional interest could be mistaken for evidence of associative loosening. A comparison between affective flattening in autism and schizophrenia show that they did not differ in degree of flattening, 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. Asperger syndrome — also referred to as Aspergers syndrome, Aspergers disorder, Aspergers, or just AS — is a pervasive developmental disorder related to autism. ... Autism is classified by the World Health Organization (WHO) and American Psychological Association as a developmental disability that results from a disorder of the human central nervous system. ... Autism is classified by the World Health Organization (WHO) and American Psychological Association as a developmental disability that results from a disorder of the human central nervous system. ...

Many people with Asperger syndrome also make idiosyncratic use of words, including new coinages and unusual juxtapositions. This can develop into a rare gift for humor (especially puns, wordplay, doggerel, satire) or writing. Tony Attwood^[4] 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). Doggerel describes verse considered of little literary value. ... Echolalia is the repetition or echoing of verbal utterances made by another person. ... Palilalia is the repetition or echoing of ones own spoken words. ...

See also

• Psychosis
• Schizophrenia
• Asperger syndrome

Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration... Asperger syndrome — also referred to as Aspergers syndrome, Aspergers disorder, Aspergers, or just AS — is a pervasive developmental disorder related to autism. ...

References

1. ^ Colman, A. M. (2001) Oxford Dictionary of Psychology, Oxford University Press. ISBN 0-19-860761-X
2. ^ Andreasen NC. Thought, language, and communication disorders. I. A Clinical assessment, definition of terms, and evaluation of their reliability. Archives of General Psychiatry 1979;36(12):1315-21. PMID 496551.
3. ^ Bentall, R. (2003) Madness explained: Psychosis and Human Nature. London: Penguin Books Ltd. ISBN 0-7139-9249-2
4. ^ Attwood, T. (1997) Asperger's Syndrome: A Guide for Parents and Professionals, London: Jessica Kingsley. ISBN 1-85302-577-1.

Richard Bentall (1956 -) is a Chair in Experimental Clinical psychology at the University of Manchester, UK. Born in Sheffield, he attended the University College of North Wales, Bangor as an undergraduate before taking a Ph. ... Tony Attwood (born 1952 in Birmingham, United Kingdom) is the author of several books on Aspergers Syndrome. ...

Further reading

• Sims, A. (1995) Symptoms in the mind: An introduction to descriptive psychopathology. Edinburgh: Elsevier Science Ltd. ISBN 0-7020-2627-1