Anomy: description, causes, symptoms and treatment

“How was it… that we used to eat soups or creams, so round on the tip?” The word that comes to most people’s minds is “spoon”.

It’s a name, a tag that refers to a certain concept that the person who asked the question knows about, but doesn’t have access to. And while it is usually a momentary slippage, sometimes we are faced with a frequent event in which the individual does not remember the name of things. This is a language disorder called anomie.

Anomy: description and symptoms

The concept of anomie refers to the presence of difficulties in naming an object or a concept, That is to say to access or produce the name or label with which we designate. It is a problem that can appear in many circumstances, and in some cases something normal like before a slip or during aging while in others it can be a symptom of a more or less severe deterioration. The difficulty lies mainly in the use of nouns, being rarer that there are problems with verbs, adjectives or adverbs.

Generally the anomie person tends to use circumlocutions to make the recipient of his message understand what he is trying to say, for example by using semantic keys as to the use of the object in question, its form or what. happens during this situation or phenomenon. It’s also common to use wedges and phrases to save time, or more general categories that include the concept they’re having difficulty with (if they can’t get to the name “dog” they can say by example “animal”).

Patients and subjects who frequently have anomy often experience it with discomfort or even worry.As they are for the most part fully aware of what they mean although they have not found a way to represent it.

Types of anomie

While he tends to think of it as an anomie as a whole, the truth is that there are several aspects that can cause a specific name not to be remembered or to be emitted. Three main types of anomie stand out.

1. Lexical anomie

The purest and most well-known form of anemia occurs when the missing element is the ability to access the word while knowing clearly what it refers to. It’s not that you don’t know how to pronounce the word or what concept it refers to, it’s that you don’t have to represent the label itself. This is the type of anomie corresponding to the example in the introduction.

2. Phonological anomie

This type of anomie occurs when, despite knowing which concept you want to refer to and what your name is, The subject does not manage to find its representation at the phonetic level, not knowing what to say to name it. It is common in aphasias in which the production of the tongue is impaired, as in that of Broca.

3. Semantic anomie

The problem in this type of anomie arises during conceptualization, there are cognitive and memory problems. It’s not that he couldn’t pronounce the words or that he couldn’t find the right tag for a concept, but that he is unable to identify it.

Anomy and aphasia

Anomie is a common symptom present in many aphasias, those alterations and losses in the ability to produce and / or understand language caused by brain damage.

However, although it is usually one of the many symptoms that occur in different types of aphasia, if it appears without other language alterations, it can constitute so-called anomic aphasia. This type of aphasia is characterized by the fact that the language of the person is fluentThere is no difficulty in understanding the language and if you are asked to repeat the same words, you do so without difficulty. The only notable alteration is therefore anomie.

Anomic aphasia also corresponds to the semantic aphasia of the classification proposed by Luria, although there are nuances between them. In this case, the ability to name and find the word in question is impaired by the fact that the subject is not able to choose between different options, also presenting other problems such as difficulty in understanding complex relationships at the logical level.

Another type of aphasia particularly linked to anomie is semantic acoustico-amnesic aphasia, in which the subject does not remember the phonetic form of the word in question that he wishes to use. He knows what it is but not what it is called, which still poses problems when it comes to storing and reproducing series of words.

Contexts and causes of appearance

Anomie can appear in several contexts, and not all are clinical. For example, in the spike phenomenon of language, there is a difficulty in remembering a word, although the problem is more memory than language (we would be dealing with a case of lexical anomie). Also with age it is common to suffer from some degree of anomy due to the aging of the brain.

Clinically, anomy can appear in a large number of mental and organic disorders. Of particular relevance is the presence of language-related lesions in different areas of the brain. The most related to the anomy are the Broca zones 37 to 39 (including angular rotation) and other areas of tertiary association in the parieto-temporo-occipital zone. Likewise if the problem is in the formulation or the choice of the concept also presents a great influence of the frontal lobe.

These injuries and alterations are common in head injuries and strokes.. It is also very common in dementias, such as Alzheimer’s disease or certain frontotemporals such as semantic dementia.

treatment

In cases where it is not a slight slip but a really anomic subjectThe treatment to be applied will largely depend on the location of the problem. In any case, he tends to require rehabilitation from a multidisciplinary perspective, in which he emphasized the role of language therapy through the use of speech therapy. In other cases, especially in dementia derivatives, occupational therapy can be very helpful.

Among the activities to be applied, we have succeeded in using matching tasks between drawings and words or tasks in which they have to judge whether or not several words are synonymous in case of semantic anomie, and in the case of pure anomies or lexicons, use tasks in which phonetic cues can be used, as well as priming (first the word is presented then the drawing of the concept or element), tasks to complete words and / or phrases or the generation of rhymes. In case of phonological anomy, reading aloud and imitation and repetition tasks are usually helpful..

Bibliographical references:

  • Castejón, L. and Cuetos, F. (2006). Rehabilitation of anomy from a multidimensional perspective. Journal of speech therapy, phoniatry and audiology 26 (2); 101-114.
  • Cuetos, F. (2003). Anomie: The difficulty of remembering words. Madrid: TEA Publishing.
  • Sants, JL (2012). Psychopathology. CEDE PIR preparation manual, 01. CEDE. Madrid.

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