Thinking disorders: what they are, their classification and their characteristics

Among the many mental illnesses that exist, those which affect thinking represent an important part.

Let’s try to condense some of the most important data to find out what it is the main disturbances of thoughtHow to distinguish them from other relevant information to learn more about these pathologies.

    What are thought disorders?

    To be able to talk about thought disorders, it is first necessary to have very basic notions about psychopathology and its diagnostic classification.

    All mental illnesses are included in textbooks which are primarily DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, from the American Psychiatric Association) and ICD-10 (International Classification of Diseases, from WHO). These manuals classify all known psychopathologies and are updated cyclically make the relevant changes based on new investigations that have been carried out during this period. So in 2021 the DSM is in its fifth iteration, while the CIM is in its tenth iteration.

    Once we have a clear understanding of where the classification of mental illness falls, we can position thought disorders as one of the building blocks of these diagnostic textbooks. The other most important typologies that we can find are somatomorphic, internalizing, externalizing or disaffection disorders.

    After this introduction, we can now focus on thought disorders to know the characteristics of this type of pathology, then to know some of the clearest examples of these mental illnesses.

    Classification and characteristics

    Thinking disorders are psychological alterations the main symptom is an alteration in the subject’s cognitions. These alterations result in a communication dysfunction, both in his level of thought and in his language. In this type of disease we have to make a distinction, because thought can be changed both in content and in form.

    1. Formal thinking disorders

    When we speak of thought disorders, in general, we are generally referring to those who have altered their form. One of the most common pathologies in which we can see obvious signs of problems in the form of is schizophrenia. TPF can also be referred to as disorganized thinking or disorganized speech because it is one of the classic symptoms of these disorders.

    Disturbances in formal thinking are a sign of psychosis and as such should be taken into account as an indicator of serious pathology in the individual. In order to assess the extent of this disease, Nancy Andreasen developed two scales, the SAPS, to analyze positive symptoms, and the SANS, to assess negative symptoms.. We will come back to these stairs later to see them in depth.

    2. Problems in thinking about content

    We have already argued that thinking disorders can also refer to their content. It would also be a characteristic of schizophrenia because it has to do with delusions. It is also observed in pathologies such as obsessive-compulsive disorder. But CPT doesn’t necessarily have to result in illusions. It can also be seen as a level of pathological concern or obsession.

    Another symptom of these thought disorders is that of magical thinking, Which involves establishing arbitrary and illogical relationships on one’s own thoughts and repercussions in the world. Without reaching this extreme, ideas can also be overstated, exaggerating our own mental processes and thus making them lose their realism.

    Likewise, very significant signals can be seen by oneself in completely random events, so called ideas of reference. Phobias towards certain stimuli and even thoughts of self-harm can also arise. As we can see, the symptomatology of content thinking disorders is very broad.

    Negative Symptom Scale WITHOUT

    Returning to the SANS scale we mentioned earlier as an instrument for assessing negative symptoms of formal thinking disorders, let’s see what type they can be.

    1. Affective flattening

    One of the first characteristics that we can observe in these subjects is emotional jam, that is to say lack of demonstration of emotions. This can be captured by the lack of gestures or facial expressions, a very poor performance of spontaneous movements, the lack of emotional resonance with the content being processed or the display of inappropriate affection with them.

    In the eye contact itself, or rather in its absence, signs of this symptom can also be seen.

      2. Alogia

      Formal thinking disorders can also result in difficulty in speaking or having an allergy. Vocabulary may be poorer than usual and therefore can be satisfied. We notice that the subject takes longer than usual to answer the questions and that he remains blocked during the speech.

      3. Apathy

      Symptoms of apathy can also be seen in these people. The same hygiene care can be affected. Likewise, it can happen an abnormal decrease in performance in their tasks and a clear demonstration of a lack of physical energy in the subject.

      4. Attention

      The fourth factor that can be affected in formal thinking disorder is attention. It will be difficult for the individual to concentrate on the test they are performing.

      Positive SAPS Symptom Scale

      The other scale developed by Andreasen is the SAPS. This allows us to see the positive symptoms of formal thinking disordersIn other words, those which are observed for their presence and not for their deficit, as was the case with the negatives. They are as follows.

      1. Derailment

      The derailment consists of making a random association in speech, Go from one subject to another which may or may not have a relation to the previous one. This positive symptom can be observed in the subject’s speech but sometimes it can also be reflected in the writing.

      2. tangentiality

      Tangential speech is another observable symptom of formal thinking disorders. In this case, the person concerned can talk about a particular problem and, at some point, suddenly jump to another problem unrelated to the previous one and not give further explanation in this regard.

      3. Inconsistency

      The so-called word salad, or inconsistency, is another symptomatology in which the subject gives a totally bumpy speech in which there is no common thread and therefore it is impossible to understand what he is trying to say. All the words they use exist, but the succession of the same ones they make does not give rise to any coherent message..

      4. Loss of logic

      Formal thinking disorders can also be observed in which a symptom is loss of logic. When faced with a particular question, the individual may try to answer in a grammatically correct manner, but it is in fact he does not answer the question put to him and therefore does not keep a logic.

      5. Excessive detail

      Excessive detail or circumstantial speech could also indicate the existence of a thought disorder. In this case, we would observe that the person is concentrating on the donation. a clearly excessive amount of contextual detail rather than just answering the central question about which he was questioned.

      6. Speech pressure

      Another indicator that can be assessed on the SAPS scale is speech or speech pressure. In this case, this feature it manifests itself in dilapidated speech and uninterrupted, Which seems to show the urgency for the person to explain the idea that he is presenting, even if this urgency is apparently not observable for the interlocutor.

      7. Distractions when talking

      Formal thinking disorders can also be detected by excessive fingernail distractions while speaking. If a person is talking about a particular topic but any environmental stimulus makes them completely forget what they are saying and move on to talk about that other topic, we may think we are dealing with that symptom.

      8. Sound associations

      The last characteristic of formal thinking disorders that we can analyze using SAPS concerns so-called sound associations, also called clicks. This phenomenon occurs when the subject begins to introduce words into his speech by the sole fact of their sound proximity to those he was using, either in the form of rhymes or similar.

      This causes the speech to keep a certain harmony in terms of sound, but is nonetheless inconsistent in terms of content, which therefore makes it unintelligible to the interlocutor.

      Bibliographical references:

      • Andreasen, North Carolina, Grove, WM (1986). Assessment of positive and negative symptoms of schizophrenia. Psychiatry and psychobiology.
      • Andreasen, North Carolina (1989). The negative symptom assessment scale (SANS): conceptual and theoretical foundations. The British Journal of Psychiatry.
      • Kotov, R., Krueger, RF, Watson, D., Achenbach, TM, Althoff, RR, Bagby, RM, Brown, TA, Carpenter, WT, Caspi, A., Clark, LA, Eaton, NR, Forbes, MK , Forbush, KT, Goldberg, D., Hasin, D., Hyman, SE, Ivanova, MY, Lynam, DR, Markon, K., Miller, JD, Moffitt, TE, Morey, LC, Mullins-Sweatt, SN, Ormel, J., Patrick, CJ, Regier, DA, Rescorla, L., Ruggero, CJ, Samuel, DB, Selbom, M., Simms, LJ, Skodol, AE, Slade, T., South, SC, Tackett, JL, Waldman, ID, Waszczuk, MA, Widiger, TA, Wright, AGC (2017). The hierarchical taxonomy of psychopathology (HiTOP): a dimension
      • Alternative to traditional nosologies. Journal of Abnormal Psychology. American Psychological Association.
      • McGrath, J. (1991). Organize thoughts about the thought disorder. The British Journal of Psychiatry.

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