Download presentation
Presentation is loading. Please wait.
1
Disorders of Thoughts
2
Introduction Thinking Abstract thinking
Fantasy or autistic: common, excessive with repeated disappointment Imaginative Rational or conceptual Abstract thinking Thinking characterized by the ability to grasp the essentials of a whole, to break a whole into its parts, and to discern common properties
3
Introduction … Three aspects involved in normal thinking
Stream of thought Amount and speed of the thought pattern Flow Manner in which thoughts are linked together Content Subject that is being thought about
4
Introduction … Features of healthy thinking (Schneider)
Constancy Organization Continuity In clinical practice It is useful to determine exactly what the patient believes with regard to their thoughts and Record it verbatim in the clinical notes
5
Disorder of Thoughts Disorders Intelligence Stream of thoughts
Possession of thoughts Content of thoughts Form of thinking
6
A: Disorder of Intelligence
Intelligence: ability to think and act rationally and logically Intelligence testing was introduced by Alfred Binet in 20th century IQ score was computed by dividing the mental age by chronological age and multiplying by 100 Average IQ 100
7
A: Disorder of Intelligence …
Low intelligence “learning or “intellectual disability” Brain damage due to genetic, pregnancy / birth problems, health problems lQ 70 or > and specific learning disability
8
B: Disorders of the Stream of Thoughts
Disorders of thought tempo Flight of ideas, inhibition or slowing of thinking, circumstantiality Disorders of the continuity of thinking Perseveration, thought blocking
9
1): Disorders of Thought Tempo
Flight of ideas (with or without pressure of speech) Thought follow each other rapidly No general direction of thinking Connections between successive thoughts appear to be due to chance factors which, however can be understood Mostly in mania, schizophrenia when excited, euphoric, organic state i.e. hypothalamus lesion
10
1): Disorders of Thought Tempo …
In acute mania incoherence occurs
11
1): Disorders of Thought Tempo …
Inhibition or slowing of thinking Train of though is slowed down Number of ideas and mental images that present themselves is decreased Difficult making decisions, lack of concentration, loss of clarity of thinking, diminution in active attention - poor registration
12
1): Disorders of Thought Tempo …
Loss of memory Strange indescribable sensation in the head Diagnostic challenge mistaken for dementia Seen in depression, rare condition of manic stupor Majority have difficulties with thinking rather than inhibition
13
1): Disorders of Thought Tempo …
Circumstantiality Thinking proceeds slowly with many unnecessary and trivial details, but finally the point is reached Goal of thinking is never completely lost Thinking proceed towards the goal by an intricate and convoluted path Seen learning disability, obsessional personality trait
14
2): Disorders of the Continuity of Thinking
Perseveration Mental operations persist beyond the point at which they are relevant Prevent progress of thinking May be mainly verbal or ideational Common in generalized and local organic disorders of the brain,
15
2): Disorders of the Continuity of Thinking …
Thought blocking Sudden arrest of the train of thought, leaving a blank Entirely new thought may begin Terrifying experience when gain insight Seen in schizophrenia In exhaustion or anxiety lose thread of the conversation may appear to have thought blocking
16
C: Disorders of the Possession of Thought
A person is in control of his or her own thinking Loss of control or sense of possession of thinking
17
C: Disorders of the Possession …
Obsession Thought persists and dominate Awareness thought is either entirely without purpose or beyond the point of relevance or usefulness Obsessional mental images, ideas, fears and impulses Cause sufferer great anxiety and even guilt; repugnant; against person’s will
18
C: Disorders of the Possession …
Obsession occurs in obsessional states, depression, schizophrenia and occasionally in organic states
19
C: Disorders of the Possession …
Compulsion Merely obsessional motor acts Result from obsessional impulse or mediated by an obsessional mental image or thought Common in post encephalitic parkinsonism, OCD
20
C: Disorders of the Possession …
Thought alienation Experience that thoughts are under the control of an outside agency or Others are participating in their thinking Result from obsessional impulse or mediated by an obsessional mental image or thought Commonly associated with schizophrenia
21
C: Disorders of the Possession …
Experience of thought alienation include Thought insertion Thought being placed in minds Recognize them as being foreign and coming from without
22
C: Disorders of the Possession …
Thought deprivation or withdraw Thought are suddenly disappear and are taken from people’s mind by a foreign influence Suggested to be subjective experience of thought blocking and omission
23
C: Disorders of the Possession …
Thought broadcasting As people are thinking, everyone else is thinking in unison with them Other people might be able to access them Experience of hearing one’s thoughts spoken aloud as the result others can hear them
24
D: Disorders of the Content of Thinking
Delusion Customary: false, unshakable beliefs Belief firmly held on inadequate grounds Not affected by rational arguments Not a conventional belief Need not be false e.g., delusional jealousy, then discover partner actually is unfaithful
25
D: Disorders of the Content of Thinking
Need not be totally unshakeable Cognitive therapy for delusions; many patients have some insight Wrongly arrived at belief Primary delusion - “out of the blue” Secondary delusion - “arises out of” e.g.. hallucination Overvalued idea Unreasonable, sustained false beliefs, less firm Bizarre or non bizarre
26
D: Disorders of the Content of Thinking
Delusions of persecutory (commonly paranoid) Primary delusional experiences, auditory / bodily hallucinations, experience of passivity i.e. hypnotism, demonical possession, witchcraft, waves Delusion of reference Others talking, slandering, spying on him/her Self reference, common in severe depression i.e. believe they are extremely wicked, other people know this, quite justifiably spying on them
27
D: Disorders of the Content of Thinking
Delusions of guilt Believes s/he is about to be put to death or imprisoned for life; are bad or evil, ruined others Delusions of infidelity “delusion of jealousy” Been suspicious, sensitive, and mildly jealous Seen in affective psychosis, organic brain disorders, associated with alcohol dependency syndrome
28
D: Disorders of the Content of Thinking
Delusions of love (fantasy lover syndrome and erotomania) Convinced that some person is in love with them although the alleged lover may never have spoken to them Seen in abnormal personality states, sometimes schizophrenia Grandiose delusions Believe they are God, Queen of England, famous star, skilled
29
D: Disorders of the Content of Thinking
Grandiose delusions … Important person who is able to help others; special power or ability Expansive may be supported by auditory hallucination i.e. hearing voices of God or saints confirming their elevated status Commonly associated with manic psychosis in the context of bipolar affective disorder
30
D: Disorders of the Content of Thinking
Delusions of ill health Worry about health i.e. believe they have a serious disease such as cancer, brain tumor; incurable diseases; preoccupations with facial or bodily appearance Characteristic feature of depressive illnesses Many puerperal women fear or believe that the newborn child has learning disabilities of some kind
31
D: Disorders of the Content of Thinking
Nihilistic delusions (negation) Denies existence of body, mind, loved ones and the world around them Assert they have no mind, intelligence Occur in the context of severe, agitated depression, schizophrenia and states of delirium Delusion of poverty Believe are impoverished and destitution is facing them
32
D: Disorders of the Content of Thinking
Delusion of control Beliefs that one’s actions, behavior or feeling are not under personal control or own doing Imposed by an external force Delusion of mind reading Believe that people can read one’s mind or know one’s thoughts
33
E: Disorders of the Form of Thinking
Disorder of conceptual or abstract thinking Deficits in cognition Commonly seen in schizophrenia, organic brain disorders Over inclusion (Cameron, 1994) Inability to narrow down the operations of thinking and bring into action the organized attitudes and specific responses relevant to the task at hand
34
E: Disorders of the Form of Thinking
Disorder of conceptual or abstract thinking … Concrete style of thinking (Goldstein, 1944) Due to the loss of abstract attitude Five features of formal thought disorder (Schneider, 1930) Derailment, substitution, omission, fusion and driveling
35
E: Disorders of the Form of Thinking
Varieties of objective thought disorder Transitory thinking Characterized by derailments, substitutions and omissions Driveling thinking Loss of preliminary organization, have a critical attitude Desultory thinking Speech is grammatically correct, sudden ideas force their way in from time to time
36
References Casey P. & Kelly B (2007) Fish’s Clinical Psychopathology; signs and Symptoms in Psychiatry 3rd Edition
Similar presentations
© 2025 SlidePlayer.com Inc.
All rights reserved.