Thought disorders: what they are, classification and characteristics.

A summary of the characteristics of thought disorders and their associated symptoms.

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

We are going to try to condense some of the most important data to know what they are the main thought disordersHow to distinguish between them and other relevant information to know more about these pathologies.

What are thought disorders?

To be able to talk about thought disorders we must first have some very basic notions about psychopathology and its diagnostic classification.

All mental illnesses are included in manuals, mainly the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, of the American Psychiatric Association) and the ICD-10 (International Classification of Diseases, of the WHO). These manuals classify all known psychopathologies and are updated on a cyclical basis to make the relevant modifications according to new to make the relevant modifications according to new research carried out during that period. Thus, in the year 2021, the DSM is in its fifth version, while the ICD is in its tenth iteration.

Once we are clear on where the classification of mental illnesses stands, we can place thought disorders as one of the building blocks of these diagnostic manuals. Other of the most important typologies that we can find are somatoform disorders, internalizing disorders, externalizing disorders or detachment disorders.

After this introduction, we can now focus on thought disorders in order to know the characteristics of this type of pathologies, and later on we will get to know some of the clearest examples of these mental illnesses.

Classification and characteristics

Thought disorders are psychological disturbances whose main symptom is an alteration in the subject's cognitions.. These alterations have as a consequence a dysfunction in the communication, as much in the own level of thought as in the language. Within this type of ailments, we must make a distinction, since thinking can be altered both in its content and in its form.

1. Disorders of formal thinking

When we speak of thought disorders, in general, we usually refer to those whose form is altered. One of the most frequent pathologies in which we can observe clear indications of problems in the form of thought is schizophrenia.. TPFs can also be referred to as disorganized thinking or disorganized speech, as this is one of the classic symptoms of these disorders.

Formal thought disorders are a sign of psychosis and as such must be taken into account as an indicator of serious pathology in the individual. In order to evaluate the extent of this disease, Nancy Andreasen developed two scales, the SAPS, to analyze the positive symptoms, and the SANS, to assess the negative ones.. We will return to these scales later for an in-depth look at them.

2. Disorders of content thinking

We have already mentioned that thought disorders can also refer to the content of thought. This would also be a characteristic of schizophrenia, as it has to do with delusions and it has to do with delusions. It is also observed in pathologies such as Obsessive-Compulsive Disorder. But CPT does not necessarily translate into delusions. It can also be observed as a level of pathological preoccupation or obsession.

Another symptom of these thought disorders is that of magical thinking, which consists of establishing arbitrary relationships between the two.which consists of establishing arbitrary and illogical relationships about one's own thoughts about oneself and the repercussions in the world. Without going to that extreme, one can also overvalue ideas, exaggerating one's own mental processes and thus making them unrealistic.

Similarly, one can see very meaningful signals for oneself in totally random events, which are known as reference ideas. Phobias towards certain stimuli and even self-injurious ideations may also arise. As we can see, the symptomatology of content thought disorders is very broad.

SANS scale of negative symptoms

Returning to the SANS scale that we mentioned earlier as an instrument for evaluating the negative symptoms of formal thought disorders, let us see what type they may be.

Affective flattening

One of the first characteristics that we can observe in these subjects is the affective blunting, i.e, the lack of demonstration of emotions. This can be captured by a lack of facial gesticulation or expressions, very little spontaneous movement, no affective resonance with the contents being discussed, or the demonstration of inappropriate affect with the contents.

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

2. Allogia

Disorders of formal thinking can also be translated into difficulties in uttering speech, or allogia.. The vocabulary may be poorer than usual and the content may be poorer than usual. The subject may be observed to take longer than usual to respond to questions and to become blocked during speech.

3. Apathy

Symptoms of apathy may also be seen in these individuals. Hygiene care itself may be affected. Likewise, there may be an abnormal decrease in performance in their tasks and a clear demonstration of lack of physical energy in the subject. in the subject.

4. Attention

The fourth factor that may be affected in formal thought disorders is attention. The individual will have trouble concentrating on the test he/she is performing.

SAPS Positive Symptom Scale

The other scale developed by Andreasen is the SAPS. It allows us to see the positive symptoms of formal thought disorders, i.e., those that are observed by their presence and not by their presence.that is to say, those that are observed by their presence and not by their deficit, as was the case with the negative ones. They are the following.

1. Derailment

Derailment consists of the realization of a random association in the discourse, jumping from one theme to another.jumping from one theme to another, which may or may not be related to the previous one. This positive symptom can be observed in the subject's speech, but sometimes it can also appear in writing.

Tangentiality

Tangential speech is another symptom observable in formal thought disorders. In this case, the person concerned may be talking about a particular issue and, at a given moment, make an abrupt jump to another issue totally unrelated to the previous one and give no further explanation about it.

3. Incoherence

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

4. Loss of logic

Formal thought disorders can also be observed in which a symptom is the loss of logic. Faced with a given question, the individual may try to answer in a way that is grammatically correct, but which in fact is not answering the question that has been asked and therefore does not keep a logic.

5. Excessive detail

Excessive detail or circumstantial speech could also denote the existence of a thought disorder. In this case, we would observe that the person focuses on giving an obviously excessive amount of detail. an evidently excessive amount of contextual detail rather than simply answering the central question about which he/she has been asked. about which he or she has been asked.

6. Speech pressure

Speech pressure or pressured speech is another indicator that can be assessed on the SAPS scale. In this case, this characteristic is manifested by a rushed speech, without any pauseswhich seems to demonstrate an urgency in the person to explain the idea being presented, although this urgency is not apparently observable to the interlocutor.

7. Distractions while speaking

Formal thought disorders can also be detected by excessive distractions during speech. If a person is talking about a specific topic but any environmental stimulus makes him/her completely forget what he/she is saying to talk about another topic, we can think that we are facing this symptom.

8. Sound associations

The last characteristic of formal thought disorders that we can analyze by means of the SAPS has to do with the so-called sound associations, also known as clanging.. This phenomenon occurs when the subject begins to introduce words in his speech by the mere fact of their sonorous proximity to the ones he was using, either in the form of rhyme, or similar.

Esto hace que el discurso guarde una cierta armonía en cuanto a los sonidos, pero sin embargo sea incoherente a nivel de contenidos, haciéndolo, por lo tanto, ininteligible para el interlocutor.

Referencias bibliográficas:

• Andreasen, N.C., Grove, W.M. (1986). Evaluation of positive and negative symptoms in schizophrenia. Psychiatry and Psychobiology.
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