Thought Disorders

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When thoughts become disorganized, chaotic word use and jumbled sentences ensue. We all suffer from occasional confusion. Perhaps, cloudy minds are loosely related to thought disorders. Thought disorders represent more than stumbling for just the right word.

​Thought disorders represent a chaotic symphony of tangled words, collisions of unrelated thoughts, or a mixture of unrelated words. Individuals suffering from thought disorders often display inability to control, organize, or express coherent thoughts.

Form and Content Though Disorders

Thought disorders are broadly defined, including a large variety of peculiarities typically observed in the speech of those inflicted with the disorder. Speech may display disordered thoughts through content, form, or both.

​Content Disorder

The content of thought is the beliefs, ideas, and interpretations of stimuli. The content of our minds can go haywire. Its not a problem of translating thoughts into speech but the thoughts themselves are disordered. We sometimes refer to this as poverty of thought.

The chaos of content disorder may be observed as a continual flight of ideas, jumping from one topic to another. The individual’s speech may derail from one thought, jumping to another, and then another without a clear foundational goal for what they are trying to communicate.

Form Disorder

Form disorder refers to the presentation of thoughts through speech. Generally, our form of speech is characterized by “rate, pressure, rhythm, idiosyncrasy of word usage, tightness of associational linkage, and forms of associational linkage” (Berenbaum & Barch, 2005).

We observe thought disorders characterized by form in patterns of speech. A person suffering from the disorder may use clang associations, where they choose words by sound rather than meaning; or they may over include trivial and irrelevant details; or invent numerous new words.

While thought content maybe intact, the person with form disorders cannot express them in a coherent manner. We sometimes refer to this as empty speech.​

History of Thought Disorders

German psychiatrist ​Emil Kraepelin (1856-1926), who introduced the diagnostic construct dementia praecox, believed that thought disorders were a central feature of psychosis. The psychotic patient, according to Kraepelin, experienced deterioration of mental functions as evidenced by ‘derailments’ and ‘incoherence’ of thought processes (Hart & Lewine, 2017). 

Since Kraepelin, practitioners have continued to observe thought disorders as an observable symptom associated with modern day schizophrenia. However, with the publication of DSM-III in 1980, the American Psychiatric Society no longer characterized thought disorders as the central feature of psychosis, instead the schizophrenia’s main characterization centered on hallucinations and delusions. DSM-IV reduced thought disorders to simply “disorganized speech” (2017).

Cause of Thought Disorders

While thought disorder is typically associated with psychosis, most psychopathologist believe the cause of the disorder “is not a unitary construct​, but rather encompasses several different components” (Berenbaum & Barch, 2005). Accordingly, we may observe thought disorders in a wide variety of form and content disturbances.

​Thought and speech utilize many different brain regions, and deficits in one or a amalgamation of several of these regions could result in disorganized speech.

Early theories include organ inferiority, inner conflict, developmental disruptions, and social learning. However, modern science is uncovering greater involvement of biological causes, leading to the disease. Family histories can identify heightened risk for future development of schizophrenia.

Most likely there is some environmental influence. the diathesis stress model suggests a mix of genetic predisposition and environmental stress often leads to disease. “​The diathesis–stress model explores how biological or genetic traits (diatheses) interact with environmental influences (stressors) to produce disorders such as depression, anxiety, or schizophrenia” (Murphy, 2021).

Disordered thoughts, while usually associated with schizophrenia, occasionally, some thought disorders also accompany dementia and major depression.

Treatment of Thought Disorder

While we may not cure schizophrenia, many medications may mitigate the impact of the disease on normal functioning. We may sufficiently treat many mild forms of the disease so the individual can function well in society. However, it is essential we consult with a physician early and often when ever we experience symptoms of disordered thought.

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Berenbaum, H., & Barch, D. (2005). The categorization of thought disorder. Journal of Psycholinguistic Research, 24(5), 349-376.

Hart, M., & Lewine, R. (2017). Rethinking Thought Disorder. Schizophrenia Bulletin, 43(3), 514-522.

Murphy, T. Franklin (2021). Diathesis Stress Model. Psychology Fanatic. Published 9-7-2021. Accessed 10-18-2022.

Rule, A., & , (2005). Ordered thoughts on thought disorder. Psychiatric Bulletin

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