Talk:Thought disorder

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© LEEDS, The BreadPerspective, 2003-2006 re:ELLA’S COMPETENCY PRINCIPLE "At 6 months of age Ella revealed the brain was just an organ that could collect the right information or the wrong information and usually is assisted by the environment to collect the right information. She did this by demonstrating competency at [say] opening or closing her mouth when tasty or pungent food was offered. She revealed an incompetency at drinking from a cup however. She would grasp the cup, in the same way she grasped a toy, but licked the bottom and sides in preference to drinking from it. By the time she was 12 months old she was competent at drinking from the cup. Furthermore the sides and bottom now did not interest her. A person who has not learnt to be competent is said to suffer from a mental illness to some degree. I consider this attitude to be unprofessional to the point of abuse. For example, try to explain the following:- The dispersion or variation in a distribution, equal to the square root of the arithmetic mean of the squares, of the deviations from the arithmetic mean.

In some respects, the reader is like Ella trying to “understand” the cup. It will take quite a lot of effort to be competent to recognize ‘standard deviation’ in its various forms. A lot of evidence is incompetent evidence. Because the omissions, fallacies and manipulations it contains are beyond the comprehension of most people, it often reads like a plausible statement or the reader writes it off as beyond their level of expertise. However, some people do make an inner directed adaption. A person is inner directed when they believe their thoughts, knowledge, values etc., are better than external ones. In a few isolated cases, this is true. For example, whoever said the world was round when the logical uneducated response is to say it is flat, reveals an outstanding level of insight. Most people who are inner directed are or become incompetent to some degree. These people are often stigmatized as mentally ill, instead of diagnosed as having a knowledge deficit". I have not referenced the quote as most dictionaries give the same definition - therefore it does not contain substantial originality, plus it only describes a common mathematical principle.



Hi there,

I've replaced the original initial sentence of this entry.

In the case of this entry the construction "thought disorder or formal thought disorder is a symptom of psychotic mental illness" suggests a confidence that we do not currently have in being able to define this symptom.

What thought disorder actually is, is an incoherent definition for a symptom of mental illness (see 'Diagnostic Issues' section). Something cannot be a symptom of mental illness and an incoherent definition for one.

Similarly, in science definitions may change over time, may be used in subtly different ways or there may be several competing theories as to what the actualy phenomena really is. Therefore the simpler construction is misleading as it suggests Wikipedia is able to precisely define the term. The term does not adequately define the phenomena, it refers to its general properties of common usage.

"A dog is not a TERM TO DESCRIBE an animal; a dog is an animal" is a little bit of a red herring as 'dog' is a concrete noun and hence the understanding of what it refers to is unlikely to change.

-- [[User:Vaughan|Vaughan]

Contents

[edit] Diagnostic Issues - NPOV

"The concept of thought disorder has been criticised as being based on circular or incoherent definitions. For example, thought disorder is inferred from disordered speech, however it is assumed that disordered speech arises because of disordered thought. Similarly the definition of 'Incoherence' (word salad) is that speech is incoherent."

This doesn't seem to be a valid criticism. E.g., "For example, lack of light is inferred from darkness, however it is assumed that darkness arises because of a lack of light." This is a perfectly reasonable statement. If we have a premise that X arises because of Y, then inferring Y after observing X is valid.--Simoes 07:08, 4 Sep 2004 (UTC)

Some of the described language disorders are very common in autism and Asperger Syndrome. A recent study in Finland of adults attending an out patient clinic, 4 to 6 % were newly reassessed has having an autism spectrum condition, a third of those were previously misdiagnosed with schizophrenia. Sz diagnosis are often made on the bases of unusual speech patterns, social isolation and flat effect.

I have AS myself, I’m for example highly tangential. In the book, Eccentrics, Jamie James presented analyses the speech patterns of eccentrics (about half of who imho had AS /autism) and found that half subjectively fitted the language patterns of schizophrenia. On objective analysis, their speech patterns were more obsessive, there was much less derailment and loss of goal than normal individuals and far less than Sz. Even if eccentrics were on the surface highly illogical and tangential (in common with Sz), every eccentric returned to the initial subject question “via a highly circuitous route”. Also, in eccentrics, suggesting they had autism (a developmental delay) used "I" as often as children and many exhibited pronoun reversal, using we instead of "I" or referring to themselves by their first name.

Speech of autistics...

Pressure of speech - V. Common, esp. in High Functioning Autism (HFA)
Distractible speech - Common, often due to special interest, the person collects ties.
Neologisms - Very common
Circumstantiality - Common
Echolalia - Very common, particularly in HFA
Stilted speech - Very common, pedantic speech is thought by some to distinguish AS
Self-reference - Very common, autism is a developmental delay after all
Word approximations - common
Tangentiality - seems tangential but not, obsessive
Loss of goal - less than normal subjects

As such, I would like to see a reference to Autism and it’s speech idiosyncrasies.

Diamond Dave 18:56, 4 Sep 2004 (UTC)

Hence my edit condemning this article as it is not an inherent function of psychosis, but it appears in psychotic disorders-I should know this, as I have Asperger's Syndrome also and am subject to some of these at times, although I can center my thoughts, I go on many tangents on details of interest and also paraphasia, I sometimes mess up my syllables based on similar sounds via the mouth (I'll say-or type, for that matter, ds as ts, cs as gs, etc.). None the less, this disorder is very consistant with Autism and Autistic Spectrum disorders, and not just psychosis; I'm putting an NPOV tag up on this article for lack of explanation about how this relates to autism, if it does at all, and why it "doesn't" as there might be people out there like me running around doing things in this particular article, and there might be someone thinking that people like me are schizophrenic/psychotic because we go on tangents.
Also, topic of interest, puns: I make a lot of them, and they're very intentional, as I find them humorous. If anything, it should state unintentional punning, for example. Is this a problem of formal thought disorder? Or is it a problem of autistic spectrum disorders? Or is it a sense of humor and little more? More clarification is needed.J. M. 08:26, 27 May 2006 (UTC)
Hi there,
Formal thought disorder typically refers to thought disorder present in psychosis (see books on descriptive psychopathology - I recommend Sims; ISBN 0702026271). This does not mean similar phenomena can't be present in people with other diagnoses, it just means it wouldn't be labelled as formal thought disorder (compare with aphasia). This is also why the criteria include everyday activites such as punning.
Your objection is like saying that you sometimes make actions like a ballet dancer, but as you're a gymnast, the ballet article must be NPOV.
- Vaughan 14:01, 27 May 2006 (UTC)
See, there's something notable here: I'm criticizing lack of criticism into it. Look at ADD/ADHD articles, and look at anti-psychiatry, or dopamine theory of psychosis. I am saying that there are disorders that mimic this, and that it should include mention of things that mimic this for further research and study. Lack of mentioning Asperger's, for instance, is inapproriate even if it doesn't fit the definition. As far as I'm concerned, the comparison is creative, but inappropriate since there are clear understood boundries between a ballet dancer and a gymnast. However, I am stating that the boundries between this and what I suggest, as well as Diamond Dave aren't so clear cut, and there may be studies out there to prove it. If the misdiagnosis on such a scale is true, it suggests-strongly-that this definition is invalid unless it is called "Formal Thought Disorder of Psychosis" and adding "Formal Thought Disorder of Autism" or something, clearly hilighting why it can not be something that's pretty much the same thing or simply scrapped. I would add that several definitions are too limiting, and are very commonly changed. It also is of considerable note that Autism was once referred to as "Childhood Schizophrenia"-not, once again, if Autism is considered schizophrenia (Which it is not and in fact it is very different) then clearly it fits these guidelines, hypothetically. The point is there are clear overlapping traits, though clearly not all traits are in the other (Autistics don't hallucinate based on autism but only if they have another disorder, and schizophrenics don't have these symptoms that mimic negative schizophrenia (alogia, emotional flattening)/formal thought disorder until later in life).J. M. 07:20, 28 May 2006 (UTC)
And I think it needs to be said: You aren't the only one who has an opinion, or even information on this topic and I would caution you from acting as if you are. It is highly insulting and not in the spirit of wikipedia. It is acceptable to prevent wrong information to go in. However, it is unacceptable to remove other people's tags without a discussion of why they're there. As far as I'm concerned, this article is extremely POV because it is extremely selective of what information is in there. It only talks about psychosis and schizophrenia. It doesn't talk about similar disorders, and how it is different aside from the fact it is simply defined as psychosis. If someone is researching something, it might make them miss the correct information as it is censored.J. M. 07:32, 28 May 2006 (UTC)
And, even similar, you mean to tell me that you're such an expert that these disorders can't be all linked? That seems a bit dubious. For instance, lets say I cut my arm and I break my bone. They'll both hurt. But the point is, the problem is ON MY ARM. You can say a cut is a cut and a broken bone is a broken bone, but an arm is an arm. But lets say that the cut is on my leg and my arm is broken. Then it is two different things, distinctly. I don't think there's enough information availible to say why that the causes aren't similar, or possibly the same. That's the point.J. M. 07:37, 28 May 2006 (UTC)
Hi there,
Please add the information that you feel would balance the article (with references please).
- Vaughan 09:26, 28 May 2006 (UTC)
Knowledge of Autism Spectrum Disorders (ASD's) in adult psychiatry is very poor...autism in the 70’s and 80’s was thought to be (when most practicing psychiatrists were educated) a rare and severe “childhood” condition. Beginning in 1981 and particularly after 1994 (with DSM-IV), the understanding of ASD’s has changed radically to encompass a wide spectrum, from severe Kanner’s Autism to a personality type seen in Asperger’s Syndrome (Which now represents 60% of ASD's and ~0.5% of the general population; schizophrenia I believe is 0.5 to 1%?). This realisation is shaking psychiatry to its foundations, it is causing much friction and difficulty. I was told by a psychologist friend (an expert on ASD’s) that the DSM should be thrown away because various personality disorders e.g. OCD personality disorder, avoidant personality disorder, social phobia; are various expressions of ASD’s in adulthood. The differing opinions seen in Wiki reflect this change, so lets be patient.
-Diamond Dave - 15/06/2006 15:09 UT

"And, even similar, you mean to tell me that you're such an expert that these disorders can't be all linked? That seems a bit dubious. For instance, lets say I cut my arm and I break my bone. They'll both hurt. But the point is, the problem is ON MY ARM. You can say a cut is a cut and a broken bone is a broken bone, but an arm is an arm. But lets say that the cut is on my leg and my arm is broken. Then it is two different things, distinctly. I don't think there's enough information availible to say why that the causes aren't similar, or possibly the same. That's the point." - Another way of viewing this though is that the FUNCTIONAL impact of your cut and your fracture may be the same, given the location - ie pain, reduced mobility etc. But what you'd do for each injury might be very different, and they may not have had the same cause. It's true that they MAY have, and their being in the same 'place' could make this more likely - but then to further your analogy, if you've been kicked in the arm by a horse and sustain a fracture AND an overlying laceration, that's NOT the same cause as if you fell and broke your arm and then cut your arm with a knife in a separate incident. May look the same, but would have a different cause. Psychiatric disorders may be like that (and given the complexity of the 'machinery' involved they likely have multiple common features) - but there IS the possibility that they just express some similarities in phenotype BECAUSE of the common machinery (ie the brain) that they use. Carly 203.166.230.84 16:57, 29 September 2006 (UTC)

[edit] "Thought disorder" vs "Formal thought disorder"

Hi. Thought disorder redirects here, but is "thought disorder" really the same as "formal thought disorder"? My Swedish dictionary of psychology differentiates between two kinds of thought disorder:

  • formal thought disorders such as thought deprivation, neologisms and flight of speech; and
  • content disorders such as delusions, megalomanic or paranoid ideas, etc.

This website, randomly found with google, says that "Formal Thought Disorder is a Disorder of Thought, but not all Disorders of Thinking are Formal Thought Disorder". What do you think? /skagedal[talk] 17:37, 20 February 2006 (UTC)

Hi Skagedal,
What you describe is a common distinction made in psychiatry, so you're quite right. However, 'formal thought disorder' is typically abbreviated to 'thought disorder', although perhaps the article should contain some text that warns the reader of this ambiguity.
- Vaughan 20:33, 20 February 2006 (UTC)

[edit] Knight's move

What's illogical about the way a knight moves in chess? Could we have a better word, please - non-linear, perhaps? --Khendon 21:05, 1 March 2006 (UTC)

I've been thinking the same thing. How about "discontinuous"? /skagedal... 11:40, 2 March 2006 (UTC)
Knights Move is the official description of this language error. However, I would like to point out that it very common in Asperger's Syndrome Asperger’s Syndrome, I have witnesses this myself. People with AS are often obsessed with unusually intense and narrow intellectual interests and in conversation they will (depending on how affected they are)...suddenly switch a conversation to their obsession, with little regard to the listener. It is quite jarring and sudden. For example
Me - “how was your day?”, friend with AS – “Fine, I got into college at 10am. Did you see any mechanical diggers? I did, I saw 4 mechanical diggers, I don’t know why workers don’t uses shovels anymore.”
My friends obsession is mechanical diggers but I worry that a psychiatrist unfamiliar with AS would see the Knights Move = thought disorder. My other AS friends are into...the Titanic, The Beatles, films. In all cases conversations switch suddenly to one or between several different subjects. I’m quite disturbed by this, as the Knights Move was said to be a very reliable and unique attribute of a thought disorder. And thus, a good indicator of schizophrenia.
- Diamond Dave- 15/06/2006 15:32 UT

It's important not to get too distracted by the association between formal thought disorder and schizophrenia, as demonstration of the former is NOT pathognomonic of the latter. Bipolar affective disorder (in particular the manic phase) frequently displays phenomena outlined in this article as formal thought disorder, for example circumstantiality and tangentiality - but it is a totally different clinical entity to schizophrenia. Displaying formal thought disorder doesn't automatically earn the label of schizophrenia in the clinical setting, it is more indicative of psychosis in general (with whatever underlying cause). Incidentally pressured speech is often not referred to by clinicians as "formal thought disorder" but thought more to be a sign of the underlying symptom of racing thoughts (commonly described by and found in manic patients). It is also observed in a separate category of the mental state examination (which by one commonly used model goes Appearance/Behaviour, Speech (where pressure is noted), Mood/Affect, Thought (both form and content), Perception, Intelligence/Cognition, Rapport, Insight/Judgement).

I freely admit this is opinion, observation and experience based on study and working as a psychiatric resident at a hospital for three months, but I can heartily recommend reading both the DSM-IV and moreover a great text by Kaplan & Sadoch for accurate but accessible descriptions of the terms and their associations. 203.166.230.84 16:44, 29 September 2006 (UTC)Carly

[edit] Phonemic paraphasia Example

Can someone explain this to me? "Phonemic paraphasia - Mispronunciation; syllables out of sequence. e.g. "I slipped on the ice broke my arm". What syllables are out of sequence? All I note is the missing 'and'. Did some confused wikiknome 'correct' the spelling? Ed 21:24, 7 April 2006 (UTC)

I originally thought what it was saying is that the two sentences "I slipped on the ice" and "The ice broke my arm" got melded into one. But that doesn't fit with the definition at all, and having checked the history of edits, it seems Drrngrvy changed the word "lice" to "ice" on March 28. I'm pretty certain lice was intentional, seeing as it was in the very first version of the article, so I'm changing it back. :) JulianDalloway 15:53, 24 April 2006 (UTC)
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