Cognitive slippage

Last updated

Cognitive slippage is considered a milder and sub-clinical presentation of formal thought disorder observed via unusual use of language. [1] It is often identified when a person attempts to make tangential connections between concepts that are not immediately understandable to listeners. [2] When observed repeatedly, this is taken as evidence for unusual, maladaptive or illogical thinking patterns.

Contents

Cognitive slippage is typically assessed in the context of mental health evaluations, but there is ongoing debate about how to best quantify this type of unusual language usage in research settings. [3] Cognitive slippage is supposed to exist on a continuum which can be observed in its most extreme forms among some individuals with schizophrenia (e.g., word salad). [4] Several mental disorders are known to co-occur with cognitive slippage. [1] [5] [6] [7] [8] [9] Although cognitive slippage is associated with difficulties in communication, it is not necessarily indicative of lower intelligence. [10]

Examples

An example of cognitive slippage:

"List some types of cars."
"Let's see, there's Ford, Chevrolet, Toyota, Japan, Rising Sun, Hiroshima, Atomic Bomb, Enola Gay, oh and Miata."

The inclusion of extraneous items in the list is evidence of cognitive slippage. Although the concepts such as Toyota, Japan, Rising Sun, etc. are all related, the relation does not fall under the category of the initial prompt: types of cars.

Another example:

"What animals did you see at the zoo today?"
"We saw tigers, bears, Dolphins, the Baltimore Ravens, the Packers, Carolina Panthers, jaguars, lions, and otters."

Here we see the slip occur between animal names and football teams with animals as their mascot. As the person lists animals they saw at the zoo, they mention "bears" and "dolphins" which double as the names of NFL teams. This results in a "slip" to a tangentially related list of football teams then back again to animals after the mention of the Carolina Panthers relates to the other big cats they saw - jaguars and lions. The cognitive slippage is associated with an inability to identify and disregard these extraneous connections. It results in patterns of speech and associations similar to those seen here.

Theory

In 1962, Paul E. Meehl emphasized that thought disorder was a critical component of schizophrenia diagnosis. He coined the term "cognitive slippage" to describe a more mild form of thought disorder that he believed was still relevant. He recognized that even in the absence of more severe forms of thought disorder, individuals with schizophrenia exhibited more cognitive slippage than non-schizophrenic individuals. As a result, Meehl deemed thought disorder a necessary component of the disorder for diagnoses, regardless of severity. He declared that any characterization of either schizophrenia or schizotypy that lacked cognitive slippage as a component was unacceptable [1] and he insisted that cognitive slippage, interpersonal aversiveness, anhedonia, and ambivalence were the universal "core behavior traits" of all schizotypic individuals. [11] He also noted that the amount of slippage can vary from case to case, with some highly anxious individuals exhibiting less slippage than some minimally anxious individuals. This suggests that cognitive slippage may be affected by altering the effect of the individual, but Meehl mentions that this feature is not groundbreaking or unique to cognitive slippage. [1]

Meehl (1962) also noted that cognitive slippage occurred in some typically developed relatives of individuals with schizophrenia. Though the findings were preliminary, he noted that among a group of ten individuals with schizophrenia, they were able to detect mild thought disorder in at least one parent of each individual. He thus suggested that future research into this discovery should be a priority of schizophrenia researchers. [1] Meehl also sought to understand where the cognitive dysfunctions associated with schizophrenia stemmed from, yet he found cognitive slippage a difficult symptom to parse out. He considered that, on some level, "everybody has to learn how to think straight," and supposed there could be a social learning component to the development of organized, rational thought and speech.

Meehl noticed that slippage occurred even when an individual was trying fervently to communicate clearly. [1] He considered a neurological explanation that suggested cognitive slippage was tied to "synaptic slippage," or an error in the electrical transmission of messages from neuron to neuron in the brain. He suggested this issue was caused by an error in cell selectivity, meaning the wrong neuron received the message. [1] According to this theory, "primary cognitive slippage" refers to the slippage at the central nervous system synapse as a result of an error in neural transmission. The observable behavior of disorganized speech, as a result of the transmission error, would be classified as "secondary cognitive slippage". [12] He also contemplated the possibility that cognitive slippage could stem from different underlying causes based on the disorder it was a part of. [1]

Measure of cognitive slippage

The Cognitive Slippage Scale (CSS) was introduced in 1985 by Miers and Raulin. The CSS is composed of 35 self-reported true or false questions intended to identify speech deficits and disorganized, confused thinking. [13] Higher scores on this test indicate a higher level of cognitive slippage. The test has been shown to be applicable and accurate to both clinical and non-clinical populations. Examples of questions included on the test are, "Often when I am talking I feel that I am not making sense," and "Sometimes my thoughts just disappear.". [14]

With a few exceptions, this scale has seldom been evaluated for its reliability and validity. The validity of the CSS was assessed in 1992 by comparing clinical and non-clinical, undergraduate samples. [13] The reliability of the CSS was assessed using Cronbach's alpha, a coefficient between 0 and 1 that indicates that the items on a scale have greater covariance as it approaches 1. They found that the CSS had a coefficient of 0.89 for the clinical participants with schizophrenia, and 0.86 for the non-clinical, undergraduate participants. They also suggested the CSS has adequate test-retest reliability by re-administering the CSS after a 4-week period. [13]

In 2013, a study conducted by Loas, Dimassi, Monetes, and Yon proposed that validity could also be assessed by comparing the CSS results of healthy first-degree relatives of individuals with schizophrenia to those without it. They recruited 27 first-degree relatives of individuals with schizophrenia and thirty first-degree relatives of individuals without schizophrenia. All participants were administered the French version of the CSS. The results indicate that the first-degree relatives of individuals with schizophrenia scored significantly higher on the CSS than did the first-degree relatives of typically developed individuals. [2]

Research on specific disorders

As a symptom of schizophrenia

Cognitive slippage is characterized as a mild symptom of schizophrenia. [15] Schizophrenia is a psychiatric illness defined by both abnormal behaviors and cognitive dysfunctions. Formal thought disorder (FTD) is characterized by problems with thought, language, and communication and is considered to be the key feature of the cognitive dysfunction component of schizophrenia. [16] As Meehl suggested, cognitive slippage is a milder form of FTD, making it also a key component of schizophrenia.

In considering the genetic element of schizophrenia, researchers have examined the presence of symptoms, such as cognitive slippage, in first degree relatives. For example, Oltmanns (1978) looked at the prevalence of cognitive slippage in the children of individuals with schizophrenia. For their purposes, they defined "cognitive slippage" to include associative disturbances, difficulties in thinking, and errors in reasoning. The researchers administered an object sorting task to 156 children of schizophrenic individuals, 102 children of depressed individuals, and 139 children of healthy parents. The task required participants to either sort objects or explain the reasoning behind a sorted group of objects. The task was designed to target responses that would differ noticeably between individuals with schizophrenia and without schizophrenia. All the participants were children between the ages of 6 and 15. Their responses were then sorted as either superordinate, complex, vague, or thematic. The children of parents with schizophrenia made fewer superordinate responses and more complex responses than the control children. Though small, the findings were reliable, and suggest that the children of individuals with schizophrenia are more prone to the cognitive dysfunctions associated with cognitive slippage. [5]

The loose definition of cognitive slippage can make the symptom difficult to identify, so Braatz (1970) designed a study to determine if preference intransitivity could be used as an indicator of cognitive slippage. He proposed that from a logical standpoint, intransitivities in preference would result from cognitive slippage. Preference intransitivity occurs when one's preferences and values lead to potentially unresolvable conflicts. He administered a scale of 120 items meant to judge preferences of both schizophrenia patients and healthy controls and found that individuals with schizophrenia endorse more intransitive judgments than healthy individuals. Though he acknowledges that the scale in its current form is underdeveloped, his findings suggest that further research into the connection between preference intransitivity and cognitive slippage could result in a scale powerful enough to aid schizophrenia diagnosis. He also suggests future research could expand the scale to apply in cases other than clinical schizophrenia. [17]

Kagan and Oltmanns (1981) also made an attempt to clear up some of the ambiguity surrounding cognitive slippage among individuals with schizophrenia. Their research sought to develop an objective index of cognitive slippage. They administered a word matching task to individuals with schizophrenia, individuals with affective disorders, and normal controls. They found that the individuals with schizophrenia did, in fact, perform differently on the task than the normal controls, but that they performed similarly to the individuals with affective disorders. This creates an issue as it complicates the feasibility of the task being used to measure cognitive slippage specifically to identify schizophrenia. [3]

As it relates to schizotypy

Meehl (1962) identified cognitive slippage as a fundamental component of schizotypy. Thus individuals that do not meet full diagnostic criteria for schizophrenia, yet fall on the spectrum of schizotypy, still exhibit high levels of cognitive slippage. [12] Due to this underpinning, The Referential Thinking Scale was designed as a measure to get at the underlying cognitive process of cognitive slippage. By targeting referential thinking, a measurable behavior, the idea was the scale could detect schizotypy based on the presence of cognitive slippage. [18] Eckblad & Chapman (1983) identified magical ideation as the aspect of cognitive slippage critical to schizotypy. They define Magical Ideation as magical and superstitious beliefs about reality reliant on false causal relations between events. [19] By this definition, cognitive slippage can manifest as fallacious, causal connections between correlated or unrelated events.

Gooding, Tallent, And Hegyi (2001), found that in addition to greater cognitive slippage, schizotypic individuals performed worse on the Wisconsin Card Sorting Test, which was designed to assess overall high-level cognitive functioning. Specifically, they found that individuals who only endorsed the negative symptoms of schizotypy reported lower levels of cognitive slippage than those who endorsed both positive and negative schizotypy symptoms. [14] Due to the wide variety of individuals on the schizotypal spectrum, McCarthy (2015) suggests further research should be conducted on individuals at different points on the spectrum in order to enhance understanding of symptom severity and the appropriate use of measures such as the Cognitive Slippage Scale. [20]

As a symptom of personality disorders

Schizoid

Among individuals with schizoid personality disorder, cognitive slippage manifests as an inability to control associations made within the context of things such as dreams, creative thoughts and free association. The slippage results in an inability to override subordinate associations between topics in order to purposefully acknowledge clearer, surface level associations. Such individuals have no difficulty making links between topics, but rather are unable to prioritize which links are more salient and thus suppress less applicable links. [1] For instance, the individual in the example above has no difficulty making connections between various zoo animals, or NFL teams, but is unable to intentionally suppress the NFL associations in order to prioritize and answer the questions specifically regarding zoo animals.

Narcissism

A study was conducted using the Rorschach test to evaluate ego differences between individuals with borderline and narcissistic personality disorders. Responses to the test given by the narcissist included more answers indicative of cognitive dysfunctions they described as "cognitive slippage". Researchers suggest the slippage results from the narcissist attempting to combine idealized components of an object into a cohesive entity. This was demonstrated by individuals who interpreted the inkblots as two discrete objects somehow joined in the middle (e.g. "A head of two foxes back to back sharing a crown."). [6]

As it relates to subclinical psychosis

In addition to inclusion as diagnostic criteria, the presence of cognitive slippage as a form of formal thought disorder is considered to be associated with psychosis proneness. [21] Martin and Chapman (1982) determined that college students at risk for psychosis displayed signs of cognitive slippage on a referential communication task. Allen, Chapman, and Chapman (1987) identified college students who scored high on the Per-Mag Scale, a measure designed to identify thought processes indicative of psychosis. They found that most of these high-scoring students also exhibited signs of cognitive slippage on two measures of it. Of the students who scored very high on the Per-Mag, those who also scored above the mean on a depression scale were the most likely to demonstrate cognitive slippage. [22] Additionally, Edell (1987) reinforced the idea that although individuals with sub-clinical psychopathology exhibit more severe thought disorder on unstructured tests, they perform relatively normally on more structured measures of cognition. [23]

Thought disorder and autism

Dykens, Volkman, and Glick (1991) considered the relationship between thought disorder and high-functioning adult autism by utilizing both objective and projective measures. They collected objective data using the Thought, Language, and Communication Disorder Scale, and projective data through use of the Rorschach test. In their definition of "cognitive slippage," they broke the dysfunction down into processes such as "incongruous combinations," "fabulized combinations," "deviant responses," and "inappropriate logic." Their findings suggest that individuals with autism display more disordered thinking than typically developed individuals. To explain this, they suggest that cognitive slippage is rooted in difficulty with complex perceptual processing, a known feature of autism. [24] Another study used Rorschach inkblots to compare individuals with Asperger syndrome to high-functioning individuals with Autism. They found that individuals with Asperger syndrome tended to exhibit greater levels of disordered and disorganized thinking in their responses than the typically developed individuals. [7]

As it relates to eating disorders

In response to implications that cognitive dysfunctions were rooted in eating disorder etiology, researchers Strauss and Ryan (1988) conducted a study to compare the rates of logical errors, cognitive slippage, and conceptual complexity among individuals with eating disorders compared to their healthy counterparts. They evaluated 19 restrictive anorexic individuals, 14 purging anorexic individuals, 17 bulimic individuals, 15 individuals with sub-clinical eating pathology, and 17 healthy control individuals. Though they found differences between the anorexic groups and the others in regards to logical errors, there were no significant differences between any group on rates of cognitive slippage. [8]

As it relates to test anxiety

Broadbent et al. (1982) developed the Cognitive Failures Questionnaire (CFQ), a self-report measure designed to identify the presence of "cognitive slippage." For the purposes of the CFQ, however, they used this term to refer to lapses in attention, difficulty processing information, memory issues, perception problems, and complications in decision-making. [9] As such, their definition tapped into issues such as "forgetfulness" or "inattention" rather than the clinically significant cognitive dysfunction defined by Meehl. Yates, Hannell, and Lippett (1985) designed a study to evaluate the predictive value of the CFQ as a means to identify psychological vulnerability under stressful conditions, such as during a test. 72 female participants were administered the CFQ as well as the Test Anxiety Scale as they completed two tasks - the former of which, they were told, was a practice test for the later. It was found that during the second test condition, subjects did report more "cognitive slippage" in the form of mind-wandering and distractibility. [9]

See also

Related Research Articles

Psychosis is a condition of the mind or psyche that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.

<span class="mw-page-title-main">Schizoid personality disorder</span> Medical condition

Schizoid personality disorder is a personality disorder characterized by a lack of interest in social relationships, a tendency toward a solitary or sheltered lifestyle, secretiveness, emotional coldness, detachment, and apathy. Affected individuals may be unable to form intimate attachments to others and simultaneously possess a rich and elaborate but exclusively internal fantasy world. Other associated features include stilted speech, a lack of deriving enjoyment from most activities, feeling as though one is an "observer" rather than a participant in life, an inability to tolerate emotional expectations of others, apparent indifference when praised or criticized, all forms of asexuality, and idiosyncratic moral or political beliefs.

<span class="mw-page-title-main">Anhedonia</span> Inability to feel pleasure

Anhedonia is a diverse array of deficits in hedonic function, including reduced motivation or ability to experience pleasure. While earlier definitions emphasized the inability to experience pleasure, anhedonia is currently used by researchers to refer to reduced motivation, reduced anticipatory pleasure (wanting), reduced consummatory pleasure (liking), and deficits in reinforcement learning. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anhedonia is a component of depressive disorders, substance-related disorders, psychotic disorders, and personality disorders, where it is defined by either a reduced ability to experience pleasure, or a diminished interest in engaging in previously pleasurable activities. While the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) does not explicitly mention anhedonia, the depressive symptom analogous to anhedonia as described in the DSM-5 is a loss of interest or pleasure.

<span class="mw-page-title-main">Thought disorder</span> Disorder of thought form, content or stream

A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, neologisms, paralogia, word salad, and delusions—all disturbances of thought content and form. Two specific terms have been suggested—content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term thought disorder is often used to refer to an FTD: a disruption of the form of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses. Disorganized speech leads to an inference of disorganized thought. Thought disorders include derailment, pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking. One of the first known cases of thought disorders, or specifically OCD as it is known today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy."

In psychology, alogia is poor thinking inferred from speech and language usage. There may be a general lack of additional, unprompted content seen in normal speech, so replies to questions may be brief and concrete, with less spontaneous speech. This is termed poverty of speech or laconic speech. The amount of speech may be normal but conveys little information because it is vague, empty, stereotyped, overconcrete, overabstract, or repetitive. This is termed poverty of content or poverty of content of speech. Under Scale for the Assessment of Negative Symptoms used in clinical research, thought blocking is considered a part of alogia, and so is increased latency in response.

Schizotypal personality disorder, also known as schizotypal disorder, is a cluster A personality disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) classification describes the disorder specifically as a personality disorder characterized by thought disorder, paranoia, a characteristic form of social anxiety, derealization, transient psychosis, and unconventional beliefs. People with this disorder feel pronounced discomfort in forming and maintaining social connections with other people, primarily due to the belief that other people harbor negative thoughts and views about them. Peculiar speech mannerisms and socially unexpected modes of dress are also characteristic. Schizotypal people may react oddly in conversations, not respond, or talk to themselves. They frequently interpret situations as being strange or having unusual meanings for them; paranormal and superstitious beliefs are common. Schizotypal people usually disagree with the suggestion that their thoughts and behaviors are a 'disorder' and seek medical attention for depression or anxiety instead. Schizotypal personality disorder occurs in approximately 3% of the general population and is more commonly diagnosed in males.

In psychology, schizotypy is a theoretical concept that posits a continuum of personality characteristics and experiences, ranging from normal dissociative, imaginative states to extreme states of mind related to psychosis, especially schizophrenia. The continuum of personality proposed in schizotypy is in contrast to a categorical view of psychosis, wherein psychosis is considered a particular state of mind, which the person either has or does not have.

<span class="mw-page-title-main">Creativity and mental health</span> Concept in psychology

Links between creativity and mental health have been extensively discussed and studied by psychologists and other researchers for centuries. Parallels can be drawn to connect creativity to major mental disorders including bipolar disorder, autism, schizophrenia, major depressive disorder, anxiety disorder, OCD and ADHD. For example, studies have demonstrated correlations between creative occupations and people living with mental illness. There are cases that support the idea that mental illness can aid in creativity, but it is also generally agreed that mental illness does not have to be present for creativity to exist.

The mental status examination (MSE) is an important part of the clinical assessment process in neurological and psychiatric practice. It is a structured way of observing and describing a patient's psychological functioning at a given point in time, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight, and judgment. There are some minor variations in the subdivision of the MSE and the sequence and names of MSE domains.

<span class="mw-page-title-main">Paul E. Meehl</span> American psychologist (1920–2003)

Paul Everett Meehl was an American clinical psychologist. He was the Hathaway and Regents' Professor of Psychology at the University of Minnesota, and past president of the American Psychological Association. A Review of General Psychology survey, published in 2002, ranked Meehl as the 74th most cited psychologist of the 20th century, in a tie with Eleanor J. Gibson. Throughout his nearly 60-year career, Meehl made seminal contributions to psychology, including empirical studies and theoretical accounts of construct validity, schizophrenia etiology, psychological assessment, behavioral prediction, metascience, and philosophy of science.

Latent inhibition (LI) is a technical term in classical conditioning, where a familiar stimulus takes longer to acquire meaning than a new stimulus. The term originated with Lubow and Moore in 1973. The LI effect is latent in that it is not exhibited in the stimulus pre-exposure phase, but rather in the subsequent test phase. "Inhibition", here, simply connotes that the effect is expressed in terms of relatively poor learning. The LI effect is extremely robust, appearing in both invertebrate and mammalian species that have been tested and across many different learning paradigms, thereby suggesting some adaptive advantages, such as protecting the organism from associating irrelevant stimuli with other, more important, events.

A spectrum disorder is a disorder that includes a range of linked conditions, sometimes also extending to include singular symptoms and traits. The different elements of a spectrum either have a similar appearance or are thought to be caused by the same underlying mechanism. In either case, a spectrum approach is taken because there appears to be "not a unitary disorder but rather a syndrome composed of subgroups". The spectrum may represent a range of severity, comprising relatively "severe" mental disorders through to relatively "mild and nonclinical deficits".

In psychology and neuroscience, executive dysfunction, or executive function deficit, is a disruption to the efficacy of the executive functions, which is a group of cognitive processes that regulate, control, and manage other cognitive processes. Executive dysfunction can refer to both neurocognitive deficits and behavioural symptoms. It is implicated in numerous psychopathologies and mental disorders, as well as short-term and long-term changes in non-clinical executive control. Executive dysfunction is the mechanism underlying ADHD paralysis, and in a broader context, it can encompass other cognitive difficulties like planning, organizing, initiating tasks and regulating emotions. It is a core characteristic of ADHD and can elucidate numerous other recognized symptoms.

Philip Holzman (1922–2004) was the Esther and Sidney R. Rabb Professor of Psychology Emeritus at Harvard University and one of the world’s preeminent scientists in schizophrenia research. His landmark studies of oculomotor function documented the presence of abnormal smooth pursuit eye movements in individuals with schizophrenia and their clinically unaffected biological relatives. He was one of the first to investigate the genetic basis of schizophrenia. Another key contribution to the study of schizophrenia was his work on language and thought disorder in individuals with schizophrenia. He also discovered the presence of an active short-term memory deficit in people with schizophrenia and their biological relatives.

The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States.

<span class="mw-page-title-main">Imprinted brain hypothesis</span> Conjecture on the causes of autism and psychosis

The imprinted brain hypothesis is an unsubstantiated hypothesis in evolutionary psychology regarding the causes of autism spectrum and schizophrenia spectrum disorders, first presented by Bernard Crespi and Christopher Badcock in 2008. It claims that certain autistic and schizotypal traits are opposites, and that this implies the etiology of the two conditions must be at odds.

The evolution of schizophrenia refers to the theory of natural selection working in favor of selecting traits that are characteristic of the disorder. Positive symptoms are features that are not present in healthy individuals but appear as a result of the disease process. These include visual and/or auditory hallucinations, delusions, paranoia, and major thought disorders. Negative symptoms refer to features that are normally present but are reduced or absent as a result of the disease process, including social withdrawal, apathy, anhedonia, alogia, and behavioral perseveration. Cognitive symptoms of schizophrenia involve disturbances in executive functions, working memory impairment, and inability to sustain attention.

Evolutionary psychiatry, also known as Darwinian psychiatry, is a theoretical approach to psychiatry that aims to explain psychiatric disorders in evolutionary terms. As a branch of the field of evolutionary medicine, it is distinct from the medical practice of psychiatry in its emphasis on providing scientific explanations rather than treatments for mental disorder. This often concerns questions of ultimate causation. For example, psychiatric genetics may discover genes associated with mental disorders, but evolutionary psychiatry asks why those genes persist in the population. Other core questions in evolutionary psychiatry are why heritable mental disorders are so common how to distinguish mental function and dysfunction, and whether certain forms of suffering conveyed an adaptive advantage. Disorders commonly considered are depression, anxiety, schizophrenia, autism, eating disorders, and others. Key explanatory concepts are of evolutionary mismatch and the fact that evolution is guided by reproductive success rather than health or wellbeing. Rather than providing an alternative account of the cause of mental disorder, evolutionary psychiatry seeks to integrate findings from traditional schools of psychology and psychiatry such as social psychology, behaviourism, biological psychiatry and psychoanalysis into a holistic account related to evolutionary biology. In this sense, it aims to meet the criteria of a Kuhnian paradigm shift.

A self-disorder, also called ipseity disturbance, is a psychological phenomenon of disruption or diminishing of a person's minimal self the fundamental sense that one's experiences are truly one's own. People with self-disorder feel that their internal experiences are actually external; for example, they may experience their own thoughts as coming from outside themselves, whether in the form of true auditory hallucinations or merely as a vague sense that their thoughts do not belong to them.

<span class="mw-page-title-main">Basic symptoms of schizophrenia</span> Subjective symptoms of schizophrenia

Basic symptoms of schizophrenia are subjective symptoms, described as experienced from a person's perspective, which show evidence of underlying psychopathology. Basic symptoms have generally been applied to the assessment of people who may be at risk to develop psychosis. Though basic symptoms are often disturbing for the person, problems generally do not become evident to others until the person is no longer able to cope with their basic symptoms. Basic symptoms are more specific to identifying people who exhibit signs of prodromal psychosis (prodrome) and are more likely to develop schizophrenia over other disorders related to psychosis. Schizophrenia is a psychotic disorder, but is not synonymous with psychosis. In the prodrome to psychosis, uncharacteristic basic symptoms develop first, followed by more characteristic basic symptoms and brief and self-limited psychotic-like symptoms, and finally the onset of psychosis. People who were assessed to be high risk according to the basic symptoms criteria have a 48.5% likelihood of progressing to psychosis. In 2015, the European Psychiatric Association issued guidance recommending the use of a subscale of basic symptoms, called the Cognitive Disturbances scale (COGDIS), in the assessment of psychosis risk in help-seeking psychiatric patients; in a meta-analysis, COGDIS was shown to be as predictive of transition to psychosis as the Ultra High Risk (UHR) criteria up to 2 years after assessment, and significantly more predictive thereafter. The basic symptoms measured by COGDIS, as well as those measured by another subscale, the Cognitive-Perceptive basic symptoms scale (COPER), are predictive of transition to schizophrenia.

References

  1. 1 2 3 4 5 6 7 8 9 Meehl, P. E. (1962). Schizotaxia, schizotypy, schizophrenia. American Psychologist,17(12), 827-838. doi:10.1037/h0041029
  2. 1 2 Loas, G., Dimassi, H., Monestes, J. L., & Yon, V. (2013). Criterion Validity Of The Cognitive Slippage And Schizotypal Ambivalence Scales1. Psychological Reports,113(3), 930-934. doi:10.2466/02.19.pr0.113x27z5
  3. 1 2 Kagan, D. L., & Oltmanns, T. F. (1981). Matched tasks for measuring single-word, referent communication: The performance of patients with schizophrenic and affective disorders. Journal of Abnormal Psychology,90(3), 204-212. doi:10.1037/0021-843x.90.3.204
  4. O'Connor, Kieron (March 2009). "Cognitive and Meta-cognitive Dimensions of Psychoses". Canadian Journal of Psychiatry. 54: 152.
  5. 1 2 Oltmanns, T. F., Weintraub, S., Stone, A. A., & Neale, J. M. (1978). Cognitive Slippage in Children Vulnerable to Schizophrenia. Journal of Abnormal Child Psychology,6(2), 237-245. doi:10.1007/bf00919128
  6. 1 2 Berg, J. L. (1990). Differentiating Ego Functions of Borderline and Narcissistic Personalities. Journal of Personality Assessment,55(3-4), 537-548. doi:10.1080/00223891.1990.9674089
  7. 1 2 Ghaziuddin, M., Leininger, L., & Tsai, L. (1995). Brief report: Thought disorder in asperger syndrome: Comparison with high-functioning autism. Journal of Autism and Developmental Disorders,25(3), 311-317. doi:10.1007/bf02179292
  8. 1 2 Strauss, J., & Ryan, R. M. (1988). Cognitive dysfunction in eating disorders. International Journal of Eating Disorders,7(1), 19-27. doi:10.1002/1098-108x(198801)7:1<19::aid-eat2260070103>3.0.co;2-2
  9. 1 2 3 Yates, G. C., Hannell, G., & Lippett, R. M. (1985). Cognitive Slippage, Test Anxiety, And Responses In A Group Testing Situation. British Journal of Educational Psychology,55(1), 28-33. doi:10.1111/j.2044-8279.1985.tb02603.x
  10. Beck, Aaron T.; et al. (2009). Schizophrenia : Cognitive theory, research, and therapy . New York: Guilford Press. pp.  53. ISBN   9781606230183.
  11. Kendler, K. S. (1985). Diagnostic Approaches to Schizotypal Personality Disorder: A Historical Perspective. Schizophrenia Bulletin,11(4), 538-553. doi:10.1093/schbul/11.4.538
  12. 1 2 Lenzenweger, M. F. (2006). Schizotaxia, Schizotypy, and Schizophrenia: Paul E. Meehl's Blueprint for the Experimental Psychopathology and Genetics of Schizophrenia. Journal of Abnormal Psychology,115(2), 195-200. doi:10.1037/0021-843x.115.2.195
  13. 1 2 3 Osman, A. (1992). Reliability And Validity Of The Cognitive Slippage Scale In Two Populations. Psychological Reports,70(1), 131. doi:10.2466/pr0.70.1.131-136
  14. 1 2 Gooding, D. C., Tallent, K. A., & Hegyi, J. V. (2001). Cognitive Slippage in Schizotypic Individuals. The Journal of Nervous and Mental Disease,189(11), 750-756. doi:10.1097/00005053-200111000-00004
  15. Cognitive Slippage, Journal of Nervous and Mental Disease. Retrieved 20 March 2014
  16. Radanovic, M., Sousa, R. T., Valiengo, L., Gattaz, W. F., & Forlenza, O. V. (2013). Formal Thought Disorder and language impairment in schizophrenia. Arquivos de Neuro-Psiquiatria,71(1), 55-60. doi:10.1590/s0004-282x2012005000015
  17. Braatz, G. A. (1970). Preference intransitivity as an indicator of cognitive slippage in schizophrenia. Journal of Abnormal Psychology, 75(1), 1-6. doi:10.1037/h0028808
  18. Lenzenweger, M. F., Bennett, M. E., & Lilenfeld, L. R. (1997). The Referential Thinking Scale as a measure of schizotypy: Scale development and initial construct validation. Psychological Assessment,9(4), 452-463. doi:10.1037/1040-3590.9.4.452
  19. Eckblad, M., & Chapman, L. J. (1983). Magical ideation as an indicator of schizotypy. Journal of Consulting and Clinical Psychology, 51(2), 215-225. doi:10.1037/0022-006x.51.2.215
  20. Mccarthy, J. B. (2015). The Continuum Of Psychosis Proneness And Schizotypal Traits: A Comment On Loas, et Al. (2013)1. Psychological Reports,116(3), 914-919. doi:10.2466/02.19.pr0.116k30w2
  21. Gooding, D. C. (2014). Cognitive Slippage, Psychosis-Proneness, And Schizotypy: A Comment On Loas, et Al. (2013)1. Psychological Reports,115(2), 537-540. doi:10.2466/02.19.pr0.115c21z3
  22. Allen, J. J., Chapman, L. J., & Chapman, J. P. (1987). Cognitive Slippage and Depression in Hypothetically Psychosis-Prone College Students. The Journal of Nervous and Mental Disease,175(6), 347-353. doi:10.1097/00005053-198706000-00004
  23. Edell, W. (1987). Role of Structure in Disordered Thinking in Borderline and Schizophrenic Disorders. Journal of Personality Assessment,51(1), 23-41. doi:10.1207/s15327752jpa5101_3
  24. Dykens, E., Volkmar, F., & Glick, M. (1991). Thought disorder in high-functioning autistic adults. Journal of Autism and Developmental Disorders,21(3), 291-301. doi:10.1007/bf02207326