Stilted speech

Last updated

In psychiatry, stilted speech or pedantic speech [1] is communication characterized by situationally inappropriate formality. [2] This formality can be expressed both through abnormal prosody [3] as well as speech content that is "inappropriately pompous, legalistic, philosophical, or quaint". [4] Often, such speech can act as evidence for autism spectrum disorder (ASD) [3] or a thought disorder, [5] a common symptom in schizophrenia [6] or schizoid personality disorder. [7]

To diagnose stilted speech, researchers have previously looked for the following characteristics: [8]

While literal and long-winded word content is often the most identifiable feature of stilted speech, such speech often displays irregular prosody, especially in resonance. [8] Often, the loudness, pitch, rate, and nasality of pedantic speech vary from normal speech, resulting in the perception of pedantic or stilted speaking. For example, overly loud or high-pitched speech can come across to listeners as overly forceful while slow or nasal speech creates an impression of condescension. [9]

These attributions, which are commonly found in patients with ASD, [9] partially account for why stilted speech has been considered a diagnostic criterion for the disorder. [8] Stilted speech, along with atypical intonation, semantic drift, terseness, and perseveration, are all known deficits with adolescents on the autistic spectrum. [10] Often, stilted speech found in children with ASD will also be especially stereotypic or in some cases even rehearsed. [10]

Patients with schizophrenia are also known to experience stilted speech. This symptom is attributed to both an inability to access more commonly used words and a difficulty understanding pragmatics—the relationship between language and context. [11] However, stilted speech appears as a less common symptom compared to a certain number of other symptoms of the psychosis (Adler et al 1999). [12] This element of cognitive disorder is also exhibited as a symptom in the narcissistic personality disorder (Akhtar & Thomson 1982). [13]

See also

Related Research Articles

<span class="mw-page-title-main">Asperger syndrome</span> Neurodevelopmental diagnosis now categorized under Autism Spectrum Disorder

Asperger syndrome (AS), also known as Asperger's syndrome, formerly described a neurodevelopmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavior, interests, and activities. The syndrome has been merged with other disorders into autism spectrum disorder (ASD) and is no longer considered a stand-alone diagnosis. It was considered milder than other diagnoses that were merged into ASD by relatively unimpaired spoken language and intelligence.

<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, a degree of asexuality, and idiosyncratic moral or political beliefs.

<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."

<span class="mw-page-title-main">Avoidant personality disorder</span> Personality disorder

Avoidant personality disorder (AvPD) or Anxious personality disorder is a Cluster C personality disorder characterized by excessive social anxiety and inhibition, fear of intimacy, severe feelings of inadequacy and inferiority, and an overreliance on avoidance of feared stimuli as a maladaptive coping method. Those affected typically display a pattern of extreme sensitivity to negative evaluation and rejection, a belief that one is socially inept or personally unappealing to others, and avoidance of social interaction despite a strong desire for it. It appears to affect an approximately equal number of men and women.

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.

Pervasive developmental disorder not otherwise specified (PDD-NOS) is a historic psychiatric diagnosis first defined in 1980 that has since been incorporated into autism spectrum disorder in the DSM-5 (2013).

<span class="mw-page-title-main">Conditions comorbid to autism spectrum disorders</span> Medical conditions more common in autistic people

Autism spectrum disorders (ASD) are neurodevelopmental disorders that begin in early childhood, persist throughout adulthood, and affect three crucial areas of development: communication, social interaction and restricted patterns of behavior. There are many conditions comorbid to autism spectrum disorders such as attention-deficit hyperactivity disorder and epilepsy.

<span class="mw-page-title-main">Hyperfocus</span> Intense form of mental concentration

Hyperfocus is an intense form of mental concentration or visualization that focuses consciousness on a subject, topic, or task. In some individuals, various subjects or topics may also include daydreams, concepts, fiction, the imagination, and other objects of the mind. Hyperfocus on a certain subject can cause side-tracking away from assigned or important tasks.

High-functioning autism (HFA) was historically an autism classification where a person exhibits no intellectual disability, but may experience difficulty in communication, emotion recognition, expression, and social interaction.

The Autism Diagnostic Observation Schedule (ADOS) is a standardized diagnostic test for assessing autism spectrum disorder. The protocol consists of a series of structured and semi-structured tasks that involve social interaction between the examiner and the person under assessment. The examiner observes and identifies aspects of the subject's behavior, assigns these to predetermined categories, and combines these categorized observations to produce quantitative scores for analysis. Research-determined cut-offs identify the potential diagnosis of autism spectrum disorder, allowing a standardized assessment of autistic symptoms.

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".

<span class="mw-page-title-main">Classic autism</span> Neurodevelopmental condition

Classic autism, also known as childhood autism, autistic disorder, (early) infantile autism, infantile psychosis, Kanner's autism,Kanner's syndrome, or (formerly) just autism, is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted, repetitive behaviors, activities, and interests. These symptoms first appear in early childhood and persist throughout life.

Several factors complicate the diagnosis of Asperger syndrome (AS), an autism spectrum disorder (ASD). Like other ASD forms, Asperger syndrome is characterized by impairment in social interaction accompanied by restricted and repetitive interests and behavior; it differs from the other ASDs by having no general delay in language or cognitive development. Problems in diagnosis include disagreement among diagnostic criteria, the controversy over the distinction between AS and other ASD forms or even whether AS exists as a separate syndrome, and over- and under-diagnosis for non-technical reasons. As with other ASD forms, early diagnosis is important, and differential diagnosis must consider several other conditions.

<span class="mw-page-title-main">Autism spectrum</span> Neurodevelopmental disorder

Autism, formally called autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder marked by deficits in reciprocal social communication and the presence of restricted and repetitive patterns of behavior. Other common signs include difficulty with social interaction, verbal and nonverbal communication, along with perseverative interests, stereotypic body movements, rigid routines, and hyper- or hyporeactivity to sensory input. Autism is clinically regarded as a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there is wide variation in the support needs of people across the autism spectrum.

Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.

<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 history of autism spans over a century; autism has been subject to varying treatments, being pathologized or being viewed as a beneficial part of human neurodiversity. The understanding of autism has been shaped by cultural, scientific, and societal factors, and its perception and treatment change over time as scientific understanding of autism develops.

<span class="mw-page-title-main">Grunya Sukhareva</span> Ukrainian-Russian psychiatrist and university teacher

Grunya Efimovna Sukhareva was a Soviet child psychiatrist.

The Ritvo Autism & Asperger Diagnostic Scale (RAADS) is a psychological self-rating scale developed by Dr. Riva Ariella Ritvo. An abridged and translated 14 question version was then developed at the Department of Clinical Neuroscience at the Karolinska Institute, to aid in the identification of patients who may have undiagnosed ASD.

References

  1. ↑ McKenna P.J., Oh T.M. (2012.) Schizophrenic Speech: Making Sense of Bathroots and Ponds that Fall in Doorways , Cambridge University Press, ISBN   978-0-521-00905-8
  2. ↑ Encyclopedia of autism spectrum disorders. Volkmar, Fred R. New York, NY: Springer. 2013. ISBN   9781441916976. OCLC   822231140.{{cite book}}: CS1 maint: others (link)
  3. 1 2 Rosenblau, G; Kliemann, D; Dziobek, I; Heekeren, HR (February 2017). "Emotional prosody processing in autism spectrum disorder". Social Cognitive and Affective Neuroscience. 12 (2): 224–39. doi:10.1093/scan/nsw118. PMC   5390729 . PMID   27531389.
  4. ↑ Peter F. Liddle, Royal College of Psychiatrists Disordered mind and brain: the neural basis of mental symptoms, 301 pages RCPsych Publications, 2001 Retrieved 2012-01-12 ISBN   1-901242-65-X
  5. ↑ Victor Peralta, Manuel J. Cuesta, Jose de Leon Title:Formal thought disorder in schizophrenia: A factor analytic study, Publication:Comprehensive Psychiatry Elsevier March–April 1992, Elsevier Retrieved 2012-01-12
  6. ↑ doi : 10.1016/j.schres.2005.01.016 Retrieved 2012-01-12
  7. ↑ Khan M (2022). "Understanding and psychosocial treatment of schizoid personality disorder: a cognitive behavioural, psychoanalytical and bio energetic analysis approach". In Naik S (ed.). Emerging trends in medical sciences. Vol. 4. New Delhi: Integrated publications. pp. 45–62. ISBN   978-93-95118-07-1.
  8. 1 2 3 Ghaziuddin, M.; Gerstein, L. (December 1996). "Pedantic speaking style differentiates Asperger syndrome from high-functioning autism". Journal of Autism and Developmental Disorders. 26 (6): 585–595. doi:10.1007/bf02172348. hdl: 2027.42/44615 . ISSN   0162-3257. PMID   8986845. S2CID   8508542.
  9. 1 2 Shriberg, L. D.; Paul, R.; McSweeny, J. L.; Klin, A. M.; Cohen, D. J.; Volkmar, F. R. (October 2001). "Speech and prosody characteristics of adolescents and adults with high-functioning autism and Asperger syndrome". Journal of Speech, Language, and Hearing Research. 44 (5): 1097–1115. CiteSeerX   10.1.1.385.7116 . doi:10.1044/1092-4388(2001/087). ISSN   1092-4388. PMID   11708530. S2CID   1676598.
  10. 1 2 de Villiers, Jessica; Fine, Jonathan; Ginsberg, Gary; Vaccarella, Liezanne; Szatmari, Peter (August 2007). "Brief report: a scale for rating conversational impairment in autism spectrum disorder". Journal of Autism and Developmental Disorders. 37 (7): 1375–1380. doi:10.1007/s10803-006-0264-1. ISSN   0162-3257. PMID   17082976. S2CID   6433996.
  11. ↑ Covington, Michael A.; He, Congzhou; Brown, Cati; Naçi, Lorina; McClain, Jonathan T.; Fjordbak, Bess Sirmon; Semple, James; Brown, John (2005-09-01). "Schizophrenia and the structure of language: the linguist's view". Schizophrenia Research. 77 (1): 85–98. CiteSeerX   10.1.1.532.2190 . doi:10.1016/j.schres.2005.01.016. ISSN   0920-9964. PMID   16005388. S2CID   7206375.
  12. ↑ Jeffrey A. Lieberman, T. Scott Stroup, Diana O. Perkins, American Psychiatric Publishing The American Psychiatric Publishing textbook of schizophrenia - 435 pages American Psychiatric Pub, 2006 Retrieved 2012-01-12 ISBN   1-58562-191-9
  13. ↑ S. Akhtar and J. Anderson Thomson, "Overview: Narcissistic personality Disorder" American Journal of Psychiatry139:1 Retrieved 2012-01-12
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.