Thought blocking

Last updated

Thought blocking is a neuropsychological symptom expressing a sudden and involuntary silence within a speech, and eventually an abrupt switch to another topic. [1] Persons undergoing thought blocking may utter incomprehensible speech; they may also repeat words involuntarily or make up new words.[ citation needed ] The main causes of thought blocking are schizophrenia, anxiety disorders, petit mal seizures, post-traumatic stress disorder, bradyphrenia, aphasia, dementia and delirium. [2]

Contents

Schizophrenia

Thought blocking occurs most often in people with psychiatric illnesses, most commonly schizophrenia. [3] A person's speech is suddenly interrupted by silences that may last a few seconds to a minute or longer. [4] [5] When the person begins speaking again, after the block, they will often speak about an unrelated subject. Blocking is also described as an experience of unanticipated, quick and total emptying of the mind. [6] People with schizophrenia commonly experience thought blocking and may interpret the experience in peculiar ways. [6] For example, a person with schizophrenia might remark that another person has removed their thoughts from their brain. [6]

When evaluating a patient for schizophrenia, a physician may look for thought blocking. [7] In schizophrenia, patients experience two types of symptoms: positive and negative. Positive symptoms include behavior added on to a person's daily functioning. For instance, delusions, hallucinations, disorganized speech, disorganized behavior and thought are all positive symptoms. In contrast, negative symptoms are characterized by missing parts of the average individual's persona, including flat affect, apathy, speaking very little, not finding enjoyment in any activity, and not attending to basic acts of daily living (ADLs), such as bathing, eating, and wearing clean clothes.

Anxiety disorders

Generalized anxiety disorder (GAD) is defined as excessive worry about matters in two or more separate subjects for at least six months. [8] When a person experiences an anxiety attack, they may become so hyperfocused on the distressing stimuli or overwhelmed with the situation that regular speech is difficult for that person to produce. The thought blocking that occurs in this instance is usually short lived because anxiety attacks are transient. After an episode occurs, a person is typically able to resume their normal way of speaking.

Seizures

Thought blocking is associated with absence seizures. As such, it can be hard for people to organize their speech, resulting in thought blocking. [9]

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can occur after a person experiences a traumatic event and is significantly handicapped because of it, and can develop inappropriate coping strategies. [10] These maladaptive approaches can include, but are not limited to dissociation, especially depersonalization and derealization. When these dissociative symptoms surface, they can be extremely intrusive and result in a person not being able to focus on their diction, or manner of speaking, and result in thought blocking. People with PTSD may find that blocking of thought occurs more often if they have not addressed the source of their PTSD. [ citation needed ]

Cognitive and motor disorders

In older adults, blocking of thought can be a feature of several cognitive and motor disorders, including underlying dementia and delirium. It is common that as a person ages, they may become forgetful and/or lose their train of thought. When it becomes more persistent and affects one's ability to carry out their ADLs (activities of daily living), a major neurocognitive disorder like dementia is among the possible causes. [11] In addition, thought blocking can occur in patients with parkinsonism, a disorder that features slowing of movement, muscle rigidity, and impairment. The distinguishing feature between parkinsonism and Parkinson's disease is that the causes of parkinsonism are numerous, including drugs, toxins, metabolic disorders, and head trauma. [12] Furthermore, a stroke can result in a disordered speech process such as thought blocking. [2] When a stroke affects the middle cerebral artery (MCA), it can result in damage to the Wernicke's area or Broca's area. As such, people afflicted can understand speech well but have problems saying the words they want to, or be able to speak but have nonsensical syntax and word choice. These symptoms are referred to as aphasias, and aphasias can present with thought blocking. [2]

Related Research Articles

<span class="mw-page-title-main">Catatonia</span> Psychiatric behavioural syndrome

Catatonia is a complex syndrome, most commonly seen in people with underlying mood, such as major depressive disorder, or psychotic disorders, such as schizophrenia. People with catatonia have abnormal movement and behaviors, which vary from person to person and fluctuate in intensity within a single episode. People with catatonia appear withdrawn, meaning that they do not interact with the outside world and have difficulty processing information. They may be nearly motionless for days on end or perform repetitive purposeless movements. Two people may exhibit very different sets of behaviors and both still be diagnosed with catatonia. Treatment with benzodiazepines or ECT are most effective and lead to remission of symptoms in most cases.

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 disorganized thinking and 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.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event and can include triggers such as misophonia. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind–body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.

<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, 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.

<span class="mw-page-title-main">Mood swing</span> Extreme or rapid change in mood

A mood swing is an extreme or sudden change of mood. Such changes can play a positive or a disruptive part in promoting problem solving and in producing flexible forward planning. When mood swings are severe, they may be categorized as part of a mental illness, such as bipolar disorder, where erratic and disruptive mood swings are a defining feature.

Conversion disorder (CD) was a formerly diagnosed psychiatric disorder characterized by abnormal sensory experiences and movement problems during periods of high psychological stress. Individuals diagnosed with CD presented with highly distressing neurological symptoms such as numbness, blindness, paralysis, or convulsions, none of which were consistent with a well-established organic cause and could be traced back to a psychological trigger. CD is no longer diagnosed and was superseded by functional neurologic disorder (FND), a similar diagnosis that notably removed the requirement for a psychological stressor to be present.

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.

Acute stress reaction (ASR), also known as psychological shock, mental shock, or simply shock, as well as acute stress disorder (ASD), is a psychological response to a terrifying, traumatic, or surprising experience. The reactions may include but are not limited to intrusive thoughts, or dissociation, and reactivity symptoms such as avoidance or hyperarousal. It may be exhibited for days or weeks after the traumatic event. If the condition is not correctly addressed, it may develop into post-traumatic stress disorder (PTSD).

Pressure of speech is a speech fast and frenetic, including some irregularities in loudness and rhythm or some degrees of circumstantiality; it is hard to interpret and expresses a feeling/affect of emergency. It is mainly a neuropsychological symptom of specific mental disorders, such as bipolar disorders, thought disorders, and stress-related disorders among others.

This glossary covers terms found in the psychiatric literature; the word origins are primarily Greek, but there are also Latin, French, German, and English terms. Many of these terms refer to expressions dating from the early days of psychiatry in Europe; some are deprecated, and thus are of historic interest.

<span class="mw-page-title-main">Complex post-traumatic stress disorder</span> Psychological disorder

Complex post-traumatic stress disorder is a stress-related mental and behavioral disorder generally occurring in response to complex traumas.

Traumatic stress is a common term for reactive anxiety and depression, although it is not a medical term and is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The experience of traumatic stress include subtypes of anxiety, depression and disturbance of conduct along with combinations of these symptoms. This may result from events that are less threatening and distressing than those that lead to post-traumatic stress disorder. The fifth edition of the DSM describes in a section titled "Trauma and Stress-Related Disorders" disinhibited social engagement disorder, reactive attachment disorder, acute stress disorder, adjustment disorder, and post-traumatic stress disorder.

Brief psychotic disorder—according to the classifications of mental disorders DSM-IV-TR and DSM-5—is a psychotic condition involving the sudden onset of at least one psychotic symptom lasting 1 day to 1 month, often accompanied by emotional turmoil. Remission of all symptoms is complete with patients returning to the previous level of functioning. It may follow a period of extreme stress including the loss of a loved one. Most patients with this condition under DSM-5 would be classified as having acute and transient psychotic disorders under ICD-10. Prior to DSM-IV, this condition was called "brief reactive psychosis." This condition may or may not be recurrent, and it should not be caused by another condition.

Derealization is an alteration in the perception of the external world, causing those with the condition to perceive it as unreal, distant, distorted or in other words falsified. Other symptoms include feeling as if one's environment is lacking in spontaneity, emotional coloring, and depth. Described as "Experiences of unreality or detachment with respect to surroundings in the DSM-5, it is a dissociative symptom that may appear in moments of severe stress.

Traumatic brain injury can cause a variety of complications, health effects that are not TBI themselves but that result from it. The risk of complications increases with the severity of the trauma; however even mild traumatic brain injury can result in disabilities that interfere with social interactions, employment, and everyday living. TBI can cause a variety of problems including physical, cognitive, emotional, and behavioral complications.

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.

Pseudoneurotic schizophrenia is a postulated mental disorder categorized by the presence of two or more symptoms of mental illness such as anxiety, hysteria, and phobic or obsessive-compulsive neuroses. It is often acknowledged as a personality disorder. Patients generally display salient anxiety symptoms that disguise an underlying psychotic disorder.

Simple-type schizophrenia is a sub-type of schizophrenia included in the International Classification of Diseases (ICD-10), in which it is classified as a mental and behaviour disorder. It is not included in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the upcoming ICD-11, effective 1 January 2022. Simple-type schizophrenia is characterized by negative ("deficit") symptoms, such as avolition, apathy, anhedonia, reduced affect display, lack of initiative, lack of motivation, low activity; with absence of hallucinations or delusions of any kind.

References

  1. ↑ World Health Organization (2023). "MB25.3 Thought blocking". International Classification of Diseases, eleventh revision – ICD-11. Genova – icd.who.int.
  2. 1 2 3 Tani, Masayuki; Iwanami, Akira (October 2013). "[Disorder of train of thought in the elderly]". Nihon Rinsho. Japanese Journal of Clinical Medicine. 71 (10): 1793–1797. ISSN   0047-1852. PMID   24261209.
  3. ↑ Raymond Lake, C. (January 2008). "Disorders of thought are severe mood disorders: the selective attention defect in mania challenges the Kraepelinian dichotomy a review". Schizophrenia Bulletin. 34 (1): 109–117. doi:10.1093/schbul/sbm035. ISSN   0586-7614. PMC   2632389 . PMID   17515440.
  4. ↑ Nurcombe Barry, Ebert Michael H, "Chapter 4. The Psychiatric Interview" (Chapter). Ebert MH, Loosen PT, Nurcombe B, Leckman JF: CURRENT Diagnosis & Treatment: Psychiatry, p.2e: "AccessMedicine | the Psychiatric Interview: Introduction". Archived from the original on 2011-07-22. Retrieved 2010-07-20..
  5. ↑ "Blocking". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 28 February 2020.
  6. 1 2 3 Gelder, Mayou, Geddes (2005). Psychiatry. New York, NY; Oxford University Press Inc.
  7. ↑ Administration, Substance Abuse and Mental Health Services (June 2016). "Table 3.22, DSM-IV to DSM-5 Schizophrenia Comparison". www.ncbi.nlm.nih.gov. Retrieved 2020-11-10.
  8. ↑ Munir, Sadaf; Takov, Veronica (2020), "Generalized Anxiety Disorder", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   28722900 , retrieved 2020-11-14
  9. ↑ Abood, Waleed; Bandyopadhyay, Susanta (2020), "Postictal Seizure State", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   30252260 , retrieved 2020-11-14
  10. ↑ Treatment (US), Center for Substance Abuse (2014). "Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD". www.ncbi.nlm.nih.gov. Retrieved 2020-11-14.
  11. ↑ Hugo, Julie; Ganguli, Mary (August 2014). "Dementia and Cognitive Impairment: Epidemiology, Diagnosis, and Treatment". Clinics in Geriatric Medicine. 30 (3): 421–442. doi:10.1016/j.cger.2014.04.001. ISSN   0749-0690. PMC   4104432 . PMID   25037289.
  12. ↑ Shrimanker, Isha; Tadi, Prasanna; Sánchez-Manso, Juan Carlos (2020), "Parkinsonism", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   31194381 , retrieved 2020-11-14
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.