Thought blocking (German : Sperrung), or simply blocking, is a phenomenon that occurs in people with psychiatric illnesses (usually schizophrenia). A person's speech is suddenly interrupted by silences that may last a few seconds to a minute or longer. When the person begins speaking again, after the block, they will often speak about a subject unrelated to what was being discussed when blocking occurred. Blocking is described as an experience of unanticipated, quick and total emptying of the mind. People with schizophrenia commonly experience thought blocking and may comprehend the experience in peculiar ways. For example, a person with schizophrenia might remark that another person has removed their thoughts from their brain.
When doctors diagnose thought blocking, it is important that they consider other causes of pauses in speech and expression, such as petit mal or absence seizures, aphasia, hesitation brought on by anxiety, dissociation (e.g., secondary to PTSD), or slow thought processes. When looking for schizophrenia they may look for thought blocking. It is a common issue with schizophrenic patients.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication for the classification of mental disorders using a common language and standard criteria. It is published by the American Psychiatric Association (APA) and is used by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, the legal system, and policy makers.
Psychosis is an abnormal condition of the mind that results in difficulties determining what is real and what is not. Symptoms may include false beliefs (delusions) and seeing or hearing things that others do not see or hear (hallucinations). Other symptoms may include incoherent speech and behavior that is inappropriate for the situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities.
Dissociative identity disorder (DID), previously known as multiple personality disorder (MPD), is a mental disorder characterized by the maintenance of at least two distinct and relatively enduring personality states. The illness is accompanied by memory gaps beyond what would be explained by ordinary forgetfulness. The personality states alternately show in a person's behavior; presentations, however, are variable. Other conditions that often occur in people with DID include posttraumatic stress disorder (PTSD), personality disorders, depression, substance use disorders, conversion disorder, somatic symptom disorder, eating disorders, OCD, and sleep disorders. Self-harm, non-epileptic seizures, flashbacks with amnesia for content of flashbacks, and anxiety disorders and suicidality are also common.
The term paranoid schizophrenia is no longer used in the United States since the 2013 change in the DSM-V that classifies the range of symptoms of former sub-types all under "schizophrenia". Schizophrenia is defined as "a chronic mental disorder in which a person is withdrawn from reality". Prior to 2013 schizophrenia had been divided into subtypes based on the "predominant symptomatology at the time of evaluation". The subtypes were classified as: paranoid, disorganized, catatonic, undifferentiated, and residual type. However, they are not completely separate diagnoses, and cannot predict the progression of the mental illness.
Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. The diagnosis is made when the person has symptoms of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not meet the diagnostic criteria for schizophrenia or a mood disorder individually. The main criterion for the schizoaffective disorder diagnosis is the presence of psychotic symptoms for at least two weeks without any mood symptoms present. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, psychotic bipolar disorder, schizophreniform disorder, or schizophrenia. It is imperative for providers to accurately diagnose patients, as treatment and prognosis differs greatly for each of these diagnoses.
Delusional disorder is a generally rare mental illness in which a person presents delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. Delusions are a specific symptom of psychosis. Delusions can be bizarre or non-bizarre in content; non-bizarre delusions are fixed false beliefs that involve situations that occur in real life, such as being harmed or poisoned. Apart from their delusion or delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behavior does not necessarily generally seem odd. However, the preoccupation with delusional ideas can be disruptive to their overall lives.
A thought disorder (TD) is any disturbance in cognition that adversely affects language and thought content, and thereby communication. A variety of thought disorders were said to be characteristic of people with schizophrenia. A content-thought disorder is typically characterised by the experience of multiple delusional fragments. The term, thought disorder, is often used to refer to a formal thought disorder.
In psychology, alogia, is a process of poor thinking inferred from speech and language usage. There may be a general lack of additional, unprompted content seen in normal speech: the replies to questions may be brief and concrete, with a reduction in spontaneous speech. This is termed poverty of speech or laconic speech.. The amount of speech may be normal, but conveys little information because the phrases are 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.
Kurt Schneider was a German psychiatrist known largely for his writing on the diagnosis and understanding of schizophrenia, as well as personality disorders then known as psychopathic personalities.
Schizotypal personality disorder (STPD), or schizotypal disorder, is a mental disorder characterized by severe social anxiety, thought disorder, paranoid ideation, derealization, transient psychosis and often unconventional beliefs. People with this disorder feel extreme discomfort with maintaining close relationships with people and avoid forming them, mainly because the subject thinks their peers harbor negative thoughts towards them. Peculiar speech mannerisms and odd modes of dress are also symptoms of this disorder. Those with STPD may react oddly in conversations, not respond or talk to themselves. They frequently interpret situations as being strange or having unusual meaning for them; paranormal and superstitious beliefs are common. Such people frequently seek medical attention for anxiety or depression instead of their personality disorder. Schizotypal personality disorder occurs in approximately 3% of the general population and is more common in males.
The mental status examination or mental state 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.
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.
An auditory hallucination, or paracusia, is a form of hallucination that involves perceiving sounds without auditory stimulus.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has significant practical importance. The DSM-5 is the first DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the first "living document" version of a DSM.
Dual diagnosis is the condition of suffering from a mental illness and a comorbid substance abuse problem. There is considerable debate surrounding the appropriateness of using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and alcoholism, or it can be restricted to specify severe mental illness and substance misuse disorder, or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. Diagnosing a primary psychiatric illness in substance abusers is challenging as drug abuse itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness.
Grandiose delusions (GD), delusions of grandeur, expansive delusions are a subtype of delusion that occur in patients suffering from a wide range of psychiatric diseases, including two-thirds of patients in manic state of bipolar disorder, half of those with schizophrenia, patients with the grandiose subtype of delusional disorder, and a substantial portion of those with substance abuse disorders. GDs are characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. The delusions are generally fantastic and typically have a religious, science fictional, or supernatural theme. There is a relative lack of research into GD, in contrast to persecutory delusions and auditory hallucinations. About 10% of healthy people experience grandiose thoughts but do not meet full criteria for a diagnosis of GD.
The Critical Psychiatry Network (CPN) is a psychiatric organization based in the United Kingdom. It was created by a group of British psychiatrists who met in Bradford, England in January 1999 in response to proposals by the British government to amend the 1983 Mental Health Act (MHA). They expressed concern about the implications of the proposed changes for human rights and the civil liberties of people with mental health illness. Most people associated with the group are practicing consultant psychiatrists in the United Kingdom's National Health Service (NHS), among them Dr Joanna Moncrieff. A number of non-consultant grade and trainee psychiatrists are also involved in the network.
Childhood schizophrenia is schizophrenia – characterized by hallucinations, disorganized speech, delusions, and negative symptoms, such as blunted affect and avolition, with onset before 13 years of age.
Tangential speech or tangentiality is a communication disorder in which the train of thought of the speaker wanders and shows a lack of focus, never returning to the initial topic of the conversation. It tends to occur in situations where a person is experiencing high anxiety, as a manifestation of the psychosis known as schizophrenia, in dementia or in states of delirium. It is less severe than logorrhea and may be associated with the middle stage in dementia. It is, however, more severe than circumstantial speech in which the speaker wanders, but eventually returns to the topic.
A self-disorder, also called ipseity disturbance, is a psychological phenomenon of disruption or diminishing of a person's sense of minimal self. The sense of minimal self refers to the very basic sense of having experiences that are one's own; it has no properties, unlike the more extended sense of self, the narrative self, which is characterized by the person's reflections on themselves as a person, things they like, their identity, and other aspects that are the result of reflection on one's self. Disturbances in the sense of minimal self, as measured by the Examination of Anomalous Self-Experience (EASE), aggregate in the schizophrenia spectrum disorders, to include schizotypal personality disorder, and distinguish them from other conditions such as psychotic bipolar disorder and borderline personality disorder.
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