Thought broadcasting

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In psychiatry, thought broadcasting is the belief that others can hear or are aware of an individual's thoughts. [1] The person experiencing this symptom can also think that their thoughts are being broadcast through different medias, such as the television or the radio. [2] Different people can experience thought broadcasting in different ways. [3] Thought broadcasting is most commonly found among people that have schizophrenia, schizoaffective disorder, or bipolar disorder. People with thought broadcasting rarely admit to having this symptom or to the severity of the symptom. [4] Thought broadcasting is treated with the use of an atypical antipsychotic and in certain cases cognitive behavioral therapy.

Contents

Diagnosis and classification

Thought broadcasting is considered a form of obsessive–compulsive disorder (OCD) and has multiple accepted definitions based on the many ways it can present itself. The first definition is that the person may hear their thoughts out loud and believe that others can hear the thoughts too. This definition relies on the fact that the thoughts are audible, through auditory hallucinations, in order for other people to hear them. The second definition consists of the individual believing that others can hear their thoughts with no associated auditory hallucinations and no real explanation of how others can hear the thoughts. The thoughts are said to be leaving the person's head silently, and the way their thoughts are known by others is unknown to the patient. A third possible definition is that the person believes that others are able to control or think with them and can hear their thoughts that way. The thoughts do not become audible to the patient since there are no auditory hallucinations. [3]

An example of thought broadcasting would be if a student is sitting in class and is thinking about what he or she may have planned for the upcoming weekend. They may start to believe that their teacher can hear their plans, and that the teacher knows that they are not paying attention to the lecture being given. They may also believe that the other students in the classroom can hear their thoughts and may be judging them for the plans that they have. The student experiencing this symptom may then be embarrassed and become even more disengaged in the lesson since they may start to try to control their thoughts in order to make sure no one can hear anything they are thinking. Depending on the severity, they may even leave class or attempt to distance themselves from others in social situations.

Association with schizophrenia

Thought broadcasting can be considered a positive symptom of schizophrenia. [5] Thought broadcasting has been suggested as one of the first rank symptoms (Schneider's first-rank symptoms) believed to distinguish schizophrenia from other psychotic disorders. The prevalence of comorbid OCD and schizophrenia ranges anywhere from 7.8% to 40.5%. The width of this range may be explained by obsessive-compulsive (OC) symptoms commonly being overlooked due to their hierarchy in the diagnosis of schizophrenia. OC symptoms may initially present or worsen in presentation with the use of atypical antipsychotics, a common treatment modality for schizophrenia.

In mild manifestations, a person with this thought disorder may doubt their perception of thought broadcasting. When thought broadcasting occurs on a regular basis, the disorder can affect behavior and interfere with the person's ability to function in society. According to an individual's personality, this is considered to be a severe manifestation of thought broadcasting that is usually indicative of schizophrenia. [6] Those who experience this symptom often steer clear from many social interactions, and can become socially isolated to ensure that no one can hear their thoughts. This symptom is often stress-induced, tends to worsen as their stress level increases, and may lessen when the individual is around those that they trust. In severe cases, the person may believe that people who are not even in the same room as them, or even in the house next door, can hear their thoughts. [4]

Over time, thought broadcasting can shape how one thinks. If someone says a word or phrase similar to what the patient may have been thinking, that could catalyze this symptom, especially if it happens fairly frequently. [7]

Treatment

A combination of antipsychotic medication (such as Abilify, Zyprexa, Risperdal, and Clozaril) and psychotherapy are used to treat thought broadcasting. [4] Although case studies utilizing a combination of antipsychotics and cognitive behavioral therapy have been completed with mixed results, individuals with psychotic disorders are often excluded from clinical trials studying psychological treatments for obsessive-compulsive symptoms. [4] [8]

David Letterman lawsuit

Colleen Nestler, an Albuquerque, New Mexico woman filed a lawsuit against David Letterman in 2005 alleging that he caused her sleep deprivation and forced her into bankruptcy over a 10 year period. The suit blamed Letterman for mental cruelty beginning in 1993 when his show moved to CBS. Nestler stated that she began sending Letterman love letters in 1993, which he responded to via coded messages. Examples of the coded messages highlighted in the suit by Nestler included things such as Letterman wearing a baseball cap with the letter "C" on it which she believed referred to her. Others included secret communications through songs sung by his guests and a marriage proposal communicated through Oprah Winfrey. After Letterman's attorneys responded by stating Letterman had never met Nestler, a judge rescinded the restraining order which had called for Letterman to remain 3 yards from Nestler at all times.

See also

Related Research Articles

Psychosis Condition of the mind that involves a loss of contact with reality

Psychosis is an abnormal condition of the mind 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.

Schizophrenia Mental disorder characterized by psychosis

Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations, delusions, paranoia, and disorganized thinking. Other symptoms include social withdrawal, decreased emotional expression, and apathy. Symptoms typically come on gradually, begin in young adulthood, and in many cases never resolve. There is no objective diagnostic test; the diagnosis is used to describe observed behavior that may stem from numerous different causes. Besides observed behavior, doctors will also take a history that includes the person's reported experiences, and reports of others familiar with the person, when making a diagnosis. To diagnose someone with schizophrenia, doctors are supposed to confirm that symptoms and functional impairment are present for six months (DSM-5) or one month (ICD-11). Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.

Hypochondriasis Medical condition

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. An old concept, the meaning of hypochondria has repeatedly changed. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious 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. The main criterion for a diagnosis of schizoaffective disorder 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 Mental illness featuring beliefs with inadequate grounding

Delusional disorder is a mental illness in which a person has 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 could 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.

Thought disorder Disorder of thought form, content or stream

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 characterized by the experience of multiple delusional fragments. The term thought disorder is often used to refer to a formal thought disorder.

Obsessive–compulsive personality disorder Personality disorder involving orderliness

Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by an excessive need for orderliness, neatness, and perfectionism. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.

Kleptomania is the inability to resist the urge to steal items, usually for reasons other than personal use or financial gain. First described in 1816, kleptomania is classified in psychiatry as an impulse control disorder. Some of the main characteristics of the disorder suggest that kleptomania could be an obsessive-compulsive spectrum disorder, but also share similarities with addictive and mood disorders.

Mental status examination Way of observing and describing a patients current state of mind

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.

Schizophreniform disorder is a mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of time, but signs of disturbance are not present for the full six months required for the diagnosis of schizophrenia.

An intrusive thought is an unwelcome, involuntary thought, image, or unpleasant idea that may become an obsession, is upsetting or distressing, and can feel difficult to manage or eliminate. When such thoughts are associated with obsessive-compulsive disorder (OCD), depression, body dysmorphic disorder (BDD), and sometimes attention-deficit hyperactivity disorder (ADHD), the thoughts may become paralyzing, anxiety-provoking, or persistent. Intrusive thoughts may also be associated with episodic memory, unwanted worries or memories from OCD, post-traumatic stress disorder, other anxiety disorders, eating disorders, or psychosis. Intrusive thoughts, urges, and images are of inappropriate things at inappropriate times, and generally have aggressive, sexual, or blasphemous themes.

Olfactory reference syndrome (ORS) is a psychiatric condition in which there is a persistent false belief and preoccupation with the idea of emitting abnormal body odors which the patient thinks are foul and offensive to other individuals. People with this condition often misinterpret others' behaviors, e.g. sniffing, touching their nose or opening a window, as being referential to an unpleasant body odor which in reality is non-existent and cannot be detected by other people.

An auditory hallucination, or paracusia, is a form of hallucination that involves perceiving sounds without auditory stimulus.

Grandiose delusions Subtype of delusion

Grandiose delusions (GD), also known as delusions of grandeur or 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.

Primarily cognitive obsessive-compulsive disorder is a lesser-known form or manifestation of OCD. It is not a diagnosis in the DSM-5. For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD. While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. Primarily obsessional OCD takes the form of intrusive thoughts of a distressing or violent nature.

Obsessive–compulsive disorder Disorder that involves repeated thoughts that make a person feel driven to do something

Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which a person has intrusive thoughts and/or feels the need to perform certain routines repeatedly to the extent where it induces distress or impairs general function. As indicated by the disorder's name, the primary symptoms of OCD are obsessions and compulsions. Obsessions are persistent unwanted thoughts, mental images, or urges that generate feelings of anxiety, disgust, or unease. Common obsessions include fear of contamination, obsession with symmetry, and intrusive thoughts about religion, sex, and harm. Compulsions are repeated actions or routines that occur in response to obsessions. Common compulsions include excessive hand washing, cleaning, arranging things, counting, seeking reassurance, and checking things. Many adults with OCD are aware that their compulsions do not make sense, but they perform them anyway to relieve the distress caused by obsessions. Compulsions occur so often, typically taking up at least one hour per day, that they impair one's quality of life.

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.

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

The relationship between religion and schizophrenia is of particular interest to psychiatrists because of the similarities between religious experiences and psychotic episodes; religious experiences often involve auditory and/or visual hallucinations, and those with schizophrenia commonly report similar hallucinations, along with a variety of beliefs that are commonly recognized by modern medical practitioners as delusional. In general, religion has been found to have "both a protective and a risk increasing effect" for schizophrenia.

The delayed-maturation theory of obsessive-compulsive disorder suggests that obsessive-compulsive disorder (OCD) can be caused by delayed maturation of the frontal striatal circuitry or parts of the brain that make up the frontal cortex, striatum, or integrating circuits. Some researchers suspect that variations in the volume of specific brain structures can be observed in children that have OCD. It has not been determined if delayed-maturation of this frontal circuitry contributes to the development of OCD or if OCD is the ailment that inhibits normal growth of structures in the frontal striatal, frontal cortex, or striatum. However, the use of neuroimaging has equipped researchers with evidence of some brain structures that are consistently less adequate and less matured in patients diagnosed with OCD in comparison to brains without OCD. More specifically, structures such as the caudate nucleus, volumes of gray matter, white matter, and the cingulate have been identified as being less developed in people with OCD in comparison to individuals that do not have OCD. However, the cortex volume of the operculum (brain) is larger and OCD patients are also reported to have larger temporal lobe volumes; which has been identified in some women patients with OCD. Further research is needed to determine the effect of these structural size differences on the onset and degree of OCD and the maturation of specific brain structures.

References

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