7.1 psychopathology of thought

7.1 psychopathology of thought

Non-delusional abnormal thought content

• Suicidal thoughts

• Homicidal thoughts

• Culturally deviant ideas

Suicidal thoughts

• broad term used to describe a range of contemplations, wishes, & preoccupations with death & suicide

• varies in intensity, duration, & character

• encompasses everything from fleeting wishes of falling asleep & never awakening to intensely disturbing preoccupations with self-annihilation fueled by delusions.

• magnitude & characteristics fluctuate dramatically

• Not everyone who experiences a suicidal thought attempts suicide → presence of suicidal thoughts

  increases the risk of suicide

•  suicide risk assessment

 suicide risk assessment most common cause 

• mood disorder

• persons with personality and substance abuse disorders.

•  in states of intoxication

• general medical illness associated with chronic dysfunction or pain.

Homicidal thoughts

• pattern of thoughts about homicide of one or more persons

• may range from vague ideas to detailed or fully formulated plans without taking action (“I Feel like killing someone“)

• Do not always translate into murder

• Assessment & detection of risk 

• common in drug use: alcoholics, psychotic &  traumatic brain injury, or antisocial personality disorder

Culturally deviant ideas

• Appear deviant

• not a psychopathology →  are culturally consistent.

• Behaviours understood as unusual, but not as illness by their respective cultures.

• Whether the behaviour represents illness is based on the form of the ideas or emotions that elicit the behaviour.

Example of  Culturally deviant ideas

DISORDERS OF THE

FORM OF THOUGHT

How the patient is thinking, how thoughts are linked together

types of DISORDERS OF THE

FORM OF THOUGHT

• Transitory thinking

• Drivelling thinking

• Desultory thinking

Formal thought disorder’

• disorders of conceptual or abstract thinking,

• schizophrenia & organic brain disorders

Formal thought disorder in schizophrenia

• coexist with deficits in cognition

• difficult to distinguish

5 features of formal thought disorder could be identified:

• derailment (slides on to a subsidiary)

• substitution (of major thought)

• omission (senseless)

• fusion (heterogenous elements are interwoven)

• drivelling (disordered intermixture of constituent parts of one complex thought).

three features of healthy thinking

• constancy

• organisation

• continuity

constancy

completed thought that does not change in content 

organisation

contents of thought are related to each other

continuity

 continuity of the sense continuum

3 different disorders of thinking corresponding to features of normal/non-disordered thinking:

• Transitory thinking (instead of constancy)

• Drivelling thinking (instead of organization)

• Desultory thinking (instead of continuity)

Transitory thinking (instead of constancy)

• Peculiar transitoriness of thinking characterised by:

  • derailments 

  • substitutions

  • omissions

• Intention itself is interrupted & there is a gap.

• Both the grammatical & syntactical structures are disturbed.

example of Transitory thinking (instead of constancy)

Drivelling thinking (instead of organization):

• preliminary outline of a complicated thought with all its necessary particulars, but loses preliminary organisation of the thought

• critical attitude towards their thoughts

• not organised & inner material relationships between them become obscured and change 

example of Drivelling thinking (instead of organization):

Desultory thinking (instead of continuity):

• Sudden appearance of simple ideas not related to the rest of the ideas or the external situation 

• sudden ideas force their way in from time to time (continuity is loosened)

• Ex.: “My actual problem is that the people never understand me, & my stomach feels like an empty

  bucket

example of Desultory thinking (instead of continuity):