Mental Health Nursing
open access articles on mental health nursing
Psychopathology - ABNORMALITIES of THINKING
Autistic thinking: an abnormal absorption with the self distinguished by the interpersonal communication difficulties, a short attention span, and inability to relate others
A. Abnormalities of Stream of Thought
- Flight of ideas: the thoughts follow each other rapidly and there is no general direction of thinking, seen in mania /excited schizophrenics.
- Prolixity: ordered flight of ideas seen in hypomania.
- Pressure of thoughts: Rapid abundant varying thoughts associated with pressure of speech and flight of ideas.
- Poverty of thoughts: Few, slow, unvaried thoughts associated with poverty of speech.
- Thought block: Sudden cessation of thought flow with complete emptying of the mind not caused by an external influence.
B. Abnormalities of Form of thought
- ‘Formal thought disorder’: a synonym for the disorders of conceptual or abstract thinking which occur in schizophrenia and coarse brain disease.
- Tangentiality: Replies are oblique, tangential or even irrelevant.
- Looseness of Association: (asyndesis) more severe version of tangentiality.
- Derailment: a pattern of spontaneous speech where ideas slip off onto another one, which is clearly but obliquely related or completely unrelated.
- Neologism: completely new word or phrase whose deviation cannot be understood.
C. Abnormal Thought Content
- Overvalued Ideas: “A thought which, because of the associated feeling tone, takes precedence over all other ideas and maintains this precedence permanently or for a long period of time.”
- Delusions: Unshakable false beliefs out of keeping with the person’s cultural background not arrived at through logic thinking and not amenable to reasoning.
- Delusional mood: the patient has the knowledge that there is something going on around him which concerns him, but he does not know what it is.
- Delusional memory: a primary delusion which is recalled as arising as result of a memory.
- Delusional perception (apophanous perception): the attribution of a new meaning, usually in the sense of self-reference, to a normally perceived object.
- Autochthonous delusions: a primary delusion which appeasers to arise fully formed in the patient’s mind without explanation.
Delusional Contents
- Persecutory (paranoid) delusion: Delusion of being persecuted (cheated, mistreated, etc.)
- Grandiose delusion: Delusion of exaggerated self-importance, power or identity.
- Delusion of reference: Delusion that some events and others‟ behaviour refer to oneself.
- “Idea of Reference”: misattribution of events as referring to oneself.
- Delusion of jealousy: Delusion that a loved person (wife/husband) is unfaithful (infidelity delusion).
- Delusions of love (‘fantasy lover’, ‘erotomania’): Delusion that someone, (usually inaccessible, high social class person) is deeply in love with the patient.
- Nihilistic delusion: Delusion of nonexistence of self, part of the body, belongings, others or the world.
- Delusion of self - accusation: Delusion that a patient has done something sinful, with excessive feeling of remorse and guilt.
- Delusion of influence: Delusion that person’s thoughts, actions, or feelings are controlled by outside forces.
- Passivity phenomena: person reports being made feel, made think or made act.
- Delusions of Replacement (Capgras Syndrome): a belief that important people in one's life have been replaced by impostors.
- Delusions can be either :
- Mood-Congruent Delusion – Delusional content has association to mood:
- in depressed mood: delusion of self - accusation.
- in elevated mood: grandiose delusion.
Delusions can also be either:
- Systematized Delusion - Delusion united by a single event or theme e.g. delusion of jealousy/thematically well connected with each other.
- Bizarre Delusion - Totally odd and strange delusional belief, e.g. delusion that person’s acts are controlled by stars.
D. Abnormalities of Possession of thought
- Obsessions:
- Repetitive ideas, images, feelings or urges insistently entering person’s mind despite resistance. They are unwanted, distressful and recognized as senseless and irrational. Obsessions are frequently followed by compelling actions (compulsions)
- Common Obsessional Contents:
- dirt/contamination/cleaning
- orderliness/symmetry
- doubts/checking/counting
- aggressive impulses/inappropriate acts
- religion (blasphemous thoughts)
- ruminations: obsessional thoughts.
- rituals: certain repeated compulsions.
- Thought Alienation:
- Thought Insertion: Delusion that some of person’s thoughts being put into the mind by an external force (other people, certain agency).
- Thought Withdrawal: Delusion that some of person’s thoughts being taken out of the mind.
- Thought Broadcasting: Delusion that others can read or hear the person’s thoughts, as they are broadcast over the air, radio or some other unusual way.
- Dysmorphophobia: a type overvalued idea where the patient believes one aspect of his body is abnormal or conspicuously deformed.
References
- Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.
- Sims, A. Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier, 2002.
- Fish, F. Clinical Psychopathology, Signs and Symptoms in Psychiatry. Bristol: J. Wright & Sons. 1967.
This page was last updated on: 18/12/2020