ISQ – Psyche-pathology
Bhaskar Punukollu, Michael Phelan, Anish Unadkat in MRCPsych Part 1 In a Box, 2019
Other types of thought disorder: — Metonym – An inappropriate or imprecise but related word is used in place of the correct word in a sentence.— Neologism – A new word that has no meaning is created,— Echolalia – Automatic and pointless repetition of another person’s words or phrases.— Verbigeration – Imitation of another person’s phrases in a stereotyped manner.— Palilalia – Repetition of a word from an individual’s own spoken words.— Logoclonia – Repetition of words or phrases, particularly the end syllables.— Logorrhoea: excessive flow of words or pressure of speech as occurs in mania.
Psychodynamic Psychological Testing in the Mental Health Inpatient Setting
Meidan Turel, Michael Siglag, Alexander Grinshpoon in Clinical Psychology in the Mental Health Inpatient Setting, 2019
One particularly useful contribution of testing to these ends is its ability to detect discrete forms of thought disorder that, when present, often play a central role in patients’ struggles. Unrecognized differences between how a psychotherapist and patient perceive, make sense of, and respond to the treatment situation are often at play in the kinds of impasse that lead to treatments devolving and patients ultimately being deemed “treatment resistant.” These troubles are often difficult to detect without testing, especially for patients who are verbally gifted and able to hide their confusion beneath sophisticated verbiage. By thought disorder, we mean the processes underlying illogical thinking and reasoning (e.g., loose associations), perceptual confusion and impaired reality testing, linguistic disturbances and neologisms, and boundary disturbances. As noted earlier, we attend to the contexts in which these troubles occur, as well as to the conditions that help the patient recover. Perhaps more interpersonal structure, a less ambiguous environment, more interpersonal distance, or less affective stimulation might be helpful. Further, rather than conceptualizing disordered thinking as absolute or strictly indicative of deficit, we consider how apparent breakdowns in thinking might be breakthroughs, how lapses in organization might be on the way to reorganization that is more complex and adaptive, and how disorganization and disintegration might be serving protective functions (Leonhardt et al., 2016).
Application of errorless learning in schizophrenia
Catherine Haslam, Roy P.C. Kessels in Errorless Learning in Neuropsychological Rehabilitation, 2018
Schizophrenia is a chronic and severe mental illness, affecting about 0.4% of the world’s population (McGrath, Saha, Chant & Welham, 2008). Its symptoms fall into three main categories that are described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), comprising positive symptoms, negative symptoms and thought disorder (see Table 8.1). Among the positive symptoms, hallucinations are most prominent. These are a distortion in a person’s perception of reality. Auditory hallucinations (typically “voices”) are more common than visual hallucinations in schizophrenia. Delusions are other positive symptom manifestations in schizophrenia. These are unshakeable false beliefs that are not based on reality. Included in the negative symptoms are flat affect (evident in monotonous speech and reduced facial expression), anhedonia (the absence of, or reduced pleasure in, enjoyable activities of daily living), and aboulia/apragmatism (the inability to plan, initiate or sustain activities). These symptoms often result in interpersonal difficulties, social isolation and withdrawal, and neglect of basic personal hygiene (incuria). Thought disorders are unusual or dysfunctional ways of thinking that can affect thinking, speech, emotion and behaviour. Patients who present with thought disorder describe difficulties in concentration, and drift from one idea to another. Their speech and conversation may be difficult to understand due to incoherent and illogical content and inclusion of meaningless words or neologisms.
What is the potential of neurostimulation in the treatment of motor symptoms in schizophrenia?
Published in Expert Review of Neurotherapeutics, 2020
Stephanie Lefebvre, Anastasia Pavlidou, Sebastian Walther
Schizophrenia is a neurodevelopmental disorder with adolescent onset of symptoms, which affects approximately 1% of the population worldwide. Typical features are delusions, formal thought disorder, hallucinations, and negative symptoms such as avolition, cognitive impairment, and abnormal psychomotor behavior. Peculiar movements have been part of the earliest descriptions of schizophrenia [1]. The general public readily observes these motor abnormalities in patients and frequently attributes the very obvious behavioral abnormalities to mental illness. In contrast, psychiatrists tended to oversee motor abnormalities or to reduce these symptoms to side effects of antipsychotic pharmacotherapy since the late 1960 s [2,3]. In the past two decades, however, researchers found renewed interest in studying motor abnormalities in psychotic disorders, due to the prognostic value, refined assessment methods, continued suffering of patients, and the scarcity of treatment options. Furthermore, motor abnormalities might even indicate mechanisms critically involved in the development of schizophrenia. Currently, the field is starting to unravel the pathobiology of motor abnormalities in psychoses, paving the way for novel treatment options [4].
The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.
Published in Psychiatry, 2018
Then Gartner proposes that “Trump could be the poster child for the dictum that when it comes to hypomania, nothing fails like success” (p. 105). To support this diagnosis, he quotes an article by David Brooks (2016) that refers to Trump’s “mania,” “flight of ideas,” and “formal thought disorder.” While Brooks is a columnist, Gartner is a psychiatrist. Why does Gartner regard a layperson’s opinion as a substitute for a clinical assessment? Is his a professional tone when he refers to Trump as a “poster child” for hypomania or calls him a “profoundly evil man exhibiting malignant narcissism”? We cannot educate the larger public if we are speaking to the converted within our bubble. As mental health professionals, we should analyze polarization rather than contribute to it. Gartner conflates moral judgments with clinical assessment; he equates lay opinions with clinical insights; and he substitutes stereotypes for a careful clinical analysis of data. But then it gets worse.
Professional Practice Guidelines for Personality Assessment
Published in Journal of Personality Assessment, 2022
Radhika Krishnamurthy, Giselle A. Hass, Adam P. Natoli, Bruce L. Smith, Paul A. Arbisi, Emily D. Gottfried
Like any healthcare service, the practice of personality assessment often requires prior authorization for reimbursement of the service. Generally, authorization is predicated on the medical necessity of the service. In the United States, for instance, medical necessity is defined as “health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine” (U.S. Centers for Medicare & Medicaid Services, n.d.). Following this definition, other third-party payers establish medical necessity guidelines to determine insurance coverage for diagnostic and treatment services. Some examples are determination of thought disorder, differential diagnosis of psychiatric conditions not resolved by interview and observation processes, and determination of treatment options for optimal clinical outcomes. From the perspective of the third-party carrier, medical necessity will be reflected in the proper coding of the assessment service. The assessor should therefore be familiar with current coding procedures.
Related Knowledge Centers
- Cognition
- Delusion
- Mania
- Mood Disorder
- Neurological Disorder
- Psychosis
- Dementia
- Schizophrenia
- Glossary of Psychiatry
- Word Salad