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Thought & its disorders (Dr. Subrata Naskar)

The document discusses the concept of thought, detailing its definition, processes, and various types, including problem solving, decision making, and creative thinking. It also examines disorders of thought, highlighting conditions such as delusions, obsessions, and compulsions, along with their characteristics. The document emphasizes the complexity of human thinking and its essential role in understanding human behavior and mental health.

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BY DR. SUBRATA NASKAR Email : nsubrata09@gmail.com
PLAN OF PRESENTATION • INTRODUCTION • DEFINITION OF THOUGHT • THINKING PROCESS • TYPES OF THINKING • CONCEPT • PROBLEM SOLVING • DECISION MAKING • CREATIVE THINKING • DISORDERS OF THOUGHT • RECENT ADVANCES • BIBLIOGRAPHY
INTRODUCTION WHAT IS THOUGHT ?
INTRODUCTION • THOUGHT CAN REFER TO THE IDEAS OR ARRANGEMENTS OF IDEAS THAT RESULT FROM THINKING. • THINKING REPRESENTS THE MOST COMPLEX FORM OF HUMAN BEHAVIOUR, THE HIGHEST FORM OF MENTAL ACTIVITY. • ALL HUMAN ACHIEVEMENTS AND PROGRESS ARE SIMPLY THE PRODUCTS OF THOUGHT.
THINKING IS MORE THAN LANGUAGE, AND LANGUAGE IS MORE THAN THINKING - PHILIP.S.DALE
THINKING CAN BE DEFINED AS THE COGNITIVE REARRANGEMENT OR MANIPULATION OF BOTH INFORMATION FROM THE ENVIRONMENT AND THE SYMBOLS STORED IN LONG TERM MEMORY
THE THINKING PROCESS • REQUIREMENTS: • WORDS • LANGUAGE • IMAGES LANGUAGE WORDSIMAGES THOUGHT
THE THINKING PROCESS THE THINKING PROCESS IS BY THE USE OF SYMBOLS IN THE FORM OF WORDS,LANGUAGE AND IMAGES. A ‘SYMBOL’ REPRESENTS , OR STANDS FOR SOME EVENT OR ITEM IN THE WORLD, AS WE SEE IMAGES AND LANGUAGE SYMBOLS ARE USED IN MUCH OF OUR THINKING.
LANGUAGE AND THINKING • WE, THINK USING LANGUAGE SYMBOLS AS A TOOL OF THINKING PROCESS • IN WHICH SYMBOLS ARE, WORDS AND RULES OF GRAMMAR. • THE WORDS, THEIR MEANINGS, AND THE RULES FOR JOINING THEM TOGETHER ARE STORED IN OUR SEMANTIC LONG-TERM MEMORIES. • SOME THEORISTS TAKE A MORE EXTREME VIEW OF THE ROLE OF LANGUAGE IN THINKING PROCESS • THAT LANGUAGE CAN ACTUALLY DETERMINE THE THOUGHTS WE ARE CAPABLE OF THINKING. • THIS IS CALLED AS THE LINGUISTIC RELATIVITY HYPOTHESIS • ALSO DEAF PEOPLE WHOSE VERBAL LANGUAGE ABILITIES ARE MINIMAL, SEEMS TO HAVE NONVERBAL LANGUAGE TOOL OF THOUGHT; THEY CAN THINK IN SIGNS (VERNON & KOH, 1971: STUCKLESS & BIRCH, 1966)
LANGUAGE AND THINKING “ TALKING TO YOURSELF UNDER YOUR BREATH ” • LANGUAGE IS SO MUCH INVOLVED IN THINKING PROCESS THAT THE IDEA AROSE IN PSYCHOLOGY THAT THINKING IS ACTUALLY A KIND OF INNER SPEECH OR “ TALKING TO YOURSELF UNDER YOUR BREATH ” • ACCORDING TO THIS IDEA PEOPLE MAKE SMALL MOVEMENTS OF VOCAL APPARATUS WHILE THINKING AND NUMBER OF EXPERIMENTS HAVE INDICATED THAT MOVEMENTS OF VOCAL APPARATUS MAY ACCOMPANY THOUGHTS, BUT ALSO HAVE MADE IT CLEAR THAT SUCH MOVEMENTS ARE NOT NECESSARY FOR THINKING (SMITH ET AL, 1947)
IMAGES AND THINKING • IMAGES ARE REMARKABLY USED IN THINKING ALONG WITH WORDS AS SYMBOLS FOR E.G. MANY PEOPLE MAKE A VISUAL ROAD MAP TO FIND AND DESCRIBE HOW THEY WILL GO FROM ONE PLACE TO ANOTHER (IN AN KNOWN CITY OR PLACE) • WHEN WE USE IMAGES TO THINK, THEY ARE USUALLY NOT COMPLETE. (HUTTENLOCHER, 1973) • THIS INCOMPLETE IMAGES MOST OF US USE IN THINKING, SEEMS TO BE CONSTRUCTED FROM ELEMENTS STORED IN LONG TERM MEMORY. • ALSO THIS IMAGES CONSTRUCTED CAN BE OF ANY SIZE OR COLOUR OR SHAPE, ETC. • THIS VARIATIONS ADD TO THE EASE WITH WHICH INFORMATION IS FOUND IN AN IMAGE. (KOSSIYN, 1975, 1983) • E.G. AN ELEPHANT CAN BE IMAGINED AS THE SIZE OF A MOUSE OR A MOUSE IMAGINED AS A SIZE OF AN ELEPHANT
CONCEPTS WHAT IS CONCEPT ?
CONCEPTS • CONCEPTS ARE IMPORTANT LANGUAGE SYMBOLS USED IN THINKING. • A CONCEPT IS A SYMBOLIC CONSTRUCTION THAT REPRESENT SOME COMMON AND GENERAL FEATURE OR FEATURES OF MANY OBJECTS OR EVENTS. • EXAMPLES ARE “MAN”, “RED”, “TRIANGLE”, “MOTIVATION”, “ATOM”, “ANGER”, ETC. • IN FACT MOST OF THE NOUNS IN OUR VOCABULARY ARE NAMES OF CONCEPTS, EXCEPT PROPER NOUNS– NAMES OF SPECIFIC THINGS OR PERSON. • ABILITY TO FORM CONCEPTS ENABLES US TO CLASSIFY THINGS INTO CATEGORIES. • E.G. WITH A CONCEPT OF RED WE CAN SORT OBLECTS INTO RED AND NON-RED,WITH A CONCEPT OF FRUIT WE CAN SORT OBJECTS INTO FRUIT OR NON-FRUIT, CONCEPTS WE SELECT- GIVES US BASE FOR CLASSIFICATIONS WHEN A CLASSIFICATION HAS BEEN MADE, WE TEND TO BEHAVE TOWARDS AND THINK ABOUT, THE MEMBERS OF THE CLASS. THUS, CONCEPTS ARE THE CONVENIENT TOOLS TO USE IN THINKING AND SOLVING PROBLEMS
HOW ARE CONCEPTS FORMED ?
• BASIC/NATURAL CONCEPT: • SOME CONCEPTS ARE “BASIC” AND “ NATURAL” WHICH ARE ACQUIRED EASILY, AND APPEAR IN THINKING VERY EARLY IN LIFE • E.G. DIVISION OF COLOURS ACCORDING TO THEIR SPECTRUMS LIKE RED, GREEN, YELLOW. • BY DISCRIMINATION LEARNING: • MANY OF THE CONCEPTS ARE ACQUIRED MORE SLOWLY AND WITH EFFORTS, WHERE DISCRIMINATION LEARNING PLAYS A ROLE. THIS TYPE OF LEARNING CONCEPTS OCCURS WITH RESPONSE TO REWARDS OR REINFORCEMENTS. • E.G. SAYING “RIGHT !” WHEN A CHILD SAYS “APPLE” AND POINTS TOWARDS ONE, AND NOT AT SOMETHING ELSE. • BY DEFINITION: • SOME CONCEPTS ARE ACQUIRED BY LEARNING “DEFINITIONS”, • DEFINITIONS HELP US ACQUIRE CONCEPTS BY DESCRIBING THEM IN TERMS OF OTHER WORDS OR CONCEPTS WITH WHICH WE ARE ALREADY FAMILIAR.
TYPES OF THINKING
FREUD’S DIVISION OF THOUGHT: • PRIMARY PROCESS (RIGHT BRAIN THINKING) • FEATURES: • DISREGARDS LOGIC • PERMITS SIMULTANEOUS CONTRADICTION • DOMINATED BY WISH AND FANTASY • USES SYMBOLS,IMAGERY CONDENSATION & CONCRETISATION IN ITS ORGANISATION • A JUMBLED AND INCOHERENT STYLE OF THINKING • WHERE FOUND ? • FOUND IN DREAMS • YOUNG CHILDREN • PSYCHOTIC STATES
FREUD’S DIVISION OF THOUGHT SECONDARY PROCESS FEATURES: • CHARACTERIZED BY LOGIC. • IDEAS FOLLOW ONE ANOTHER IN SEQUENCE THAT IS UNDERSTABLE TO THE LISTENER WHERE FOUND ? • FOUND IN NON DREAMY STATE • ADULTS • NON PSYCHOTIC STATES EXAMPLE: The ability to think abstractly and to think in detail about future plan
NON FREUDIAN NON FREUDIAN TYPOLOGY OF THOUGHT FANTASY THINKING IMAGINATIVE THINKING CONCEPTUAL THINKING AUTISIC THINKING ABSTRACT THINKING CONCRETE THINKING
FANTASY THINKING THINKING BY ESCAPING FROM OR DENYING REALITY NORMAL:DAY DREAMING PATHOLOGICAL:DISSOCIATIVE AND PSYCHOTIC STATES • FANTASY IS USUALLY UNDERSTOOD TO BE THE CREATION OF IMAGES OR IDEAS WHICH HAVE NO EXTERNAL REALITY. HOWEVER, FANTASY THINKING MAY ALSO REVEAL ITSELF IN DENIAL OF EXTERNAL EVENTS. • THE OBSERVATIONS ON WHICH THE PSYCHODYNAMIC EXPLATION OF EGO DEFENCE MECHANISM HAVE BEEN DESCRIBED ARE RELEVANT IN THIS CONTEXT. • THE SLIPS OF THE TONGUE, OR THE ‘FORGETTING’ OF THE EMOTIONALLY LADEN WORDS IS NOT ACCIDENTAL, IT IS A FORM OF SELF-DECEPTION. • THE OBVIOUS, SIGNIFICANT, BUT UNPLEASANT, OBJECT OF PERCEPTION MAY BE ‘OVER-LOOKED’, AND THIS OFTEN REVELS FANTASY DENIAL.
ABSTRACT THINKING THINKING CHARACTERISED BY THE ABILITY TO GRASP THE ESSENTIALS OF A WHOLE OR BREAK A WHOLE INTO ITS PARTS,AND TO DISCERN COMMON PROPERTIES
IN THIS THINKING FANTASY AND MEMORY ARE USED TOGHETHER , GENERATES PLANS FOR EVERYDAY LIFE AND UTILIZE THE SUCCESSION OF IDEAS THAT FILLS CONSCIOUSNESS. DOES NOT GO BEYOND THE RATIONAL OR THE POSSIBLE. IMAGINATIVE THINKING
CONCEPTUAL THINKING USES LOGIC TO SOLVE PROBLEMS
CONCRETE THINKING THINKING CHARACTERISED BY ACTUAL THINGS,EVENTS,AND IMMEDIATE EXPERIENCE RATHER THAN BY ABSTRACTIONS FOUND IN SCHIZOPHRENIA COGNITIVE MENTAL DISORDER
AUTISTIC THINKING THINKING IN WHICH THE THOUGHTS ARE NARCISSISTIC AND EGOCENTRIC,WITH EMPHASIS ON SUBJECTIVITY RATHER THAN OBJECTIVITY AND WITHOUT REGARD FOR REALITY • IT MAY BE OF SHORT DURATION, OR IT MAY BECAME AN ESTABLISHED WAY OF LIFE. • IT ALSO PLAYS AN IMPORTANT ROLE IN THE WAY WE ALL CARRY OUT OUR DAY TO DAY ACTIVITIES. • IT ALLOWS A PERSON TO ESCAPE FROM, OR DENY, REALITY; OR ALTERNATIVELY CONVERT REALITY INTO SOMETHING MORE TOLERABLE. • BLEULER (1911) SAW THIS ISOLATION FROM THE REAL WORLD INTO AUTISTIC THINKING AS A CHARACTERISTIC OF SCHIZOPHRENIA. • THIS TYPE OF THINKING IS ASSOCIATED TO • PATHOLOGICAL LYING ( PSUDOLOGIA FANTASTICA ) • HYSTERICAL CONVERSIONS AND DISSOCIATION, • DELUSION-LIKE IDEAS OCCURRING IN AFFECTIVE PSYCHOSES. FOUND IN : SCHIZOPHRENIA AND AUTISTIC DISORDER
PROBLEM SOLVING WHAT IS PROBLEM ? “PROBLEM” IS DEFINED IN GENERAL AS IT IS ANY CONFLICT OR DIFFERENCE BETWEEN ONE SITUATION AND ANOTHER SITUATION WE WISH TO PRODUCE OUR GOAL. “THINKING” THAT WE DO IN PROBLEM SOLVING IS GOAL DIRECTED, AND MOTIVATED.
PROBLEM SOLVING WE USE INFORMATION AVAILABLE TO US, FROM LONG-TERM MEMORY AND FROM THE PERCEPTION OF THE PROBLEM SITUATION. WE PROCESS THIS INFORMATION ACCORDING TO RULES, THAT TELLS US WHAT WE CAN DO AND CANNOT DO. IN OTHER WORDS, MANY INSTANCES OF PROBLEM SOLVING CAN BE CONSIDERED A FORM OF RULE-GUIDED, MOTIVATED INFORMATION PROCESSING (NEWELL & SIMON, 1972)
RULES IN PROBLEM SOLVING TWO MAJOR TYPES OF RULES IN PROBLEM SOLVING ARE
RULES IN PROBLEM SOLVING IS A SET OF RULES WHICH, IF FOLLOWED CORRECTLY, WILL GUARANTEE A SOLUTION TO A PROBLEM. E.G. IN SOLVING MATHEMATICAL CALCULATIONS STRATEGIES, USUALLY BASED ON OUR PAST EXPERIENCES WITH PROBLEMS, THAT ARE LIKELY TO LEAD TO A SOLUTION BUT DO NOT GUARANTEE SUCCESS. E.G. COMMON STRATEGY OF BREAKING THE PROBLEM INTO SMALLER SUB-PROBLEMS, WHICH BRINGS US LITTLE CLOSER TO END GOAL.
DECISION MAKING DECISION MAKING IS A KIND OF PROBLEM SOLVING IN WHICH WE ARE PRESENTED WITH A NUMBER OF ALTERNATIVES AMONG WHICH WE MUST CHOOSE. PEOPLE MAKE DECISIONS THAT WILL MAXIMIZE SUBJECTIVELY EXPECTED GAIN.
HEURISTIC IN DECISION MAKING • REPRESENTATIVENESS: WE COMPARE AND SEE WHETHER THE CURRENT SITUATION IS A REPRESENTATION OF SOMETHING WE HAVE ALREADY EXPERIENCED • AVAILABILITY: BECAUSE FREQUENT EVENTS ARE EASIER TO REMEMBER THAN INFREQUENT ONES,EASILY REMEMBERED EVENTS ARE LIKELY TO BE REPEATED IN DECISION MAKING. • ADJUSTMENT: WE START WITH A CERTAIN SUBJECTIVE PROBABILITY AND RAISE IT OR LOWER IT DEPENDING ON THE CIRCUMSTANCES
CREATIVE THINKING THINKING SOMETHING NEW, PROVIDING TO THE PROBLEMS SOME NEW SOLUTIONS WHICH OTHER PEOPLE HAVE NOT THOUGHT OF EARLIER. THIS SUDDEN APPEARANCE OF NEW IDEA IS CALLED INSIGHT
STAGES IN CREATIVE THINKING 1. PREPARATION: FORMULATION OF THE PROBLEM AND COLLECTION OF THE FACTS AND MATERIALS CONSIDERED NECESSARY FOR ITS SOLUTION 2. INCUBATION: TURNING AWAY FROM THE PROBLEM, FAILING TO SOLVE IT. BUT THE UNCONSCIOUS THOUGHT PROCESSES ARE STILL AT WORK 3. ILLUMINATION: SUDDEN EMERGENCE OF AN IDEA TO THE PROBLEM 4. EVALUATION: THE APPARENT SOLUTION IS TESTED TO SEE IF IT SATISFACTORILY SOLVES THE PROBLEM 5. REVISION: MODIFICATION OF THE SOLUTION OR SOLUTION OF MINOR PROBLEMS TO CREATE A “ GOOD ” NEW IDEA.
DISORDERS OF THOUGHT DISORDERS STREAM CONTENT FORMPOSSESSION
DISORDERS OF THOUGHT STREAM TEMPO CONTINUITY
DISORDERS OF THOUGHT TEMPO CONTINUITY FLIGHT OF IDEAS INHIBITION CIRCUMSTANTIALITY PERSEVARATION THOUGHT BLOCK
DISORDERS OF THOUGHT FLIGHT OF IDEAS • RAPID SUCCESSION OF FRAGMENTARY THOUGHTS OR SPEECH IN WHICH CONTENT CHANGES ABRUPTLY AND SPEECH MAY BE INCOHERENT WITH NO DIRECTION OF THINKING AND NO CONNECTION BETWEEN TWO THOUGHTS. • PT’S SPEECH IS EASILY DIVERTED TO EXTERNAL STIMULI AND BY INTERNAL SUPERFICIAL ASSOCIATION. • ASSOCIATION BETWEEN SUCCESSIVE THOUGHTS IS BROUGHT ABOUT BY CHANCE RELATIONSHIPS & VERBAL ASSOCIATIONS LIKE CLANG ASSOCIATION & PROVERBS, MAXIMS & CLICHES • TYPICAL OF MANIA AND ALSO FOUND IN : EXCITED SCHIZOPHRENICS, ORGANIC STATES- HYPOTHALAMIC LESIONS.
DIAGRAMATIC REPRESENTATION OF FLIGHT OF IDEAS FOR EXAMPLE, A PERSON MIGHT SAY "LOOK AT THE SUN, SUN GIVES LIGHT, LIGHT IS BRIGHT, BRIGHT SKY, SKY IS THE MIRROR OF HEAVEN.“
PROLIXITY • A MARGINAL VARIETY OF FLIGHT OF IDEA WHERE DESPITE MANY IRRELEVANCES, THE PATIENT IS ABLE TO RETURN TO THE TASK IN HAND. • THE SPEED OF EMERGENCE OF THOUGHTS IS NOT AS FAST AS IN FLIGHT OF IDEA • ALSO CALLED “ORDERED FLIGHT OF IDEA” • FOUND IN HYPOMANIA
INHIBITION: • GOAL DIRECTED • PROCEEDS SO SLOWLY WITH MORBID PREOCCUPATION WITH GLOOMY THOUGHTS, THAT GOAL IS NOT ACHIEVED. • SUBJECT SHOWS: • LITTLE INITIATIVE • NO PLANNING • NO SPONTANEOUS ACTIVITY • DIFFICULTY IN TAKING DECISION • LOSS OF CLARITY OF THOUGHT • POOR REGISTRATION OF EVENTS THOSE HE NEEDS TO REMEMBER • USUALLY SEEN IN depression manic stupor [rare condition]
CIRCUMSTANTIALITY QUESTION IS ASKED PATIENT WILL ANSWER THE QUESTION WITH ALL SORTS OF UNNECESSARY ASSOCIATIONS BEFORE POINT IS REACHED. AT WHAT AGE YOUR MOTHER DIED? WHERE FOUND ? Found in schizophrenia, learning disabilities, obsessional personality, epileptic personality change SUBJECT TALKS ABOUT ACCIDENTS PEOPLE WHO ATTENDED THE FUNERAL FINALLY THE ANSWER, I.E THE AGE
DISORDERS OF CONTINUITY OF THINKING • PERSEVERATION • PATHOLOGICAL REPETITION OF THE SAME RESPONSE TO DIFFERENT STIMULI BEYOND A POINT OF RELEVANCE. • MEANINGLESS & STEREOTYPED REPETITION OF WORDS AND PHRASES IS CALLED verbigeration OR cataphasia. • FOUND IN: • RULE OUT ORGANICITY FIRST !!!! • COGNITIVE DISORDERS,SCHIZOPHRENIA, CATATONIA, COURSE BRAIN DISEASE
DISORDERS OF CONTINUITY OF THINKING • PERSEVERATION • WHERE DO YOU LIVE ? • ANS: KOLKATA • WHAT IS YOUR NAME ? • ANS: KOLKATA • WHAT DO YOU STUDY ? • ANS: KOLKATA
DISORDERS OF CONTINUITY OF THINKING  PALILALIA: THE PT. REPEATS THE PERSEVERATED WORD WITH INCREASING FREQUENCY.  EG: TEN, TEEN, TEEEEEEEEN, TEEEEEEEEEEEEN……………….. SO ON.  LOGOCLONIA: THE LAST SYLLABLE OF THE LAST WORD IS REPEATED.  EG: LION LIVES IN A DEN…EN….EN….EN….EN….EN….. • BOTH TYPES OCCUR IN COARSE BRAIN DISEASE, IN PARTICULAR IN ALZHEIMER’S DISEASE.
TYPES OF PERSEVERATION  COMPULSIVE REPETITION: THE ACT IS REPEATED UNLESS THE PT. RECEIVES ANOTHER INSTRUCTION – IS MORE FREQUENT IN SCHIZOPHRENICS.  IMPAIRMENT OF SWITCHING: THE REPETITION CONTINUES AFTER THE PT. HAS BEEN GIVEN A NEW TASK – MORE COMMON AMONG DEMENTS.  IDEATIONAL PERSEVERATION: THE PATIENT REPEATS WORDS AND PHRASES DURING HIS REPLY TO A QUESTION – EQUALLY COMMON IN BOTH GROUPS.
THOUGHT BLOCKING • SUDDEN ARREST OF THE TRAIN OF THOUGHT WHICH MAY/MAY NOT BE FOLLOWED BY AN ENTIRELY NEW THOUGHT • ITS NOT CAUSED BY DISTRACTION OR OTHER THOUGHTS. • PATIENT CANNOT GIVE ANY ADEQUATE EXPLANATION FOR IT. • SOMETIMES PATIENT MAY EXPLAIN IT IN TERMS OF THOUGHT WITHDRAWAL ‘My thinking stopped because the thoughts were suddenly taken out of my head’.
DISORDERS OF POSSESSION OF THOUGHT THOUGHT ALIENATION OBCESSION & COMPULSION
DISORDERS OF POSSESSION OF THOUGHT THOUGHT ALIENATION ALIENATION MEANS-TO TRANSFER • IN THOUGHT ALIENATION THE PATIENT HAS THE EXPERIENCE THAT HIS THOUGHTS ARE UNDER THE CONTROL OF AN OUTSIDE AGENCY OR THAT OTHERS ARE PARTICIPATING IN HIS THINKING • THOUGHT INSERTION - FEELING OF THOUGHTS BEING INSERTED INTO THE PATIENT’S MIND BY A FOREIGN INFLUENCE • THOUGHT DEPRIVATION/THOUGHT WITHDRAWAL - PATIENT FEELS THAT AS HE IS THINKING,HIS THOUGHTS SUDDENLY DISAPPEAR AND ARE WITHDRAWN FROM HIS MIND BY A FOREIGN INFLUENCE
DISORDERS OF POSSESSION OF THOUGHT THOUGHT ALIENATION • THOUGHT BROADCASTING - FEELING THAT ONE’S THOUGHTS ARE BEING BROADCASTED OR PROJECTED INTO THE ENVIRONMENT THOUGHT ALIENATION PHENOMENON IS DIAGNOSTIC OF SCHIZOPHRENIA
OBSESSIONS & COMPULSIONS OBSESSIONS ARE PERSISTENT,INVOLUNTARY AND RECURRENT IDEA,THOUGHT OR IMPULSES THAT CANNOT BE ELIMINATED FROM CONSCIOUSNESS BY LOGIC OR REASONING WHAT IS OBSESSION ?
OBSESSIONS & COMPULSIONS WHAT IS COMPULSION ? COMPULSIONS ARE OBSESSIONAL MOTOR ACTS-THE NEED TO ACT ON AN IMPULSE THAT IF RESISTED PRODUCES ANXIETY
OBSESSIONS & COMPULSIONS • THE ESSENTIAL FEATURE OF THE OBSESSION IS THAT IT APPEARS AGAINST THE PATIENT’S WILL. • COMMONEST OBSESSIVE THEMES - DIRT & CONTAMINATION, RISK AND AGGRESSION. • OBSESSIONS OCCUR IN-OBSESSIONAL STATES • DEPRESSION • SCHIZOPHRENIA • POST ENCEPHALITIC PARKINSONISM
DISORDER OF CONTENT OF THINKING DELUSION
DISORDER OF CONTENT OF THINKING FALSE UNSHAKABLE BELIEFS WHICH ARE OUT OF KEEPING WITH THE PATIENT’S SOCIAL AND CULTURAL BACKGROUND OVERVALUED IDEAS UNREASONABLE AND SUSTAINED ABNORMAL BELIEFS THAT ARE HELD BEYOND THE BOUNDS OF REASON
DISORDER OF CONTENT OF THINKING THE PSYCHIATRIST AND PHILOSOPHER KARL JASPERS WAS THE FIRST TO DEFINE THE THREE MAIN CRITERIA FOR A BELIEF TO BE CONSIDERED DELUSIONAL IN HIS 1913 BOOK GENERAL PSYCHOPATHOLOGY. THESE CRITERIA ARE: • CERTAINTY (HELD WITH ABSOLUTE CONVICTION) • INCORRIGIBILITY (NOT CHANGEABLE BY COMPELLING COUNTERARGUMENT OR PROOF TO THE CONTRARY) • IMPOSSIBILITY OR FALSITY OF CONTENT (IMPLAUSIBLE, BIZARRE OR PATENTLY UNTRUE)
DELUSION CULTURALLY INAPPROPRIATE NO DOUBT NOT PLAUSIBLE OVERVALUED IDEAS CULTURALLY APPROPRIATE SOME DOUBT IS PRESENT PLAUSIBLE
IDEAS OF REFERENCE IDEAS OF REFERENCE ARE FALSE PERSONALIZED INTERPRETATIONS OF ACTUAL EVENTS IN WHICH INDIVIDUALS BELIEVE THAT OCCURRENCES OR REMARKS REFER SPECIALLY TO THEM WHEN THEY ACTUALLY DO NOT.
TRUE DELUSIONS THE RESULT OF A PRIMARY DELUSIONAL EXPERIENCE WHICH CANNOT BE DEDUCED FROM ANY OTHER MORBID PHENOMENON DELUSION LIKE IDEAS ARE SECONDARY AND CAN BE UNDERSTABLY DERIVED FROM SOME OTHER PSYCHOLOGICAL PHENOMENON
TYPES OF DELUSION PRIMARY DELUSION SECONDARY DELUSION
PRIMARY DELUSION APOPHANY A NEW MEANING ARISES IN CONNECTION WITH SOME OTHER PSYCHOLOGICAL EVENT. TYPES (Schneider’ division) DELUSIONAL MOOD DELUSIONAL PERCEPTION REFERS TO THE EXPERIENCE OF ATTRIBUTING A NORMAL PERCEPTION WITH A DELUSIONAL MEANING,ONE THAT HAS ENORMOUS PERSONAL SIGNIFICANCE TO THE PATIENT. EG: CUTLERY CLANKING THEY ARE TRYING TO KILL ME PATIENT HAS A SENSE THAT SOMETHING ODD OR UNCANNY IS GOING ON AROUND HIM WHICH CONCERNS HIM,BUT HE DOES NOT KNOW WHAT IT IS
PRIMARY DELUSION APOPHANY A NEW MEANING ARISES IN CONNECTION WITH SOME OTHER PSYCHOLOGICAL EVENT. TYPES (Schneider’ division) SUDDEN DELUSIONAL IDEA/AUTOCHTHONOUS DELUSION TAKES FORM IN AN INSTANT WITHOUT IDENTIFIABLE PRECEEDING EVENTS
PRIMARY DELUSION APOPHANY A NEW MEANING ARISES IN CONNECTION WITH SOME OTHER PSYCHOLOGICAL EVENT. TYPES (Schneider’ division) • PRIMARY DELUSIONS FOUND IN • SCHIZOPHRENIA • EPILEPTIC PSYCHOSIS • DEPRESSION PRIMARY DELUSION = TRUE DELUSION
SECONDARY DELUSION SECONDARY DELUSIONS CAN BE UNDERSTOOD AS ARISING FROM SOME OTHER MORBID EXPERIENCE. IT CAN BE SECONDARY TO : • DEPRESSIVE MOOD • HALLUCINATION • PSYCHOGENIC OR STRESS REACTIONS FOR EXAMPLE: A PERSON BECOMES DEPRESSED, SUFFERS VERY LOW MOOD AND SELF- ESTEEM,AND SUBSEQUENTLY BELIEVES HE IS RESPONSIBLE FOR SOME TERRIBLE CRIME WHICH HE DID NOT COMMIT IN REALITY
CONARD’S5STAGESIN DEVELOPMENTOFDELUSION TREMA APOPHANY ANASTROPHY CONSOLIDATION RESIDUUM DELUSIONAL MOOD REPRESENTING A TOTAL CHANGE IN PERCEPTION OF THE WORLD. SEARCH FOR, AND FINDING OF NEW MEANING FOR PSYCHOLOGICAL EVENTS. HEIGHTENING OF PSYCHOSIS. FORMING OF A NEW WORLD OR PSYCHOLOGICAL SET BASED ON NEW MEANING. EVENTUAL AUTISTIC STATE.
SIMPLE DELUSION SIMPLE DELUSIONS CONTAIN RELATIVELY FEW ELEMENTS. COMPLEX DELUSION COMPLEX DELUSIONS MAY CONTAIN EXTENSIVE ELABORATION OF PEOPLE,SPIRITS,MOTIVES AND SITUATIONS.
COMPLETE COMPLETE DELUSIONS ARE THOSE WHICH ARE HELD WITHOUT ANY DOUBT. INCOMPLETE/PARTIAL IN PARTIAL DELUSION,THE PATIENT ENTERTAINS SOME AMOUNT OF DOUBT ABOUT HIS DELUSIONAL BELIEFS
SYSTEMATIZED SYSTEMATIZED DELUSIONS ARE RESTRICTED OR CIRCUMSCRIBED TO WELL DELINEATED AREAS AND ARE ORDINARILY ASSOCIATED WITH A CLEAR SENSORIUM AND ABSENCE OF HALLUCINATION. NON SYSTEMATIZED NON SYSTEMATIZED DELUSION EXTEND INTO MANY AREAS OF LIFE AND NEW PEOPLE AND SITUATIONS ARE CONSTANTLY INCORPORATED TO SUPPORT THE PRESENCE OF DELUSION.
THE CONTENT OF DELUSIONS DELUSION OF PERSECUTION • THE ARCHETYPE OF DELUSIONAL DISORDER • FALSE BELIEF OF BEING HARASSED OR PERSECUTED. • ASSOCIATED WITH QUERULOUSNESS, IRRITABILITY& ANGER AND THE INDIVIDUAL WHO ACTS OUT HIS OR HER ANGER MAY AT TIMES BE ASSAULTIVE OR EVEN HOMOCIDAL • DELUSION OF PERSECUTION OCCURS IN THE CONTEXT OF PRIMARY DELUSIONAL EXPERIENCE, AUDITORY HALLUCINATION, BODILY HALLUCINATIONS OR EXPERIENCES OF PASSIVITY
FORMS OF PERSECUTORY DELUSIONS
DELUSION OF REFERENCE • IN DELUSIONS OF REFERENCE THE PATIENT KNOWS THAT PEOPLE ARE TALKING ABOUT HIM, SLANDERING HIM OR SPYING ON HIM. • IT MAY BE DIFFICULT TO BE CERTAIN IF THE PATIENT HAS DELUSIONS OF SELF- REFERENCE OR IF HE HAS SELF-REFERENTIAL HALLUCINATIONS. • IDEAS AND DELUSIONS OF REFERENCE ARE NOT CONFINED TO SCHIZOPHRENIA AND CAN OCCUR IN DEPRESSIVE ILLNESS AND OTHER PSYCHOTIC ILLNESSES. • SOME PATIENTS WITH SEVERE DEPRESSION MAY BELIEVE THAT THEY ARE EXTREMELY WICKED AND THAT OTHER PEOPLE KNOW THIS AND ARE THEREFORE QUITE JUSTIFIABLY SPYING ON THEM.
DELUSION OF GUILT • DELUSIONS OF GUILT CAN BE SO MARKED THAT THE PATIENT BELIEVES THAT HE IS ABOUT TO BE PUT TO DEATH OR IMPRISONED FOR LIFE. • THIS ALLEGED PERSECUTION IS GENERALLY BELIEVED TO BE FULLY JUSTIFIED BY THE PATIENT. • OCCASIONALLY, HOWEVER, A PATIENT MAY BELIEVE THIS ALLEGED PERSECUTION IS NOT JUSTIFIED AND MAY ATTRIBUTE THEIR DEPRESSION TO IT.
DELUSION OF BEING POISONED • DELUSIONS OF BEING POISONED OR INFECTED ARE QUITE COMMON. • OFTEN DELUSIONS OF POISONING ARE EXPLANATORY DELUSIONS. • THE PATIENT FEELS MENTALLY AND PHYSICALLY CHANGED AND THE ONLY WAY IN WHICH THEY CAN ACCOUNT FOR THIS IS BY ASSUMING THAT THEIR FOOD OR CIGARETTES HAVE BEEN POISONED. • IN OTHER CASES, DELUSIONS OF POISONING ARE BASED ON HALLUCINATIONS OF SMELL AND TASTE.
DELUSION OF INFLUENCE • DELUSIONS OF INFLUENCE ARE A ‘LOGICAL’ RESULT OF EXPERIENCES OF PASSIVITY IN THE CONTEXT OF SCHIZOPHRENIA. • THESE PASSIVITY FEELINGS MAY BE EXPLAINED BY THE PATIENT AS THE RESULT OF HYPNOTISM, DEMONICAL POSSESSION, WITCHCRAFT, RADIO WAVES, ATOMIC RAYS OR TELEVISION.
DELUSION OF INFIDELITY • THE PATIENT HAS MORBID JEALOUSY AND DELUSION OF MARITAL INFIDELITY • OFTEN THE PATIENT HAS BEEN SUSPICIOUS, SENSITIVE AND MILDLY JEALOUS BEFORE THE ONSET OF THE ILLNESS • DELUSION OF INFIDELITY MAY DEVELOP GRADUALLY, AS A SUSPICIOUS OR INSECURE PERSON BECOMES MORE AND MORE CONVINCED OF THEIR SPOUSE’S INFIDELITY AND FINALLY THE IDEA REACHES DELUSIONAL LEVEL. • DELUSIONS OF INFIDELITY MAY OCCUR IN BOTH ORGANIC AND FUNCTIONAL DISORDERS. • Found in schizophrenia,coarse brain disease, alcohol addiction.
JOHN HINCKLEY JRJODIE FOSTER RONALD REGAN
JOHN HINCKLEY JRJODIE FOSTER RONALD REGAN JOHN HINCKLEY, JR. BECAME OBSESSED WITH FOSTER AFTER WATCHING TAXI DRIVER A NUMBER OF TIMES AND STALKED HER WHILE SHE ATTENDED YALE, SENDING HER LOVE LETTERS TO HER CAMPUS MAIL BOX AND EVEN TALKING TO HER ON THE PHONE. ON MARCH 30, 1981, HE ATTEMPTED TO ASSASSINATE U.S. PRESIDENT RONALD REAGAN (SHOOTING AND WOUNDING REAGAN AND THREE OTHERS) AND CLAIMED HIS MOTIVE WAS TO IMPRESS FOSTER, THEN A YALE FRESHMAN
DELUSION OF LOVE • THIS CONDITION HAS ALSO BEEN DESCRIBED AS ‘THE FANTASY LOVER SYNDROME’ , ‘EROTOMANIA’ OR ‘DE CLÉRAMBAULT'S SYNDROME’. • THE PATIENT IS CONVINCED THAT SOME PERSON IS IN LOVE WITH THEM ALTHOUGH THE ALLEGED LOVER MAY NEVER HAVE SPOKEN TO THEM. • THEY MAY PESTER THE VICTIM WITH LETTERS AND UNWANTED ATTENTION OF ALL KINDS. • Found in – abnormal personality developments, schizophrenia
GRANDIOSE DELUSION • EXAGGERATED CONCERNS ABOUT ONE’S IMPORTANCE,POWER OR IDENTITY. • BELIEVES THAT ONE HAS SPECIAL POWERS AND IS ACCOMPLISHING OR WILL ACCOMPLISH EXTRAORDINARY THINGS FOR GOOD OF THE COMMUNITY.
GRANDIOSE DELUSION • SOME PEOPLE BELIEVE THAT THEY ARE GOD, KING OR ROCK STAR WHEREAS SOME OTHERS BELIEVE THEY ARE SKILLED SPORTSPERSON OR GREAT INVESTORS. • FOUND IN MANIA, SCHIZOPHRENIA.
DELUSION OF ILL HEALTH • DELUSION OF ILL HEALTH MAY DEVELOP ON A BACKGROUND OF CONCERNS ABOUT HEALTH. • FOUND IN SCHIZOPHRENIA, DEPRESSION, ABNORMAL PERSONALITY DEVELOPMENT • HYPOCHONDRIACAL DELUSIONS: BELIEF THAT ONE’S BODY IS UNHEALTHY, DISEASED OR CHRONICALLY ILL.MAY BE THE RESULT OF DEPRESSION, BODILY HALLUCINOSIS OR A SENSE OF SUBJECTIVE CHANGE.
DELUSIONAL DYSMORPHOPHOBIA • THE DELUSIONAL PREOCCUPATIONS WITH FACIAL OR BODILY APPEARANCES IS CALLED DELUSIONAL DYSMORPHOPHOBIA. • THE SUBJECT IS CONVINCED THAT THEIR NOSE IS TOO BIG, THEIR FACE IS TWISTED, OR DISFIGURED WITH ACNE, AND SO ON. • SOMETIMES THESE PREOCCUPATIONS WITH ILL HEALTH OR THE APPEARANCE OF THE BODY HAVE A SOMEWHAT OBSESSIONAL QUALITY, SO THAT THE PATIENT CANNOT STOP THINKING ABOUT THE SUPPOSED ILLNESS OR DEFORMITY. • THE BELIEF IS OF DELUSIONAL INTENSITY AND THE PATIENT IS NEVER ABLE TO ADMIT THAT THEIR BELIEF IS GENUINELY GROUNDLESS.
DELUSION OF GUILT • PATIENT BELIEVES THEY ARE BAD OR EVIL PERSON AND HAVE RUINED THEIR FAMILY AND THAT THEY HAVE COMMITTED UNPARDONABLE SIN AND INSIST THAT THEY WILL ROT IN HELL FOR THIS. • THE SIN IS USUALLY MASTURBATION OR EXTRAMARITAL SEXUAL INTERCOURSE • DELUSION OF GUILT CAN GIVE RISE TO GRANDIOSE AND PERSECUTORY DELUSIONS • FOUND IN SEVERE DEPRESSION.
NIHILISTIC DELUSION • PATIENTS DENY THE EXISTENCE OF THEIR BODY,THEIR MIND,THEIR LOVED ONES AND THE WORLD AROUND THEM. • THEY MAY ASSERT THAT THEY HAVE NO MIND, NO INTELLIGENCE, OR THEIR BODY OR PARTS OF BODY DO NOT EXIST • THEY MAY DENY THEIR EXISTENCE AS PERSON OR BELIEVE THEY ARE DEAD OR WHOLE WORLD HAS STOPPED. • FOUND IN SEVERE DEPRESSION, SCHIZOPHRENIA,STATES OF DELIRIUM.
DELUSION OF POVERTY • THE PATIENT IS CONVINCED THAT HE IS IMPOVERISHED AND BELIEVES THAT DESTITUTION IS FACING HIM AND HIS FAMILY • TYPICAL OF DEPRESSION
A CLASS OF DELUSIONAL BELIEFS THAT INVOLVES THE MISIDENTIFICATION OF PEOPLE, PLACES, OR OBJECTS DELUSIONAL MISIDENTIFICATION
A CLASS OF DELUSIONAL BELIEFS THAT INVOLVES THE MISIDENTIFICATION OF PEOPLE, PLACES, OR OBJECTS A RARE VARIANT OF CAPGRAS' SYNDROME INVOLVING A PATIENT'S PERCEIVING THAT AN INDIVIDUAL HAS BEEN TRANSFORMED BOTH PSYCHOLOGICALLY AND PHYSICALLY INTO ANOTHER PERSON. DELUSION OF SUBJECTIVE DOUBLES
THE PATIENT BELIEVES THAT SOMEONE CLOSE TO HIM HAS BEEN REPLACED BY AN EXACT DOUBLE CAPGRAS SYNDROME
THE PATIENT’S OWN SELF IS PERCEIVED AS BEING REPLACED BY A DOUBLE DELUSION OF SUBJECTIVE DOUBLES
DELUSION OF DISGUISE (FREGOLI’S SYNDROME) A RARE DISORDER IN WHICH A PERSON HOLDS A DELUSIONAL BELIEF THAT DIFFERENT PEOPLE ARE IN FACT A SINGLE PERSON WHO CHANGES APPEARANCE OR IS IN DISGUISE. THE CONDITION IS NAMED AFTER THE ITALIAN QUICK CHANGE ARTIST LEOPOLDO FREGOLI.
SYNDROME OF INTERMETAMORPHOSIS A RARE VARIANT OF CAPGRAS' SYNDROME INVOLVING A PATIENT'S PERCEIVING THAT AN INDIVIDUAL HAS BEEN TRANSFORMED BOTH PSYCHOLOGICALLY AND PHYSICALLY INTO ANOTHER PERSON.
COTARD’S SYNDROME/ WALKING CORPSE SYNDROME INDIVIDUALS REPORT THAT THEY HAVE LOST ALL OF THEIR POSSESSIONS, STATUS AND STRENGTH INCLUDING THEIR ORGANS
DELUSION OF CONTROL FALSE BELIEF THAT ONE’S WILL,THOUGHT OR FEELINGS ARE BEING CONTROLLED BY EXTERNAL FORCES.
SHARED DELUSION (FOLIE A DEUX, FOLIE A TROIS, FOLIE A FAMILLE) FALSE BELIEF SHARED COMMONLY AMONG SPOUCES, IN A PARENT AND A CHILD, OR IN CLOSE SIBLINGS (OFTEN SISTERS) WHO HAVE LIVED TOGETHER FOR A LONG TIME
SHARED DELUSION • FOLIE IMPOSÉE • IT IS WHERE A DOMINANT PERSON (KNOWN AS THE 'PRIMARY', 'INDUCER' OR 'PRINCIPAL') INITIALLY FORMS A DELUSIONAL BELIEF DURING A PSYCHOTIC EPISODE AND IMPOSES IT ON ANOTHER PERSON OR PERSONS (KNOWN AS THE 'SECONDARY', 'ACCEPTOR' OR 'ASSOCIATE'). • THE SECONDARY PERSON MIGHT NOT HAVE BECOME DELUDED IF LEFT ON HIS OR HER OWN. • IF THE PARTIES ARE ADMITTED TO HOSPITAL SEPARATELY, THEN THE DELUSIONS IN THE PERSON WITH THE INDUCED BELIEFS USUALLY RESOLVE WITHOUT THE NEED OF MEDICATION. • FOLIE SIMULTANÉE • IT DESCRIBES EITHER THE SITUATION WHERE TWO PEOPLE CONSIDERED TO SUFFER INDEPENDENTLY FROM PSYCHOSIS INFLUENCE THE CONTENT OF EACH OTHER'S DELUSIONS SO THEY BECOME IDENTICAL OR STRIKINGLY SIMILAR, OR ONE IN WHICH TWO PEOPLE "MORBIDLY PREDISPOSED" TO DELUSIONAL PSYCHOSIS MUTUALLY TRIGGER SYMPTOMS IN EACH OTHER.
THE REALITY OF DELUSION • NOT ALL PATIENTS WITH DELUSION ACT ON THEIR DELUSIONAL BELIEF. • USUALLY WHEN A DELUSIONAL ILLNESS BECOMES CHRONIC, THERE IS DISCREPANCY BETWEEN THE DELUSIONS AND THE PATIENT’S BEHAVIOUR. • EG - A GRANDIOSE PATIENT MAY SCRUB THE FLOOR. • DELUSIONS OR OVERVALUED IDEAS OF JEALOUSY SEEM TO BE THE MOST DANGEROUS KIND. BECAUSE OVERVALUED AND DELUSION LIKE IDEAS OCCUR IN INTACT PERSONALITY BUT TRUE DELUSIONS OCCUR IN A DISINTEGRATED PERSONALITY. • ACTION IS MORE LIKELY TO BE TAKEN ON THE BASIS OF OVERVALUED IDEAS AND DELUSION LIKE IDEAS THAN ON THE BASIS OF TRUE DELUSIONS.
DISORDER OF THE FORM OF THINKING FORMAL THOUGHT DISORDERS ARE CHARACTERIZED BY DISTURBANCE IN THE FORM OR FLOW AND CONNECTIVITY OF THOUGHT.
DISORDER OF THE FORM OF THINKING SCHNEIDER’S 5 FEATURES OF FORMAL THOUGHT DISORDER DERAILMENT THE THOUGHT SLIDES ONTO A SUBSIDIARY THOUGHT SUBSTITUTION A MAJOR THOUGHT IS SUBSTITUTED BY A SUBSIDIARY ONE OMISSION SENSELESS OMISSION OF A THOUGHT OR A PART OF IT
DISORDER OF THE FORM OF THINKING SCHNEIDER’S 5 FEATURES OF FORMAL THOUGHT DISORDER FUSION HETEROGENOUS ELEMENTS OF THOUGHT ARE INTERWOVEN WITH EACH OTHER DRIVELLING THERE IS A DISORGANISED INTERMIXTURE OF CONSTITUENT PARTS OF ONE COMPLEX THOUGHT
TANGENTIALITY FORMAL THOUGHT DISORDERS OBLIQUE, DISGRESSIVE, IRRELEVANT MANNER OF SPEECH IN WHICH THE CENTRAL IDEA IS NOT COMMUNICATED AT ALL. CENTRAL IDEA
FORMAL THOUGHT DISORDERS LOOSENING OF ASSOCIATION • SCHIZOPHRENIC THINKING OR SPEECH DISTURBANCE INVOLVING A DISORDER OF LOGICAL PROGRESSION OF THOUGHT,MANIFESTED AS A FAILURE TO COMMUNICATE VERBALLY ADEQUATELY. • UNRELATED AND UNCONNECTED IDEAS SHIFT FROM ONE SUBJECT TO ANOTHER. • EG: ‘The traffic is rumbling along the main road. They are going to the north. Why do girls always play pantomime heroes.’ —given by Carl Schneider
FORMAL THOUGHT DISORDERS CLANG ASSOCIATION • IT REFERS TO A SEQUENCE OF THOUGHTS STIMULATED BY THE SOUND OF PRECEDING WORDS RATHER THAN THEIR MEANING. • MANIC PATIENT SAYS “I WILL KILL WITH A DRILL OR A PILL”
INCOHERENT, ESSENTIALLY INCOMPREHENSIBLE MIXTURE OF WORDS AND PHRASES,USUALLY SEEN IN FAR ADVANCED CASES OF SCHIZOPHRENIA. WORD SALAD ASYNDESIS CAMERON ( 1944) USED THIS TERM TO DESCRIBE THE LACK OF ADEQUATE CONNECTIONS BETWEEN SUCCESSIVE THOUGHTS.
INABILITY TO NARROW DOWN THE OPERATIONS OF THINKING OVERINCLUSION NEOLOGISM NEW WORD OR PHRASE WHOSE DERIVATION CANNOT BE UNDERSTOOD. SEEN IN SCHIZOPHRENIA
TRANSITORY THINKING: IT IS CHARACTERIZED BY DERAILMENTS,SUBSTITUTION AND OMISSIONS.THE GRAMMATICAL AND SYNTACTICAL STRUCTURES ARE BOTH DISTURBED IN TRANSITORY THINKING. DRIVELLING THINKING: THE PATIENT HAS A PRELIMINARY OUTLINE OF A COMPLICATED THOUGHT WITH ALL ITS NECESSARY PARTICULARS,BUT LOSES PRELIMINARY ORGANIZATION OF THE THOUGHT SO THAT ALL THE CONSTITUENTS GET MUDDLED TOGETHER. DESULTORY THINKING: IN DESULTORY THINKING,SPEECH IS GRAMMATICALLY CORRECT BUT SUDDEN IDEAS FORCE THEIR WAY IN FROM TIME TO TIME WHICH IF USED AT THE RIGHT TIME WOULD BE QUITE SUITABLE THESE ARE CHARACTERISTICS OF SCHIZOPHRENIA. OBJECTIVE THOUGHT DISORDER
RECENT ADVANCES • POSITIVE CORRELATIONS HAVE BEEN FOUND IN BETWEEN PERFUSION AND THE SEVERITY OF FORMAL THOUGHT DISORDER IN THE LEFT FRONTAL AND LEFT TEMPOROPARIETAL LANGUAGE AREAS. ITS BEEN OBSERVED THAT BILATERAL DEFICITS IN GREY-MATTER VOLUME, POSITIVELY CORRELATES WITH THE SEVERITY OF THOUGHT DISORDER IN TEMPOROPARIETAL AREAS AND OTHER BRAIN REGIONS. • SO, SPECIFIC GREY-MATTER DEFICITS MAY BE A RISK FACTOR FOR STATE-RELATED DYSFUNCTIONS OF THE LEFT-SIDED LANGUAGE SYSTEM, LEADING TO LOCAL HYPERPERFUSION AND FORMAL THOUGHT DISORDER. ~ The British Journal of Psychiatry (2009) 194, 130–138. doi: 10.1192/bjp.bp.107.045633
RECENT ADVANCES NEUROBIOLOGY OF CREATIVE THINKING THREE-FACTOR MODEL OF THE CREATIVE THINKING (2005 BY ALICE FLAHERTY) • DRAWING FROM EVIDENCE IN BRAIN IMAGING, DRUG STUDIES AND LESION ANALYSIS,THE CREATIVE DRIVE IS SEEN TO BE RESULTING FROM AN INTERACTION OF THE FRONTAL LOBE, TEMPORAL LOBE AND DOPAMINE FROM THE LIMBIC SYSTEM • THE FRONTAL LOBES CAN BE SEEN AS RESPONSIBLE FOR IDEA GENERATION, AND THE TEMPORAL LOBES FOR IDEA EDITING AND EVALUATION. • HIGH ACTIVITY IN THE TEMPORAL LOBE TYPICALLY INHIBITS ACTIVITY IN THE FRONTAL LOBE, AND VICE VERSA. • HIGH DOPAMINE LEVELS INCREASE GENERAL AROUSAL AND GOAL DIRECTED BEHAVIORS AND REDUCE LATENT INHIBITION, AND ALL THREE EFFECTS INCREASE THE DRIVE TO GENERATE IDEAS
RECENT ADVANCES • THE SEVERITY OF POSITIVE FTD WAS INVERSELY CORRELATED WITH THE LEVEL OF ACTIVITY IN THE WERNICKE AREA, A REGION IMPLICATED IN THE PRODUCTION OF COHERENT SPEECH. REDUCED ACTIVITY IN THIS AREA MIGHT CONTRIBUTE TO THE ARTICULATION OF INCOHERENT SPEECH. ~ Arch Gen Psychiatry. 2001;58(8):769-774. doi:10.1001/archpsyc.58.8.769. • THE HLA-A*03 GENE IS SIGNIFICANTLY ASSOCIATED WITH DELUSIONAL DISORDER AS WELL AS WITH PARANOID SCHIZOPHRENIA. THIS HLA GENE ALONE OR IN LINKAGE DISEQUILIBRIUM WITH OTHER HLA GENES OR OTHER CLOSELY LINKED NON-HLA GENES MAY INFLUENCE SUSCEPTIBILITY TO DELUSIONAL DISORDER AND PARANOID SCHIZOPHRENIA. ~ Can J Psychiatry. 2006 May;51(6):342-9.
“A HUMAN BEING IS PART OF AWHOLE, CALLED BY USTHE UNIVERSE, A PART LIMITED INTIME AND SPACE. HE EXPERIENCE HIMSELF, HISTHOUGHTSAND FEELING AS SOMETHING SEPARATE FROMTHE REST, A KIND OF OPTICAL DELUSION OF HIS CONSCIOUSNESS. THIS DELUSION IS A KIND OF PRISON FOR US.” ~ ALBERT EINSTEIN “THOSEWHO DO NOT SUFFER FROMTHIS DELUSION HAVE OFTEN BEEN CALLED DELUSIONAL BYTHOSEWHO REALLY ARE” ~ JENNIFER CRUISE
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Thought & its disorders (Dr. Subrata Naskar)

  • 1.
    BY DR. SUBRATA NASKAR Email: nsubrata09@gmail.com
  • 2.
    PLAN OF PRESENTATION •INTRODUCTION • DEFINITION OF THOUGHT • THINKING PROCESS • TYPES OF THINKING • CONCEPT • PROBLEM SOLVING • DECISION MAKING • CREATIVE THINKING • DISORDERS OF THOUGHT • RECENT ADVANCES • BIBLIOGRAPHY
  • 3.
  • 4.
    INTRODUCTION • THOUGHT CANREFER TO THE IDEAS OR ARRANGEMENTS OF IDEAS THAT RESULT FROM THINKING. • THINKING REPRESENTS THE MOST COMPLEX FORM OF HUMAN BEHAVIOUR, THE HIGHEST FORM OF MENTAL ACTIVITY. • ALL HUMAN ACHIEVEMENTS AND PROGRESS ARE SIMPLY THE PRODUCTS OF THOUGHT.
  • 5.
    THINKING IS MORETHAN LANGUAGE, AND LANGUAGE IS MORE THAN THINKING - PHILIP.S.DALE
  • 6.
    THINKING CAN BEDEFINED AS THE COGNITIVE REARRANGEMENT OR MANIPULATION OF BOTH INFORMATION FROM THE ENVIRONMENT AND THE SYMBOLS STORED IN LONG TERM MEMORY
  • 7.
    THE THINKING PROCESS •REQUIREMENTS: • WORDS • LANGUAGE • IMAGES LANGUAGE WORDSIMAGES THOUGHT
  • 8.
    THE THINKING PROCESS THETHINKING PROCESS IS BY THE USE OF SYMBOLS IN THE FORM OF WORDS,LANGUAGE AND IMAGES. A ‘SYMBOL’ REPRESENTS , OR STANDS FOR SOME EVENT OR ITEM IN THE WORLD, AS WE SEE IMAGES AND LANGUAGE SYMBOLS ARE USED IN MUCH OF OUR THINKING.
  • 9.
    LANGUAGE AND THINKING •WE, THINK USING LANGUAGE SYMBOLS AS A TOOL OF THINKING PROCESS • IN WHICH SYMBOLS ARE, WORDS AND RULES OF GRAMMAR. • THE WORDS, THEIR MEANINGS, AND THE RULES FOR JOINING THEM TOGETHER ARE STORED IN OUR SEMANTIC LONG-TERM MEMORIES. • SOME THEORISTS TAKE A MORE EXTREME VIEW OF THE ROLE OF LANGUAGE IN THINKING PROCESS • THAT LANGUAGE CAN ACTUALLY DETERMINE THE THOUGHTS WE ARE CAPABLE OF THINKING. • THIS IS CALLED AS THE LINGUISTIC RELATIVITY HYPOTHESIS • ALSO DEAF PEOPLE WHOSE VERBAL LANGUAGE ABILITIES ARE MINIMAL, SEEMS TO HAVE NONVERBAL LANGUAGE TOOL OF THOUGHT; THEY CAN THINK IN SIGNS (VERNON & KOH, 1971: STUCKLESS & BIRCH, 1966)
  • 10.
    LANGUAGE AND THINKING “TALKING TO YOURSELF UNDER YOUR BREATH ” • LANGUAGE IS SO MUCH INVOLVED IN THINKING PROCESS THAT THE IDEA AROSE IN PSYCHOLOGY THAT THINKING IS ACTUALLY A KIND OF INNER SPEECH OR “ TALKING TO YOURSELF UNDER YOUR BREATH ” • ACCORDING TO THIS IDEA PEOPLE MAKE SMALL MOVEMENTS OF VOCAL APPARATUS WHILE THINKING AND NUMBER OF EXPERIMENTS HAVE INDICATED THAT MOVEMENTS OF VOCAL APPARATUS MAY ACCOMPANY THOUGHTS, BUT ALSO HAVE MADE IT CLEAR THAT SUCH MOVEMENTS ARE NOT NECESSARY FOR THINKING (SMITH ET AL, 1947)
  • 11.
    IMAGES AND THINKING •IMAGES ARE REMARKABLY USED IN THINKING ALONG WITH WORDS AS SYMBOLS FOR E.G. MANY PEOPLE MAKE A VISUAL ROAD MAP TO FIND AND DESCRIBE HOW THEY WILL GO FROM ONE PLACE TO ANOTHER (IN AN KNOWN CITY OR PLACE) • WHEN WE USE IMAGES TO THINK, THEY ARE USUALLY NOT COMPLETE. (HUTTENLOCHER, 1973) • THIS INCOMPLETE IMAGES MOST OF US USE IN THINKING, SEEMS TO BE CONSTRUCTED FROM ELEMENTS STORED IN LONG TERM MEMORY. • ALSO THIS IMAGES CONSTRUCTED CAN BE OF ANY SIZE OR COLOUR OR SHAPE, ETC. • THIS VARIATIONS ADD TO THE EASE WITH WHICH INFORMATION IS FOUND IN AN IMAGE. (KOSSIYN, 1975, 1983) • E.G. AN ELEPHANT CAN BE IMAGINED AS THE SIZE OF A MOUSE OR A MOUSE IMAGINED AS A SIZE OF AN ELEPHANT
  • 12.
  • 13.
    CONCEPTS • CONCEPTS AREIMPORTANT LANGUAGE SYMBOLS USED IN THINKING. • A CONCEPT IS A SYMBOLIC CONSTRUCTION THAT REPRESENT SOME COMMON AND GENERAL FEATURE OR FEATURES OF MANY OBJECTS OR EVENTS. • EXAMPLES ARE “MAN”, “RED”, “TRIANGLE”, “MOTIVATION”, “ATOM”, “ANGER”, ETC. • IN FACT MOST OF THE NOUNS IN OUR VOCABULARY ARE NAMES OF CONCEPTS, EXCEPT PROPER NOUNS– NAMES OF SPECIFIC THINGS OR PERSON. • ABILITY TO FORM CONCEPTS ENABLES US TO CLASSIFY THINGS INTO CATEGORIES. • E.G. WITH A CONCEPT OF RED WE CAN SORT OBLECTS INTO RED AND NON-RED,WITH A CONCEPT OF FRUIT WE CAN SORT OBJECTS INTO FRUIT OR NON-FRUIT, CONCEPTS WE SELECT- GIVES US BASE FOR CLASSIFICATIONS WHEN A CLASSIFICATION HAS BEEN MADE, WE TEND TO BEHAVE TOWARDS AND THINK ABOUT, THE MEMBERS OF THE CLASS. THUS, CONCEPTS ARE THE CONVENIENT TOOLS TO USE IN THINKING AND SOLVING PROBLEMS
  • 14.
  • 15.
    • BASIC/NATURAL CONCEPT: •SOME CONCEPTS ARE “BASIC” AND “ NATURAL” WHICH ARE ACQUIRED EASILY, AND APPEAR IN THINKING VERY EARLY IN LIFE • E.G. DIVISION OF COLOURS ACCORDING TO THEIR SPECTRUMS LIKE RED, GREEN, YELLOW. • BY DISCRIMINATION LEARNING: • MANY OF THE CONCEPTS ARE ACQUIRED MORE SLOWLY AND WITH EFFORTS, WHERE DISCRIMINATION LEARNING PLAYS A ROLE. THIS TYPE OF LEARNING CONCEPTS OCCURS WITH RESPONSE TO REWARDS OR REINFORCEMENTS. • E.G. SAYING “RIGHT !” WHEN A CHILD SAYS “APPLE” AND POINTS TOWARDS ONE, AND NOT AT SOMETHING ELSE. • BY DEFINITION: • SOME CONCEPTS ARE ACQUIRED BY LEARNING “DEFINITIONS”, • DEFINITIONS HELP US ACQUIRE CONCEPTS BY DESCRIBING THEM IN TERMS OF OTHER WORDS OR CONCEPTS WITH WHICH WE ARE ALREADY FAMILIAR.
  • 16.
  • 17.
    FREUD’S DIVISION OFTHOUGHT: • PRIMARY PROCESS (RIGHT BRAIN THINKING) • FEATURES: • DISREGARDS LOGIC • PERMITS SIMULTANEOUS CONTRADICTION • DOMINATED BY WISH AND FANTASY • USES SYMBOLS,IMAGERY CONDENSATION & CONCRETISATION IN ITS ORGANISATION • A JUMBLED AND INCOHERENT STYLE OF THINKING • WHERE FOUND ? • FOUND IN DREAMS • YOUNG CHILDREN • PSYCHOTIC STATES
  • 18.
    FREUD’S DIVISION OFTHOUGHT SECONDARY PROCESS FEATURES: • CHARACTERIZED BY LOGIC. • IDEAS FOLLOW ONE ANOTHER IN SEQUENCE THAT IS UNDERSTABLE TO THE LISTENER WHERE FOUND ? • FOUND IN NON DREAMY STATE • ADULTS • NON PSYCHOTIC STATES EXAMPLE: The ability to think abstractly and to think in detail about future plan
  • 19.
    NON FREUDIAN NON FREUDIANTYPOLOGY OF THOUGHT FANTASY THINKING IMAGINATIVE THINKING CONCEPTUAL THINKING AUTISIC THINKING ABSTRACT THINKING CONCRETE THINKING
  • 20.
    FANTASY THINKING THINKING BY ESCAPINGFROM OR DENYING REALITY NORMAL:DAY DREAMING PATHOLOGICAL:DISSOCIATIVE AND PSYCHOTIC STATES • FANTASY IS USUALLY UNDERSTOOD TO BE THE CREATION OF IMAGES OR IDEAS WHICH HAVE NO EXTERNAL REALITY. HOWEVER, FANTASY THINKING MAY ALSO REVEAL ITSELF IN DENIAL OF EXTERNAL EVENTS. • THE OBSERVATIONS ON WHICH THE PSYCHODYNAMIC EXPLATION OF EGO DEFENCE MECHANISM HAVE BEEN DESCRIBED ARE RELEVANT IN THIS CONTEXT. • THE SLIPS OF THE TONGUE, OR THE ‘FORGETTING’ OF THE EMOTIONALLY LADEN WORDS IS NOT ACCIDENTAL, IT IS A FORM OF SELF-DECEPTION. • THE OBVIOUS, SIGNIFICANT, BUT UNPLEASANT, OBJECT OF PERCEPTION MAY BE ‘OVER-LOOKED’, AND THIS OFTEN REVELS FANTASY DENIAL.
  • 21.
    ABSTRACT THINKING THINKING CHARACTERISED BYTHE ABILITY TO GRASP THE ESSENTIALS OF A WHOLE OR BREAK A WHOLE INTO ITS PARTS,AND TO DISCERN COMMON PROPERTIES
  • 22.
    IN THIS THINKINGFANTASY AND MEMORY ARE USED TOGHETHER , GENERATES PLANS FOR EVERYDAY LIFE AND UTILIZE THE SUCCESSION OF IDEAS THAT FILLS CONSCIOUSNESS. DOES NOT GO BEYOND THE RATIONAL OR THE POSSIBLE. IMAGINATIVE THINKING
  • 23.
  • 24.
    CONCRETE THINKING THINKING CHARACTERISED BYACTUAL THINGS,EVENTS,AND IMMEDIATE EXPERIENCE RATHER THAN BY ABSTRACTIONS FOUND IN SCHIZOPHRENIA COGNITIVE MENTAL DISORDER
  • 25.
    AUTISTIC THINKING THINKING IN WHICHTHE THOUGHTS ARE NARCISSISTIC AND EGOCENTRIC,WITH EMPHASIS ON SUBJECTIVITY RATHER THAN OBJECTIVITY AND WITHOUT REGARD FOR REALITY • IT MAY BE OF SHORT DURATION, OR IT MAY BECAME AN ESTABLISHED WAY OF LIFE. • IT ALSO PLAYS AN IMPORTANT ROLE IN THE WAY WE ALL CARRY OUT OUR DAY TO DAY ACTIVITIES. • IT ALLOWS A PERSON TO ESCAPE FROM, OR DENY, REALITY; OR ALTERNATIVELY CONVERT REALITY INTO SOMETHING MORE TOLERABLE. • BLEULER (1911) SAW THIS ISOLATION FROM THE REAL WORLD INTO AUTISTIC THINKING AS A CHARACTERISTIC OF SCHIZOPHRENIA. • THIS TYPE OF THINKING IS ASSOCIATED TO • PATHOLOGICAL LYING ( PSUDOLOGIA FANTASTICA ) • HYSTERICAL CONVERSIONS AND DISSOCIATION, • DELUSION-LIKE IDEAS OCCURRING IN AFFECTIVE PSYCHOSES. FOUND IN : SCHIZOPHRENIA AND AUTISTIC DISORDER
  • 26.
    PROBLEM SOLVING WHAT ISPROBLEM ? “PROBLEM” IS DEFINED IN GENERAL AS IT IS ANY CONFLICT OR DIFFERENCE BETWEEN ONE SITUATION AND ANOTHER SITUATION WE WISH TO PRODUCE OUR GOAL. “THINKING” THAT WE DO IN PROBLEM SOLVING IS GOAL DIRECTED, AND MOTIVATED.
  • 27.
    PROBLEM SOLVING WE USEINFORMATION AVAILABLE TO US, FROM LONG-TERM MEMORY AND FROM THE PERCEPTION OF THE PROBLEM SITUATION. WE PROCESS THIS INFORMATION ACCORDING TO RULES, THAT TELLS US WHAT WE CAN DO AND CANNOT DO. IN OTHER WORDS, MANY INSTANCES OF PROBLEM SOLVING CAN BE CONSIDERED A FORM OF RULE-GUIDED, MOTIVATED INFORMATION PROCESSING (NEWELL & SIMON, 1972)
  • 28.
    RULES IN PROBLEMSOLVING TWO MAJOR TYPES OF RULES IN PROBLEM SOLVING ARE
  • 29.
    RULES IN PROBLEMSOLVING IS A SET OF RULES WHICH, IF FOLLOWED CORRECTLY, WILL GUARANTEE A SOLUTION TO A PROBLEM. E.G. IN SOLVING MATHEMATICAL CALCULATIONS STRATEGIES, USUALLY BASED ON OUR PAST EXPERIENCES WITH PROBLEMS, THAT ARE LIKELY TO LEAD TO A SOLUTION BUT DO NOT GUARANTEE SUCCESS. E.G. COMMON STRATEGY OF BREAKING THE PROBLEM INTO SMALLER SUB-PROBLEMS, WHICH BRINGS US LITTLE CLOSER TO END GOAL.
  • 30.
    DECISION MAKING DECISION MAKINGIS A KIND OF PROBLEM SOLVING IN WHICH WE ARE PRESENTED WITH A NUMBER OF ALTERNATIVES AMONG WHICH WE MUST CHOOSE. PEOPLE MAKE DECISIONS THAT WILL MAXIMIZE SUBJECTIVELY EXPECTED GAIN.
  • 31.
    HEURISTIC IN DECISIONMAKING • REPRESENTATIVENESS: WE COMPARE AND SEE WHETHER THE CURRENT SITUATION IS A REPRESENTATION OF SOMETHING WE HAVE ALREADY EXPERIENCED • AVAILABILITY: BECAUSE FREQUENT EVENTS ARE EASIER TO REMEMBER THAN INFREQUENT ONES,EASILY REMEMBERED EVENTS ARE LIKELY TO BE REPEATED IN DECISION MAKING. • ADJUSTMENT: WE START WITH A CERTAIN SUBJECTIVE PROBABILITY AND RAISE IT OR LOWER IT DEPENDING ON THE CIRCUMSTANCES
  • 32.
    CREATIVE THINKING THINKING SOMETHINGNEW, PROVIDING TO THE PROBLEMS SOME NEW SOLUTIONS WHICH OTHER PEOPLE HAVE NOT THOUGHT OF EARLIER. THIS SUDDEN APPEARANCE OF NEW IDEA IS CALLED INSIGHT
  • 33.
    STAGES IN CREATIVETHINKING 1. PREPARATION: FORMULATION OF THE PROBLEM AND COLLECTION OF THE FACTS AND MATERIALS CONSIDERED NECESSARY FOR ITS SOLUTION 2. INCUBATION: TURNING AWAY FROM THE PROBLEM, FAILING TO SOLVE IT. BUT THE UNCONSCIOUS THOUGHT PROCESSES ARE STILL AT WORK 3. ILLUMINATION: SUDDEN EMERGENCE OF AN IDEA TO THE PROBLEM 4. EVALUATION: THE APPARENT SOLUTION IS TESTED TO SEE IF IT SATISFACTORILY SOLVES THE PROBLEM 5. REVISION: MODIFICATION OF THE SOLUTION OR SOLUTION OF MINOR PROBLEMS TO CREATE A “ GOOD ” NEW IDEA.
  • 34.
  • 35.
  • 36.
    DISORDERS OF THOUGHT TEMPOCONTINUITY FLIGHT OF IDEAS INHIBITION CIRCUMSTANTIALITY PERSEVARATION THOUGHT BLOCK
  • 37.
    DISORDERS OF THOUGHT FLIGHTOF IDEAS • RAPID SUCCESSION OF FRAGMENTARY THOUGHTS OR SPEECH IN WHICH CONTENT CHANGES ABRUPTLY AND SPEECH MAY BE INCOHERENT WITH NO DIRECTION OF THINKING AND NO CONNECTION BETWEEN TWO THOUGHTS. • PT’S SPEECH IS EASILY DIVERTED TO EXTERNAL STIMULI AND BY INTERNAL SUPERFICIAL ASSOCIATION. • ASSOCIATION BETWEEN SUCCESSIVE THOUGHTS IS BROUGHT ABOUT BY CHANCE RELATIONSHIPS & VERBAL ASSOCIATIONS LIKE CLANG ASSOCIATION & PROVERBS, MAXIMS & CLICHES • TYPICAL OF MANIA AND ALSO FOUND IN : EXCITED SCHIZOPHRENICS, ORGANIC STATES- HYPOTHALAMIC LESIONS.
  • 38.
    DIAGRAMATIC REPRESENTATION OFFLIGHT OF IDEAS FOR EXAMPLE, A PERSON MIGHT SAY "LOOK AT THE SUN, SUN GIVES LIGHT, LIGHT IS BRIGHT, BRIGHT SKY, SKY IS THE MIRROR OF HEAVEN.“
  • 39.
    PROLIXITY • A MARGINALVARIETY OF FLIGHT OF IDEA WHERE DESPITE MANY IRRELEVANCES, THE PATIENT IS ABLE TO RETURN TO THE TASK IN HAND. • THE SPEED OF EMERGENCE OF THOUGHTS IS NOT AS FAST AS IN FLIGHT OF IDEA • ALSO CALLED “ORDERED FLIGHT OF IDEA” • FOUND IN HYPOMANIA
  • 40.
    INHIBITION: • GOAL DIRECTED •PROCEEDS SO SLOWLY WITH MORBID PREOCCUPATION WITH GLOOMY THOUGHTS, THAT GOAL IS NOT ACHIEVED. • SUBJECT SHOWS: • LITTLE INITIATIVE • NO PLANNING • NO SPONTANEOUS ACTIVITY • DIFFICULTY IN TAKING DECISION • LOSS OF CLARITY OF THOUGHT • POOR REGISTRATION OF EVENTS THOSE HE NEEDS TO REMEMBER • USUALLY SEEN IN depression manic stupor [rare condition]
  • 41.
    CIRCUMSTANTIALITY QUESTION IS ASKED PATIENTWILL ANSWER THE QUESTION WITH ALL SORTS OF UNNECESSARY ASSOCIATIONS BEFORE POINT IS REACHED. AT WHAT AGE YOUR MOTHER DIED? WHERE FOUND ? Found in schizophrenia, learning disabilities, obsessional personality, epileptic personality change SUBJECT TALKS ABOUT ACCIDENTS PEOPLE WHO ATTENDED THE FUNERAL FINALLY THE ANSWER, I.E THE AGE
  • 42.
    DISORDERS OF CONTINUITYOF THINKING • PERSEVERATION • PATHOLOGICAL REPETITION OF THE SAME RESPONSE TO DIFFERENT STIMULI BEYOND A POINT OF RELEVANCE. • MEANINGLESS & STEREOTYPED REPETITION OF WORDS AND PHRASES IS CALLED verbigeration OR cataphasia. • FOUND IN: • RULE OUT ORGANICITY FIRST !!!! • COGNITIVE DISORDERS,SCHIZOPHRENIA, CATATONIA, COURSE BRAIN DISEASE
  • 43.
    DISORDERS OF CONTINUITYOF THINKING • PERSEVERATION • WHERE DO YOU LIVE ? • ANS: KOLKATA • WHAT IS YOUR NAME ? • ANS: KOLKATA • WHAT DO YOU STUDY ? • ANS: KOLKATA
  • 44.
    DISORDERS OF CONTINUITYOF THINKING  PALILALIA: THE PT. REPEATS THE PERSEVERATED WORD WITH INCREASING FREQUENCY.  EG: TEN, TEEN, TEEEEEEEEN, TEEEEEEEEEEEEN……………….. SO ON.  LOGOCLONIA: THE LAST SYLLABLE OF THE LAST WORD IS REPEATED.  EG: LION LIVES IN A DEN…EN….EN….EN….EN….EN….. • BOTH TYPES OCCUR IN COARSE BRAIN DISEASE, IN PARTICULAR IN ALZHEIMER’S DISEASE.
  • 45.
    TYPES OF PERSEVERATION COMPULSIVE REPETITION: THE ACT IS REPEATED UNLESS THE PT. RECEIVES ANOTHER INSTRUCTION – IS MORE FREQUENT IN SCHIZOPHRENICS.  IMPAIRMENT OF SWITCHING: THE REPETITION CONTINUES AFTER THE PT. HAS BEEN GIVEN A NEW TASK – MORE COMMON AMONG DEMENTS.  IDEATIONAL PERSEVERATION: THE PATIENT REPEATS WORDS AND PHRASES DURING HIS REPLY TO A QUESTION – EQUALLY COMMON IN BOTH GROUPS.
  • 46.
    THOUGHT BLOCKING • SUDDENARREST OF THE TRAIN OF THOUGHT WHICH MAY/MAY NOT BE FOLLOWED BY AN ENTIRELY NEW THOUGHT • ITS NOT CAUSED BY DISTRACTION OR OTHER THOUGHTS. • PATIENT CANNOT GIVE ANY ADEQUATE EXPLANATION FOR IT. • SOMETIMES PATIENT MAY EXPLAIN IT IN TERMS OF THOUGHT WITHDRAWAL ‘My thinking stopped because the thoughts were suddenly taken out of my head’.
  • 47.
    DISORDERS OF POSSESSIONOF THOUGHT THOUGHT ALIENATION OBCESSION & COMPULSION
  • 48.
    DISORDERS OF POSSESSIONOF THOUGHT THOUGHT ALIENATION ALIENATION MEANS-TO TRANSFER • IN THOUGHT ALIENATION THE PATIENT HAS THE EXPERIENCE THAT HIS THOUGHTS ARE UNDER THE CONTROL OF AN OUTSIDE AGENCY OR THAT OTHERS ARE PARTICIPATING IN HIS THINKING • THOUGHT INSERTION - FEELING OF THOUGHTS BEING INSERTED INTO THE PATIENT’S MIND BY A FOREIGN INFLUENCE • THOUGHT DEPRIVATION/THOUGHT WITHDRAWAL - PATIENT FEELS THAT AS HE IS THINKING,HIS THOUGHTS SUDDENLY DISAPPEAR AND ARE WITHDRAWN FROM HIS MIND BY A FOREIGN INFLUENCE
  • 49.
    DISORDERS OF POSSESSIONOF THOUGHT THOUGHT ALIENATION • THOUGHT BROADCASTING - FEELING THAT ONE’S THOUGHTS ARE BEING BROADCASTED OR PROJECTED INTO THE ENVIRONMENT THOUGHT ALIENATION PHENOMENON IS DIAGNOSTIC OF SCHIZOPHRENIA
  • 50.
    OBSESSIONS & COMPULSIONS OBSESSIONSARE PERSISTENT,INVOLUNTARY AND RECURRENT IDEA,THOUGHT OR IMPULSES THAT CANNOT BE ELIMINATED FROM CONSCIOUSNESS BY LOGIC OR REASONING WHAT IS OBSESSION ?
  • 51.
    OBSESSIONS & COMPULSIONS WHATIS COMPULSION ? COMPULSIONS ARE OBSESSIONAL MOTOR ACTS-THE NEED TO ACT ON AN IMPULSE THAT IF RESISTED PRODUCES ANXIETY
  • 52.
    OBSESSIONS & COMPULSIONS •THE ESSENTIAL FEATURE OF THE OBSESSION IS THAT IT APPEARS AGAINST THE PATIENT’S WILL. • COMMONEST OBSESSIVE THEMES - DIRT & CONTAMINATION, RISK AND AGGRESSION. • OBSESSIONS OCCUR IN-OBSESSIONAL STATES • DEPRESSION • SCHIZOPHRENIA • POST ENCEPHALITIC PARKINSONISM
  • 53.
    DISORDER OF CONTENTOF THINKING DELUSION
  • 54.
    DISORDER OF CONTENTOF THINKING FALSE UNSHAKABLE BELIEFS WHICH ARE OUT OF KEEPING WITH THE PATIENT’S SOCIAL AND CULTURAL BACKGROUND OVERVALUED IDEAS UNREASONABLE AND SUSTAINED ABNORMAL BELIEFS THAT ARE HELD BEYOND THE BOUNDS OF REASON
  • 55.
    DISORDER OF CONTENTOF THINKING THE PSYCHIATRIST AND PHILOSOPHER KARL JASPERS WAS THE FIRST TO DEFINE THE THREE MAIN CRITERIA FOR A BELIEF TO BE CONSIDERED DELUSIONAL IN HIS 1913 BOOK GENERAL PSYCHOPATHOLOGY. THESE CRITERIA ARE: • CERTAINTY (HELD WITH ABSOLUTE CONVICTION) • INCORRIGIBILITY (NOT CHANGEABLE BY COMPELLING COUNTERARGUMENT OR PROOF TO THE CONTRARY) • IMPOSSIBILITY OR FALSITY OF CONTENT (IMPLAUSIBLE, BIZARRE OR PATENTLY UNTRUE)
  • 56.
    DELUSION CULTURALLY INAPPROPRIATE NO DOUBT NOTPLAUSIBLE OVERVALUED IDEAS CULTURALLY APPROPRIATE SOME DOUBT IS PRESENT PLAUSIBLE
  • 57.
    IDEAS OF REFERENCE IDEASOF REFERENCE ARE FALSE PERSONALIZED INTERPRETATIONS OF ACTUAL EVENTS IN WHICH INDIVIDUALS BELIEVE THAT OCCURRENCES OR REMARKS REFER SPECIALLY TO THEM WHEN THEY ACTUALLY DO NOT.
  • 58.
    TRUE DELUSIONS THE RESULTOF A PRIMARY DELUSIONAL EXPERIENCE WHICH CANNOT BE DEDUCED FROM ANY OTHER MORBID PHENOMENON DELUSION LIKE IDEAS ARE SECONDARY AND CAN BE UNDERSTABLY DERIVED FROM SOME OTHER PSYCHOLOGICAL PHENOMENON
  • 59.
    TYPES OF DELUSION PRIMARYDELUSION SECONDARY DELUSION
  • 60.
    PRIMARY DELUSION APOPHANY A NEWMEANING ARISES IN CONNECTION WITH SOME OTHER PSYCHOLOGICAL EVENT. TYPES (Schneider’ division) DELUSIONAL MOOD DELUSIONAL PERCEPTION REFERS TO THE EXPERIENCE OF ATTRIBUTING A NORMAL PERCEPTION WITH A DELUSIONAL MEANING,ONE THAT HAS ENORMOUS PERSONAL SIGNIFICANCE TO THE PATIENT. EG: CUTLERY CLANKING THEY ARE TRYING TO KILL ME PATIENT HAS A SENSE THAT SOMETHING ODD OR UNCANNY IS GOING ON AROUND HIM WHICH CONCERNS HIM,BUT HE DOES NOT KNOW WHAT IT IS
  • 61.
    PRIMARY DELUSION APOPHANY A NEWMEANING ARISES IN CONNECTION WITH SOME OTHER PSYCHOLOGICAL EVENT. TYPES (Schneider’ division) SUDDEN DELUSIONAL IDEA/AUTOCHTHONOUS DELUSION TAKES FORM IN AN INSTANT WITHOUT IDENTIFIABLE PRECEEDING EVENTS
  • 62.
    PRIMARY DELUSION APOPHANY A NEWMEANING ARISES IN CONNECTION WITH SOME OTHER PSYCHOLOGICAL EVENT. TYPES (Schneider’ division) • PRIMARY DELUSIONS FOUND IN • SCHIZOPHRENIA • EPILEPTIC PSYCHOSIS • DEPRESSION PRIMARY DELUSION = TRUE DELUSION
  • 63.
    SECONDARY DELUSION SECONDARY DELUSIONSCAN BE UNDERSTOOD AS ARISING FROM SOME OTHER MORBID EXPERIENCE. IT CAN BE SECONDARY TO : • DEPRESSIVE MOOD • HALLUCINATION • PSYCHOGENIC OR STRESS REACTIONS FOR EXAMPLE: A PERSON BECOMES DEPRESSED, SUFFERS VERY LOW MOOD AND SELF- ESTEEM,AND SUBSEQUENTLY BELIEVES HE IS RESPONSIBLE FOR SOME TERRIBLE CRIME WHICH HE DID NOT COMMIT IN REALITY
  • 64.
    CONARD’S5STAGESIN DEVELOPMENTOFDELUSION TREMA APOPHANY ANASTROPHY CONSOLIDATION RESIDUUM DELUSIONAL MOOD REPRESENTINGA TOTAL CHANGE IN PERCEPTION OF THE WORLD. SEARCH FOR, AND FINDING OF NEW MEANING FOR PSYCHOLOGICAL EVENTS. HEIGHTENING OF PSYCHOSIS. FORMING OF A NEW WORLD OR PSYCHOLOGICAL SET BASED ON NEW MEANING. EVENTUAL AUTISTIC STATE.
  • 65.
    SIMPLE DELUSION SIMPLE DELUSIONSCONTAIN RELATIVELY FEW ELEMENTS. COMPLEX DELUSION COMPLEX DELUSIONS MAY CONTAIN EXTENSIVE ELABORATION OF PEOPLE,SPIRITS,MOTIVES AND SITUATIONS.
  • 66.
    COMPLETE COMPLETE DELUSIONS ARE THOSEWHICH ARE HELD WITHOUT ANY DOUBT. INCOMPLETE/PARTIAL IN PARTIAL DELUSION,THE PATIENT ENTERTAINS SOME AMOUNT OF DOUBT ABOUT HIS DELUSIONAL BELIEFS
  • 67.
    SYSTEMATIZED SYSTEMATIZED DELUSIONS ARERESTRICTED OR CIRCUMSCRIBED TO WELL DELINEATED AREAS AND ARE ORDINARILY ASSOCIATED WITH A CLEAR SENSORIUM AND ABSENCE OF HALLUCINATION. NON SYSTEMATIZED NON SYSTEMATIZED DELUSION EXTEND INTO MANY AREAS OF LIFE AND NEW PEOPLE AND SITUATIONS ARE CONSTANTLY INCORPORATED TO SUPPORT THE PRESENCE OF DELUSION.
  • 68.
    THE CONTENT OFDELUSIONS DELUSION OF PERSECUTION • THE ARCHETYPE OF DELUSIONAL DISORDER • FALSE BELIEF OF BEING HARASSED OR PERSECUTED. • ASSOCIATED WITH QUERULOUSNESS, IRRITABILITY& ANGER AND THE INDIVIDUAL WHO ACTS OUT HIS OR HER ANGER MAY AT TIMES BE ASSAULTIVE OR EVEN HOMOCIDAL • DELUSION OF PERSECUTION OCCURS IN THE CONTEXT OF PRIMARY DELUSIONAL EXPERIENCE, AUDITORY HALLUCINATION, BODILY HALLUCINATIONS OR EXPERIENCES OF PASSIVITY
  • 69.
  • 70.
    DELUSION OF REFERENCE •IN DELUSIONS OF REFERENCE THE PATIENT KNOWS THAT PEOPLE ARE TALKING ABOUT HIM, SLANDERING HIM OR SPYING ON HIM. • IT MAY BE DIFFICULT TO BE CERTAIN IF THE PATIENT HAS DELUSIONS OF SELF- REFERENCE OR IF HE HAS SELF-REFERENTIAL HALLUCINATIONS. • IDEAS AND DELUSIONS OF REFERENCE ARE NOT CONFINED TO SCHIZOPHRENIA AND CAN OCCUR IN DEPRESSIVE ILLNESS AND OTHER PSYCHOTIC ILLNESSES. • SOME PATIENTS WITH SEVERE DEPRESSION MAY BELIEVE THAT THEY ARE EXTREMELY WICKED AND THAT OTHER PEOPLE KNOW THIS AND ARE THEREFORE QUITE JUSTIFIABLY SPYING ON THEM.
  • 71.
    DELUSION OF GUILT •DELUSIONS OF GUILT CAN BE SO MARKED THAT THE PATIENT BELIEVES THAT HE IS ABOUT TO BE PUT TO DEATH OR IMPRISONED FOR LIFE. • THIS ALLEGED PERSECUTION IS GENERALLY BELIEVED TO BE FULLY JUSTIFIED BY THE PATIENT. • OCCASIONALLY, HOWEVER, A PATIENT MAY BELIEVE THIS ALLEGED PERSECUTION IS NOT JUSTIFIED AND MAY ATTRIBUTE THEIR DEPRESSION TO IT.
  • 72.
    DELUSION OF BEINGPOISONED • DELUSIONS OF BEING POISONED OR INFECTED ARE QUITE COMMON. • OFTEN DELUSIONS OF POISONING ARE EXPLANATORY DELUSIONS. • THE PATIENT FEELS MENTALLY AND PHYSICALLY CHANGED AND THE ONLY WAY IN WHICH THEY CAN ACCOUNT FOR THIS IS BY ASSUMING THAT THEIR FOOD OR CIGARETTES HAVE BEEN POISONED. • IN OTHER CASES, DELUSIONS OF POISONING ARE BASED ON HALLUCINATIONS OF SMELL AND TASTE.
  • 73.
    DELUSION OF INFLUENCE •DELUSIONS OF INFLUENCE ARE A ‘LOGICAL’ RESULT OF EXPERIENCES OF PASSIVITY IN THE CONTEXT OF SCHIZOPHRENIA. • THESE PASSIVITY FEELINGS MAY BE EXPLAINED BY THE PATIENT AS THE RESULT OF HYPNOTISM, DEMONICAL POSSESSION, WITCHCRAFT, RADIO WAVES, ATOMIC RAYS OR TELEVISION.
  • 74.
    DELUSION OF INFIDELITY •THE PATIENT HAS MORBID JEALOUSY AND DELUSION OF MARITAL INFIDELITY • OFTEN THE PATIENT HAS BEEN SUSPICIOUS, SENSITIVE AND MILDLY JEALOUS BEFORE THE ONSET OF THE ILLNESS • DELUSION OF INFIDELITY MAY DEVELOP GRADUALLY, AS A SUSPICIOUS OR INSECURE PERSON BECOMES MORE AND MORE CONVINCED OF THEIR SPOUSE’S INFIDELITY AND FINALLY THE IDEA REACHES DELUSIONAL LEVEL. • DELUSIONS OF INFIDELITY MAY OCCUR IN BOTH ORGANIC AND FUNCTIONAL DISORDERS. • Found in schizophrenia,coarse brain disease, alcohol addiction.
  • 75.
    JOHN HINCKLEY JRJODIEFOSTER RONALD REGAN
  • 76.
    JOHN HINCKLEY JRJODIEFOSTER RONALD REGAN JOHN HINCKLEY, JR. BECAME OBSESSED WITH FOSTER AFTER WATCHING TAXI DRIVER A NUMBER OF TIMES AND STALKED HER WHILE SHE ATTENDED YALE, SENDING HER LOVE LETTERS TO HER CAMPUS MAIL BOX AND EVEN TALKING TO HER ON THE PHONE. ON MARCH 30, 1981, HE ATTEMPTED TO ASSASSINATE U.S. PRESIDENT RONALD REAGAN (SHOOTING AND WOUNDING REAGAN AND THREE OTHERS) AND CLAIMED HIS MOTIVE WAS TO IMPRESS FOSTER, THEN A YALE FRESHMAN
  • 77.
    DELUSION OF LOVE •THIS CONDITION HAS ALSO BEEN DESCRIBED AS ‘THE FANTASY LOVER SYNDROME’ , ‘EROTOMANIA’ OR ‘DE CLÉRAMBAULT'S SYNDROME’. • THE PATIENT IS CONVINCED THAT SOME PERSON IS IN LOVE WITH THEM ALTHOUGH THE ALLEGED LOVER MAY NEVER HAVE SPOKEN TO THEM. • THEY MAY PESTER THE VICTIM WITH LETTERS AND UNWANTED ATTENTION OF ALL KINDS. • Found in – abnormal personality developments, schizophrenia
  • 78.
    GRANDIOSE DELUSION • EXAGGERATEDCONCERNS ABOUT ONE’S IMPORTANCE,POWER OR IDENTITY. • BELIEVES THAT ONE HAS SPECIAL POWERS AND IS ACCOMPLISHING OR WILL ACCOMPLISH EXTRAORDINARY THINGS FOR GOOD OF THE COMMUNITY.
  • 79.
    GRANDIOSE DELUSION • SOMEPEOPLE BELIEVE THAT THEY ARE GOD, KING OR ROCK STAR WHEREAS SOME OTHERS BELIEVE THEY ARE SKILLED SPORTSPERSON OR GREAT INVESTORS. • FOUND IN MANIA, SCHIZOPHRENIA.
  • 80.
    DELUSION OF ILLHEALTH • DELUSION OF ILL HEALTH MAY DEVELOP ON A BACKGROUND OF CONCERNS ABOUT HEALTH. • FOUND IN SCHIZOPHRENIA, DEPRESSION, ABNORMAL PERSONALITY DEVELOPMENT • HYPOCHONDRIACAL DELUSIONS: BELIEF THAT ONE’S BODY IS UNHEALTHY, DISEASED OR CHRONICALLY ILL.MAY BE THE RESULT OF DEPRESSION, BODILY HALLUCINOSIS OR A SENSE OF SUBJECTIVE CHANGE.
  • 81.
    DELUSIONAL DYSMORPHOPHOBIA • THEDELUSIONAL PREOCCUPATIONS WITH FACIAL OR BODILY APPEARANCES IS CALLED DELUSIONAL DYSMORPHOPHOBIA. • THE SUBJECT IS CONVINCED THAT THEIR NOSE IS TOO BIG, THEIR FACE IS TWISTED, OR DISFIGURED WITH ACNE, AND SO ON. • SOMETIMES THESE PREOCCUPATIONS WITH ILL HEALTH OR THE APPEARANCE OF THE BODY HAVE A SOMEWHAT OBSESSIONAL QUALITY, SO THAT THE PATIENT CANNOT STOP THINKING ABOUT THE SUPPOSED ILLNESS OR DEFORMITY. • THE BELIEF IS OF DELUSIONAL INTENSITY AND THE PATIENT IS NEVER ABLE TO ADMIT THAT THEIR BELIEF IS GENUINELY GROUNDLESS.
  • 82.
    DELUSION OF GUILT •PATIENT BELIEVES THEY ARE BAD OR EVIL PERSON AND HAVE RUINED THEIR FAMILY AND THAT THEY HAVE COMMITTED UNPARDONABLE SIN AND INSIST THAT THEY WILL ROT IN HELL FOR THIS. • THE SIN IS USUALLY MASTURBATION OR EXTRAMARITAL SEXUAL INTERCOURSE • DELUSION OF GUILT CAN GIVE RISE TO GRANDIOSE AND PERSECUTORY DELUSIONS • FOUND IN SEVERE DEPRESSION.
  • 83.
    NIHILISTIC DELUSION • PATIENTSDENY THE EXISTENCE OF THEIR BODY,THEIR MIND,THEIR LOVED ONES AND THE WORLD AROUND THEM. • THEY MAY ASSERT THAT THEY HAVE NO MIND, NO INTELLIGENCE, OR THEIR BODY OR PARTS OF BODY DO NOT EXIST • THEY MAY DENY THEIR EXISTENCE AS PERSON OR BELIEVE THEY ARE DEAD OR WHOLE WORLD HAS STOPPED. • FOUND IN SEVERE DEPRESSION, SCHIZOPHRENIA,STATES OF DELIRIUM.
  • 84.
    DELUSION OF POVERTY •THE PATIENT IS CONVINCED THAT HE IS IMPOVERISHED AND BELIEVES THAT DESTITUTION IS FACING HIM AND HIS FAMILY • TYPICAL OF DEPRESSION
  • 85.
    A CLASS OFDELUSIONAL BELIEFS THAT INVOLVES THE MISIDENTIFICATION OF PEOPLE, PLACES, OR OBJECTS DELUSIONAL MISIDENTIFICATION
  • 86.
    A CLASS OFDELUSIONAL BELIEFS THAT INVOLVES THE MISIDENTIFICATION OF PEOPLE, PLACES, OR OBJECTS A RARE VARIANT OF CAPGRAS' SYNDROME INVOLVING A PATIENT'S PERCEIVING THAT AN INDIVIDUAL HAS BEEN TRANSFORMED BOTH PSYCHOLOGICALLY AND PHYSICALLY INTO ANOTHER PERSON. DELUSION OF SUBJECTIVE DOUBLES
  • 87.
    THE PATIENT BELIEVESTHAT SOMEONE CLOSE TO HIM HAS BEEN REPLACED BY AN EXACT DOUBLE CAPGRAS SYNDROME
  • 88.
    THE PATIENT’S OWNSELF IS PERCEIVED AS BEING REPLACED BY A DOUBLE DELUSION OF SUBJECTIVE DOUBLES
  • 89.
    DELUSION OF DISGUISE(FREGOLI’S SYNDROME) A RARE DISORDER IN WHICH A PERSON HOLDS A DELUSIONAL BELIEF THAT DIFFERENT PEOPLE ARE IN FACT A SINGLE PERSON WHO CHANGES APPEARANCE OR IS IN DISGUISE. THE CONDITION IS NAMED AFTER THE ITALIAN QUICK CHANGE ARTIST LEOPOLDO FREGOLI.
  • 90.
    SYNDROME OF INTERMETAMORPHOSIS ARARE VARIANT OF CAPGRAS' SYNDROME INVOLVING A PATIENT'S PERCEIVING THAT AN INDIVIDUAL HAS BEEN TRANSFORMED BOTH PSYCHOLOGICALLY AND PHYSICALLY INTO ANOTHER PERSON.
  • 91.
    COTARD’S SYNDROME/ WALKINGCORPSE SYNDROME INDIVIDUALS REPORT THAT THEY HAVE LOST ALL OF THEIR POSSESSIONS, STATUS AND STRENGTH INCLUDING THEIR ORGANS
  • 92.
    DELUSION OF CONTROL FALSEBELIEF THAT ONE’S WILL,THOUGHT OR FEELINGS ARE BEING CONTROLLED BY EXTERNAL FORCES.
  • 93.
    SHARED DELUSION (FOLIE ADEUX, FOLIE A TROIS, FOLIE A FAMILLE) FALSE BELIEF SHARED COMMONLY AMONG SPOUCES, IN A PARENT AND A CHILD, OR IN CLOSE SIBLINGS (OFTEN SISTERS) WHO HAVE LIVED TOGETHER FOR A LONG TIME
  • 94.
    SHARED DELUSION • FOLIEIMPOSÉE • IT IS WHERE A DOMINANT PERSON (KNOWN AS THE 'PRIMARY', 'INDUCER' OR 'PRINCIPAL') INITIALLY FORMS A DELUSIONAL BELIEF DURING A PSYCHOTIC EPISODE AND IMPOSES IT ON ANOTHER PERSON OR PERSONS (KNOWN AS THE 'SECONDARY', 'ACCEPTOR' OR 'ASSOCIATE'). • THE SECONDARY PERSON MIGHT NOT HAVE BECOME DELUDED IF LEFT ON HIS OR HER OWN. • IF THE PARTIES ARE ADMITTED TO HOSPITAL SEPARATELY, THEN THE DELUSIONS IN THE PERSON WITH THE INDUCED BELIEFS USUALLY RESOLVE WITHOUT THE NEED OF MEDICATION. • FOLIE SIMULTANÉE • IT DESCRIBES EITHER THE SITUATION WHERE TWO PEOPLE CONSIDERED TO SUFFER INDEPENDENTLY FROM PSYCHOSIS INFLUENCE THE CONTENT OF EACH OTHER'S DELUSIONS SO THEY BECOME IDENTICAL OR STRIKINGLY SIMILAR, OR ONE IN WHICH TWO PEOPLE "MORBIDLY PREDISPOSED" TO DELUSIONAL PSYCHOSIS MUTUALLY TRIGGER SYMPTOMS IN EACH OTHER.
  • 95.
    THE REALITY OFDELUSION • NOT ALL PATIENTS WITH DELUSION ACT ON THEIR DELUSIONAL BELIEF. • USUALLY WHEN A DELUSIONAL ILLNESS BECOMES CHRONIC, THERE IS DISCREPANCY BETWEEN THE DELUSIONS AND THE PATIENT’S BEHAVIOUR. • EG - A GRANDIOSE PATIENT MAY SCRUB THE FLOOR. • DELUSIONS OR OVERVALUED IDEAS OF JEALOUSY SEEM TO BE THE MOST DANGEROUS KIND. BECAUSE OVERVALUED AND DELUSION LIKE IDEAS OCCUR IN INTACT PERSONALITY BUT TRUE DELUSIONS OCCUR IN A DISINTEGRATED PERSONALITY. • ACTION IS MORE LIKELY TO BE TAKEN ON THE BASIS OF OVERVALUED IDEAS AND DELUSION LIKE IDEAS THAN ON THE BASIS OF TRUE DELUSIONS.
  • 96.
    DISORDER OF THEFORM OF THINKING FORMAL THOUGHT DISORDERS ARE CHARACTERIZED BY DISTURBANCE IN THE FORM OR FLOW AND CONNECTIVITY OF THOUGHT.
  • 97.
    DISORDER OF THEFORM OF THINKING SCHNEIDER’S 5 FEATURES OF FORMAL THOUGHT DISORDER DERAILMENT THE THOUGHT SLIDES ONTO A SUBSIDIARY THOUGHT SUBSTITUTION A MAJOR THOUGHT IS SUBSTITUTED BY A SUBSIDIARY ONE OMISSION SENSELESS OMISSION OF A THOUGHT OR A PART OF IT
  • 98.
    DISORDER OF THEFORM OF THINKING SCHNEIDER’S 5 FEATURES OF FORMAL THOUGHT DISORDER FUSION HETEROGENOUS ELEMENTS OF THOUGHT ARE INTERWOVEN WITH EACH OTHER DRIVELLING THERE IS A DISORGANISED INTERMIXTURE OF CONSTITUENT PARTS OF ONE COMPLEX THOUGHT
  • 99.
    TANGENTIALITY FORMAL THOUGHT DISORDERS OBLIQUE,DISGRESSIVE, IRRELEVANT MANNER OF SPEECH IN WHICH THE CENTRAL IDEA IS NOT COMMUNICATED AT ALL. CENTRAL IDEA
  • 100.
    FORMAL THOUGHT DISORDERS LOOSENINGOF ASSOCIATION • SCHIZOPHRENIC THINKING OR SPEECH DISTURBANCE INVOLVING A DISORDER OF LOGICAL PROGRESSION OF THOUGHT,MANIFESTED AS A FAILURE TO COMMUNICATE VERBALLY ADEQUATELY. • UNRELATED AND UNCONNECTED IDEAS SHIFT FROM ONE SUBJECT TO ANOTHER. • EG: ‘The traffic is rumbling along the main road. They are going to the north. Why do girls always play pantomime heroes.’ —given by Carl Schneider
  • 101.
    FORMAL THOUGHT DISORDERS CLANGASSOCIATION • IT REFERS TO A SEQUENCE OF THOUGHTS STIMULATED BY THE SOUND OF PRECEDING WORDS RATHER THAN THEIR MEANING. • MANIC PATIENT SAYS “I WILL KILL WITH A DRILL OR A PILL”
  • 102.
    INCOHERENT, ESSENTIALLY INCOMPREHENSIBLEMIXTURE OF WORDS AND PHRASES,USUALLY SEEN IN FAR ADVANCED CASES OF SCHIZOPHRENIA. WORD SALAD ASYNDESIS CAMERON ( 1944) USED THIS TERM TO DESCRIBE THE LACK OF ADEQUATE CONNECTIONS BETWEEN SUCCESSIVE THOUGHTS.
  • 103.
    INABILITY TO NARROWDOWN THE OPERATIONS OF THINKING OVERINCLUSION NEOLOGISM NEW WORD OR PHRASE WHOSE DERIVATION CANNOT BE UNDERSTOOD. SEEN IN SCHIZOPHRENIA
  • 104.
    TRANSITORY THINKING: IT ISCHARACTERIZED BY DERAILMENTS,SUBSTITUTION AND OMISSIONS.THE GRAMMATICAL AND SYNTACTICAL STRUCTURES ARE BOTH DISTURBED IN TRANSITORY THINKING. DRIVELLING THINKING: THE PATIENT HAS A PRELIMINARY OUTLINE OF A COMPLICATED THOUGHT WITH ALL ITS NECESSARY PARTICULARS,BUT LOSES PRELIMINARY ORGANIZATION OF THE THOUGHT SO THAT ALL THE CONSTITUENTS GET MUDDLED TOGETHER. DESULTORY THINKING: IN DESULTORY THINKING,SPEECH IS GRAMMATICALLY CORRECT BUT SUDDEN IDEAS FORCE THEIR WAY IN FROM TIME TO TIME WHICH IF USED AT THE RIGHT TIME WOULD BE QUITE SUITABLE THESE ARE CHARACTERISTICS OF SCHIZOPHRENIA. OBJECTIVE THOUGHT DISORDER
  • 105.
    RECENT ADVANCES • POSITIVECORRELATIONS HAVE BEEN FOUND IN BETWEEN PERFUSION AND THE SEVERITY OF FORMAL THOUGHT DISORDER IN THE LEFT FRONTAL AND LEFT TEMPOROPARIETAL LANGUAGE AREAS. ITS BEEN OBSERVED THAT BILATERAL DEFICITS IN GREY-MATTER VOLUME, POSITIVELY CORRELATES WITH THE SEVERITY OF THOUGHT DISORDER IN TEMPOROPARIETAL AREAS AND OTHER BRAIN REGIONS. • SO, SPECIFIC GREY-MATTER DEFICITS MAY BE A RISK FACTOR FOR STATE-RELATED DYSFUNCTIONS OF THE LEFT-SIDED LANGUAGE SYSTEM, LEADING TO LOCAL HYPERPERFUSION AND FORMAL THOUGHT DISORDER. ~ The British Journal of Psychiatry (2009) 194, 130–138. doi: 10.1192/bjp.bp.107.045633
  • 106.
    RECENT ADVANCES NEUROBIOLOGY OFCREATIVE THINKING THREE-FACTOR MODEL OF THE CREATIVE THINKING (2005 BY ALICE FLAHERTY) • DRAWING FROM EVIDENCE IN BRAIN IMAGING, DRUG STUDIES AND LESION ANALYSIS,THE CREATIVE DRIVE IS SEEN TO BE RESULTING FROM AN INTERACTION OF THE FRONTAL LOBE, TEMPORAL LOBE AND DOPAMINE FROM THE LIMBIC SYSTEM • THE FRONTAL LOBES CAN BE SEEN AS RESPONSIBLE FOR IDEA GENERATION, AND THE TEMPORAL LOBES FOR IDEA EDITING AND EVALUATION. • HIGH ACTIVITY IN THE TEMPORAL LOBE TYPICALLY INHIBITS ACTIVITY IN THE FRONTAL LOBE, AND VICE VERSA. • HIGH DOPAMINE LEVELS INCREASE GENERAL AROUSAL AND GOAL DIRECTED BEHAVIORS AND REDUCE LATENT INHIBITION, AND ALL THREE EFFECTS INCREASE THE DRIVE TO GENERATE IDEAS
  • 107.
    RECENT ADVANCES • THESEVERITY OF POSITIVE FTD WAS INVERSELY CORRELATED WITH THE LEVEL OF ACTIVITY IN THE WERNICKE AREA, A REGION IMPLICATED IN THE PRODUCTION OF COHERENT SPEECH. REDUCED ACTIVITY IN THIS AREA MIGHT CONTRIBUTE TO THE ARTICULATION OF INCOHERENT SPEECH. ~ Arch Gen Psychiatry. 2001;58(8):769-774. doi:10.1001/archpsyc.58.8.769. • THE HLA-A*03 GENE IS SIGNIFICANTLY ASSOCIATED WITH DELUSIONAL DISORDER AS WELL AS WITH PARANOID SCHIZOPHRENIA. THIS HLA GENE ALONE OR IN LINKAGE DISEQUILIBRIUM WITH OTHER HLA GENES OR OTHER CLOSELY LINKED NON-HLA GENES MAY INFLUENCE SUSCEPTIBILITY TO DELUSIONAL DISORDER AND PARANOID SCHIZOPHRENIA. ~ Can J Psychiatry. 2006 May;51(6):342-9.
  • 108.
    “A HUMAN BEINGIS PART OF AWHOLE, CALLED BY USTHE UNIVERSE, A PART LIMITED INTIME AND SPACE. HE EXPERIENCE HIMSELF, HISTHOUGHTSAND FEELING AS SOMETHING SEPARATE FROMTHE REST, A KIND OF OPTICAL DELUSION OF HIS CONSCIOUSNESS. THIS DELUSION IS A KIND OF PRISON FOR US.” ~ ALBERT EINSTEIN “THOSEWHO DO NOT SUFFER FROMTHIS DELUSION HAVE OFTEN BEEN CALLED DELUSIONAL BYTHOSEWHO REALLY ARE” ~ JENNIFER CRUISE
  • 109.