Nancy Andreasen’s 18 Thought Disorders

Thought psychopathology includes two types of thought disorders: formal disorders (which we will talk about today) and content disorders (the famous delusions). The first to speak of formal disorders of thought was Bleuler (1911), alluding to the “disorder of associations” to explain the absence of relationships between ideas that should be associated. According to him, this was a central characteristic of schizophrenic thinking.

Later, other authors came: Carl Schneider (1942), who spoke of “schizophrenic thinking,” and which was characterized by a series of distinctive elements. On the other hand, another author, Fish differentiated disorders of reasoning (formal disorders) from disorders of beliefs (content disorders).. The first referred to HOW we speak and the second to WHAT we say.

Today we will talk about 18 (formal) thought disorders, along with examples of some of them, proposed by Nancy Andreasen (1979). Andreasen is a renowned American neuroscientist and neuropsychiatrist, Chair of Psychiatry at the University of Iowa (USA). Through these disorders, Andreasen developed the famous “Thought Disorders Scale” to evaluate all these symptoms..

18 thought disorders

The neuropsychiatrist Nancy Andreasen (1979) developed a list of thought disorders (so-called formal disorders). These disorders affect the patient’s speech and language. and the author evaluates them through her scale (widely known and used), called “Thought Disorders Scale.” Let’s see what these disorders are:

Poverty of speech or laconic speech

It is a speech composed of monosyllabic responses. Thus, when faced with any question, the subject only answers us with answers of the following type: “yes, no, it depends, maybe, well, okay” etc.

Poverty of speech content

Another thought disorder is poverty of speech content. It is also called alogia or negative formal thought disorder. The language becomes vague, repetitive, stereotyped, It offers little information, the answers are long but empty (they do not contain anything), etc.

An example of this, taken from Andreasen (1979), would be when asked the question “How are you?”, the person responds: “The truth is that I would like you to know how I feel, lately this state of mind has been more and more repeated.” that I am never able to overcome. I don’t know what you think, but I wish you really knew how I feel. I don’t know how long I’ve been like this, the only thing I know is that it’s been a long time.”

speech pressure

Also called rushed speech or logorrhea, this thought disorder consists of rapid speech that is difficult to interrupt. For example, we ask the person: “How are you?”, and they respond: “How are you?” Life in general is good… I wanted to tell you how wonderfully I feel since… Do you know that I am Leticia’s family…? Any time spent in our life is summarized in… ”. And all this quickly and hastily.

Distracted speech

Distracted speech is also called divergent speech. The interlocutor changes the topic in response to immediate stimuli, that is, he is extremely easily distracted. She may be talking about something and suddenly change the subject radically because of something she just saw or heard.

Tangentiality

Tangentiality implies oblique, tangential or irrelevant responses to questions posed immediately before. An example of this disorder, also taken from Andreasen (1979), would be when asked “How old are you?”, the person answers “as many as the pyramids that are disintegrating.”

Another example, this time from Saranson and Saranson (1975), would be: when asked “Where do you live?”, the subject responds “I exist in the world, from the world to the world and through the world.”

Derailment

The next thought disorder is derailment, also called flight of ideas. it implies a loss of association between the ideas and the comments issued. There is a lack of proper connection between the sentences; That is, the sentences are syntactically correct, but they are disjointed from each other.

Incoherence

Incoherence, also called word salad, schizoaphasia, or paragrammatism, involves a lack of proper connection between words. That is to say, The sentences don’t make sense.

Illegality

There is no logic in the person’s speech. An example of this disorder, taken from Castilla del Pino (1980), would be “Today you are an apple… I find you very healthy“. That is to say, it is a confusing and meaningless speech.

Resonances

It involves selecting the words of speech solely based on their sound. That is, those that sound good together. An example (Castilla del Pino, 1980) would be: “Tábano, tobacco, tabaso.” That is, the speech does not make sense, because the words are chosen only for this criterion.

Neologisms

It consists of the invention of words. Thus, the person creates words that do not exist, for example: “Mamérica, nacos, opecu, maustralia” (Castilla del Pino, 1980).

Approximations to words

Word approximations, another thought disorder, involves unconventional use of words. It can also consist of the creation of pseudowords.

Circumstantiality

It involves including tedious details in the speech. That is to say, the speech is full of details that are really irrelevant; In this way, speech for an objective is indirect.

Loss of goal

Goal loss results in a failure to follow the chain of thought to its conclusion. The person starts to talk but loses the goal or objective they want to reach (they move away from it).

Perseveration

In perseveration, the same words are persistently repeated, phrases, ideas or comments. An example of this would be: when asked “How are you?”, the person answers “The only thing I want you to know is that I am innocent” (and to the next question, even if it is on a different topic, they answer exactly the same).

Echolalia

Echolalia, a typical disorder in people with autism, consists of echoing words or phrases previously heard (immediately). If what was heard has been heard for a long time, and is repeated, we speak of a delayed echolalia.

Blocking

Another thought disorder, blocking, involves an interruption of speech before completing a thought or an idea. So, after a brief silence, the person points out that he doesn’t know what he was going to say or what he was talking about.

Affected speech

Affected speech is pompous, distant and excessively cultured speech. Also called elation. An example of this disorder would be: “Well, that’s not true, Mercedes. What more would I like to be able to offer you, this fatuous night in the company of such a select audience.” It is typical of schizophrenia and some personality disorders.

Self-reference

Finally, another of the thought disorders according to Andreasen (1979) is self-reference. The person who suffers from it carries the topic always towards herself, although it is a neutral topic. An example of this, taken from Andreasen (1975), would be: when asked “What time is it?”, the person answers “Seven o’clock, that’s my problem, I never know what time it is.”

We have seen 18 thought disorders, although there are others (not included in the Andreasen Scale). Many of those listed are part of some pathologies, such as schizophrenia., or different mood disorders, such as depression. Its rigorous evaluation will allow us to delve into the patient’s profile and better understand their symptoms.

You might be interested…