Table of ContentsView AllTable of ContentsCausesThought Content vs. Thought ProcessTypesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes
Thought Content vs. Thought Process
Types
Diagnosis
Treatment
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Thinking refers to our ability to make decisions, solve problems, reason, and remember. In a broader sense, thinking is the totality of experiences in one’s mind.
People withschizophreniahave trouble keeping their thoughts straight and expressing them. Disorganized thinking is one of the primarysymptoms of schizophrenia.
Disorganized thinking can lead to various thought process disorders that cause tangential thought, disjointed thoughts, a collapse or sudden stop in the thought process, randomly spoken words, and incoherence.
Typically, we process our thoughts logically and coherently. However, this process is disrupted in those with schizophrenia, leading to disorganized thought and disordered speech.
Causes of Disorganized Thinking
Thoughts, emotions, sensations, memories, and fantasies are the essential building blocks of the way the brain functions. Any disruption in the thought process—the way these blocks are linked—will affect certain areas of life.
Positive Symptoms in Schizophrenia
It makes sense to try to understand disorganized thinking from two perspectives: thought content and thought process.While changes in someone’s thought content affect what they perceive or think about, changes in thought process impact the way they form their ideas and express them.
Thought Content AbnormalitiesAuditoryhallucinations(hearing sounds not based in reality)Delusions(fixed sets of ideas that are at odds with reality)Depersonalization or derealizationGrandiosityThought Process AbnormalitiesCircumstantial thinkingClang associationsDerailmentDistractibilityTangential thinkingWord salad (incoherence)
Thought Content AbnormalitiesAuditoryhallucinations(hearing sounds not based in reality)Delusions(fixed sets of ideas that are at odds with reality)Depersonalization or derealizationGrandiosity
Auditoryhallucinations(hearing sounds not based in reality)
Delusions(fixed sets of ideas that are at odds with reality)
Depersonalization or derealization
Grandiosity
Thought Process AbnormalitiesCircumstantial thinkingClang associationsDerailmentDistractibilityTangential thinkingWord salad (incoherence)
Circumstantial thinking
Clang associations
Derailment
Distractibility
Tangential thinking
Word salad (incoherence)
Types of Disorganized Thinking
Here’s a more in-depth look at those thought process abnormalities.
Circumstantial Thinking
Circumstantial thinking occurs when a person talks in circles, providing excessive and unnecessary detail before getting to the point.
One Classic ExampleHere’s an example from neuroscientist and neuropsychiatrist researcher Nancy Coover Andreasen:Question: “What is your name?“Response: “Well, sometimes when people ask me, I have to think about whether or not I will answer because some people think it’s an odd name even though I don’t really because my mom gave it to me and I think my dad helped but it’s as good a name as any in my opinion, but yeah it’s Tom.”
One Classic Example
Here’s an example from neuroscientist and neuropsychiatrist researcher Nancy Coover Andreasen:Question: “What is your name?“Response: “Well, sometimes when people ask me, I have to think about whether or not I will answer because some people think it’s an odd name even though I don’t really because my mom gave it to me and I think my dad helped but it’s as good a name as any in my opinion, but yeah it’s Tom.”
Here’s an example from neuroscientist and neuropsychiatrist researcher Nancy Coover Andreasen:
Tangential Thinking
Tangential thinking occurs when someone moves from thought to thought but never seems to get to the main point. Instead, the thoughts are somewhat connected but in a superficial or tangential way.
Derailment or Loose Associations
In cases of severely disordered thinking, thoughts lose almost all connections with one another and become disconnected and disjointed.This illogical thinking is called derailment or “loose” associations.
Clang Associations
Clanging is when the individual chooses words based on sound (rhyming or pun associations) rather than meaning. They may also use made-up words or neologisms and may speak in a flat- or unusual-sounding voice.
Clang Association in Bipolar Disorder and Schizophrenia
Incoherence
People with very severe disordered thinking may experience incoherence, where there are no discernible connections between words. This incoherence (also known as “word salad”) makes it impossible to understand the individual’s thought process.
The fifth edition of theDiagnostic and Statistical Manual of Mental Disordersincludes criteria to help your doctor diagnose schizophrenia.Your doctor will look for typical symptoms of the condition, like disordered speech, delusions, hallucinations, disorganized or catatonic behavior, and reduced emotional expression.
Your doctor will also need to rule out other conditions that can affect thought processes, like:
Treatment for Disorganized Thinking
Treatmentfor thought process abnormalities in schizophrenia often includes medication, psychotherapy, life skills training, and family support.
Medication
The right medication can help to reduce disordered thinking and improve functioning. This may include antidepressants, mood stabilizers, or anti-anxiety medication alongside antipsychotics for long term management of the symptoms of schizophrenia.
Psychotherapy
Talk therapy, includingcognitive behavioral therapy (CBT), can help you better identify thought process abnormalities and find ways to cope with unusual or dysfunctional ways of thinking.
Social Skills Training
An inability to clearly communicate your thoughts and feelings can take a toll on your family, social life, and work relationships.Social skills trainingcan help you improve communication with others to better navigate these relationships.
Family Support
Family members are often crucial providers of care for someone with schizophrenia.Family therapymay help ensure that you and your loved ones understand your condition and feel supported.
RecapTreatment for thought process problems depends on the root cause. In many cases, medication, psychotherapy, skill training, and family support are part of a treatment plan.
Recap
Treatment for thought process problems depends on the root cause. In many cases, medication, psychotherapy, skill training, and family support are part of a treatment plan.
The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.
The Takeaway
Disorganized thinking can be difficult to deal with, but with the help of a healthcare provider and the people close to you, you can make great strides and find strategies that work for you.
Learning more about the symptoms of schizophrenia can help with this process, as can joining an in-person or online support group. Finding support can provide an outlet to express your emotions and help you develop strategies to communicate your thoughts.
Living With Schizophrenia
12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hart M, Lewine RR.Rethinking thought disorder.Schizophr Bull. 2017;43(3):514-522. doi:10.1093/schbul/sbx003Wensing T, Cieslik EC, Müller VI, Hoffstaedter F, Eickhoff SB, Nickl‐Jockschat T.Neural correlates of formal thought disorder: An activation likelihood estimation meta‐analysis.Hum Brain Mapp. 2017;38(10):4946-4965. doi:10.1002/hbm.23706Hinzen W, Rosselló J.The linguistics of schizophrenia: Thought disturbance as language pathology across positive symptoms.Front Psychol. 2015;6:971. doi:10.3389/fpsyg.2015.00971Sass L, Parnas J.Thought disorder, subjectivity, and the self.Schizophr Bull. 2017;43(3):497-502. doi:10.1093/schbul/sbx032Andreasen NC.Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability.Arch Gen Psychiatry. 1979;36(12):1315-21. doi:10.1001/archpsyc.1979.01780120045006Kuperberg GR.Language in schizophrenia Part 1: an Introduction.Lang Linguist Compass. 2010;4(8):576-589. doi:10.1111/j.1749-818X.2010.00216.xAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013. doi:10.1176/appi.books.9780890425596Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T. 2014;39(9):638-645.Chen X, Long F, Cai B, Chen X, Chen G.A novel relationship for schizophrenia, bipolar and major depressive disorder Part 5: a hint from chromosome 5 high density association screen.Am J Transl Res. 2017;9(5):2473-2491.Stepnicki P, Kondej M, Kaczor AA.Current concepts and treatments of schizophrenia.Molecules. 2018;23(8). doi:10.3390/molecules23082087Almerie MQ, Okba Al Marhi M, Jawoosh M, et al.Social skills programmes for schizophrenia.Cochrane Database Syst Rev. 2015;(6):CD009006. doi:10.1002/14651858.CD009006.pub2Caqueo-Urízar A, Rus-Calafell M, Urzúa A, Escudero J, Gutiérrez-Maldonado J.The role of family therapy in the management of schizophrenia: Challenges and solutions.Neuropsychiatr Dis Treat. 2015;11:145-151. doi:10.2147/NDT.S51331
12 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hart M, Lewine RR.Rethinking thought disorder.Schizophr Bull. 2017;43(3):514-522. doi:10.1093/schbul/sbx003Wensing T, Cieslik EC, Müller VI, Hoffstaedter F, Eickhoff SB, Nickl‐Jockschat T.Neural correlates of formal thought disorder: An activation likelihood estimation meta‐analysis.Hum Brain Mapp. 2017;38(10):4946-4965. doi:10.1002/hbm.23706Hinzen W, Rosselló J.The linguistics of schizophrenia: Thought disturbance as language pathology across positive symptoms.Front Psychol. 2015;6:971. doi:10.3389/fpsyg.2015.00971Sass L, Parnas J.Thought disorder, subjectivity, and the self.Schizophr Bull. 2017;43(3):497-502. doi:10.1093/schbul/sbx032Andreasen NC.Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability.Arch Gen Psychiatry. 1979;36(12):1315-21. doi:10.1001/archpsyc.1979.01780120045006Kuperberg GR.Language in schizophrenia Part 1: an Introduction.Lang Linguist Compass. 2010;4(8):576-589. doi:10.1111/j.1749-818X.2010.00216.xAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013. doi:10.1176/appi.books.9780890425596Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T. 2014;39(9):638-645.Chen X, Long F, Cai B, Chen X, Chen G.A novel relationship for schizophrenia, bipolar and major depressive disorder Part 5: a hint from chromosome 5 high density association screen.Am J Transl Res. 2017;9(5):2473-2491.Stepnicki P, Kondej M, Kaczor AA.Current concepts and treatments of schizophrenia.Molecules. 2018;23(8). doi:10.3390/molecules23082087Almerie MQ, Okba Al Marhi M, Jawoosh M, et al.Social skills programmes for schizophrenia.Cochrane Database Syst Rev. 2015;(6):CD009006. doi:10.1002/14651858.CD009006.pub2Caqueo-Urízar A, Rus-Calafell M, Urzúa A, Escudero J, Gutiérrez-Maldonado J.The role of family therapy in the management of schizophrenia: Challenges and solutions.Neuropsychiatr Dis Treat. 2015;11:145-151. doi:10.2147/NDT.S51331
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hart M, Lewine RR.Rethinking thought disorder.Schizophr Bull. 2017;43(3):514-522. doi:10.1093/schbul/sbx003Wensing T, Cieslik EC, Müller VI, Hoffstaedter F, Eickhoff SB, Nickl‐Jockschat T.Neural correlates of formal thought disorder: An activation likelihood estimation meta‐analysis.Hum Brain Mapp. 2017;38(10):4946-4965. doi:10.1002/hbm.23706Hinzen W, Rosselló J.The linguistics of schizophrenia: Thought disturbance as language pathology across positive symptoms.Front Psychol. 2015;6:971. doi:10.3389/fpsyg.2015.00971Sass L, Parnas J.Thought disorder, subjectivity, and the self.Schizophr Bull. 2017;43(3):497-502. doi:10.1093/schbul/sbx032Andreasen NC.Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability.Arch Gen Psychiatry. 1979;36(12):1315-21. doi:10.1001/archpsyc.1979.01780120045006Kuperberg GR.Language in schizophrenia Part 1: an Introduction.Lang Linguist Compass. 2010;4(8):576-589. doi:10.1111/j.1749-818X.2010.00216.xAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013. doi:10.1176/appi.books.9780890425596Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T. 2014;39(9):638-645.Chen X, Long F, Cai B, Chen X, Chen G.A novel relationship for schizophrenia, bipolar and major depressive disorder Part 5: a hint from chromosome 5 high density association screen.Am J Transl Res. 2017;9(5):2473-2491.Stepnicki P, Kondej M, Kaczor AA.Current concepts and treatments of schizophrenia.Molecules. 2018;23(8). doi:10.3390/molecules23082087Almerie MQ, Okba Al Marhi M, Jawoosh M, et al.Social skills programmes for schizophrenia.Cochrane Database Syst Rev. 2015;(6):CD009006. doi:10.1002/14651858.CD009006.pub2Caqueo-Urízar A, Rus-Calafell M, Urzúa A, Escudero J, Gutiérrez-Maldonado J.The role of family therapy in the management of schizophrenia: Challenges and solutions.Neuropsychiatr Dis Treat. 2015;11:145-151. doi:10.2147/NDT.S51331
Hart M, Lewine RR.Rethinking thought disorder.Schizophr Bull. 2017;43(3):514-522. doi:10.1093/schbul/sbx003
Wensing T, Cieslik EC, Müller VI, Hoffstaedter F, Eickhoff SB, Nickl‐Jockschat T.Neural correlates of formal thought disorder: An activation likelihood estimation meta‐analysis.Hum Brain Mapp. 2017;38(10):4946-4965. doi:10.1002/hbm.23706
Hinzen W, Rosselló J.The linguistics of schizophrenia: Thought disturbance as language pathology across positive symptoms.Front Psychol. 2015;6:971. doi:10.3389/fpsyg.2015.00971
Sass L, Parnas J.Thought disorder, subjectivity, and the self.Schizophr Bull. 2017;43(3):497-502. doi:10.1093/schbul/sbx032
Andreasen NC.Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability.Arch Gen Psychiatry. 1979;36(12):1315-21. doi:10.1001/archpsyc.1979.01780120045006
Kuperberg GR.Language in schizophrenia Part 1: an Introduction.Lang Linguist Compass. 2010;4(8):576-589. doi:10.1111/j.1749-818X.2010.00216.x
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013. doi:10.1176/appi.books.9780890425596
Patel KR, Cherian J, Gohil K, Atkinson D.Schizophrenia: Overview and treatment options.P T. 2014;39(9):638-645.
Chen X, Long F, Cai B, Chen X, Chen G.A novel relationship for schizophrenia, bipolar and major depressive disorder Part 5: a hint from chromosome 5 high density association screen.Am J Transl Res. 2017;9(5):2473-2491.
Stepnicki P, Kondej M, Kaczor AA.Current concepts and treatments of schizophrenia.Molecules. 2018;23(8). doi:10.3390/molecules23082087
Almerie MQ, Okba Al Marhi M, Jawoosh M, et al.Social skills programmes for schizophrenia.Cochrane Database Syst Rev. 2015;(6):CD009006. doi:10.1002/14651858.CD009006.pub2
Caqueo-Urízar A, Rus-Calafell M, Urzúa A, Escudero J, Gutiérrez-Maldonado J.The role of family therapy in the management of schizophrenia: Challenges and solutions.Neuropsychiatr Dis Treat. 2015;11:145-151. doi:10.2147/NDT.S51331
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