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Derailment (thought disorder)

Thought disorder in psychiatry

Thought disorder in psychiatry

In psychiatry, derailment (aka loosening of association, asyndesis, asyndetic thinking, knight's move thinking, entgleisen, disorganised thinking) categorises any speech comprising sequences of unrelated or barely related ideas; the topic often changes from one sentence to another.

Disorder

In a mild manifestation, this thought disorder is characterized by slippage of ideas further and further from the point of a discussion. Derailment can often be manifestly caused by intense emotions such as euphoria or hysteria. Some of the synonyms given above (loosening of association, asyndetic thinking) are used by some authors to refer just to a loss of goal: discourse that sets off on a particular idea, wanders off and never returns to it. A related term is tangentiality—it refers to off-the-point, oblique or irrelevant answers given to questions.

Examples

  • "The next day when I'd be going out you know, I took control, like uh, I put bleach on my hair in California."—given by Nancy C. Andreasen
  • "I think someone's infiltrated my copies of the cases. We've got to case the joint. I don't believe in joints, but they do hold your body together."—given by Elyn Saks.

History

Entgleisen (derailment in German) was first used with this meaning by Carl Schneider in 1930. The phrase knight's move thinking was first used in the context of pathological thinking by the psychologist Peter McKellar in 1957, who hypothesized that individuals with schizophrenia fail to suppress divergent associations. Derailment was used with this meaning by Kurt Schneider in 1959.

References

References

  1. [[World Health Organization]] (2023). "{{ICD11. MB25.02. 1746204479 Disorganised thinking". ''[[International Classification of Diseases]], eleventh revision – ICD-11''. Genova – [https://icd.who.int icd.who.int].
  2. P.J. McKenna. (1997). "Schizophrenia and related syndromes". Psychology Press.
  3. A.C.P. Sims, ''Symptoms in the mind: an introduction to descriptive psychopathology'', Edition 3, Elsevier Health Sciences, 2003, {{ISBN. 0-7020-2627-1, pp. 155-156
  4. 0-566-07961-5, p. 81
  5. Richard Courtney, ''Drama and intelligence: a cognitive theory'', McGill-Queen's Press, 1990, {{ISBN. 0-7735-0766-3, p. 128
  6. (November 1979). "Thought, Language, and Communication Disorders: I. Clinical Assessment, Definition of Terms, and Evaluation of Their Reliability". Archives of General Psychiatry.
  7. (29 June 2012). "A tale of mental illness -- from the inside".
  8. 0-7020-2449-X, pp. 136, 168-170
  9. Robert Spillane, John Martin, ''Personality and performance: foundations for managerial psychology'', UNSW Press, 2005 {{ISBN. 0-86840-816-6, pp. 239-243
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