What Is a Thought Disorder?

A thought disorder involves a disturbance in how thoughts are organized and expressed. It causes disorganized thinking and leads to people expressing themselves in unusual ways when speaking or writing.

Formal thought disorder is also known as disorganized speech. It is marked by disruption to the structure or form of thought. It is one of the key symptoms of schizophrenia and psychotic disorders. Because these symptoms can be observed, they can be used to help assess the severity of psychosis.

Thinking requires the ability to organize thoughts mentally and then express them in an understandable way. A thought disorder can create problems with any or all of these areas.

Symptoms of a Thought Disorder

While thought disorders are characterized by problems with thought and language, those symptoms are not enough on their own for a diagnosis. This is because such symptoms can also occur temporarily when people are over-stressed or over-tired. 

These symptoms can become indicative of a thought disorder depending on their frequency, severity, and the impairment that they cause. Symptoms associated with a thought disorder can include:

• An inability to stay on topic
• Lack of speech
• Rapid, pressured speech
• Incoherence
• Illogical speech
• Wandering train of thought

Other symptoms that can be associated with thought disorders include delusions, hallucinations, poor judgment, changes in movement, irritability, lack of emotion, lack of expression, and paranoia.

How Are Thought Disorders Identified?

While knowing the signs of a thought disorder can help you understand when to seek help, it's important to remember that these conditions can only be diagnosed by a healthcare professional. A diagnosis usually involves asking people open-ended questions and assessing their verbal responses. 

Several assessment tools can be utilized to measure thought disorders, including:

• The Rorschach inkblot test: The Rorschach inkblot test is a projective test in which people are shown a series of ambiguous inkblots. Mental health professionals can then use a scoring system when interpreting verbal responses to the inkblots to look for signs of disordered thinking.
• The Thought Disorder Index (TDI): This assessment involves a health professional recording and then trancribing a conversation with the individual. The TDI (also known as the Delta index) is then used to evaluate the exchange, including 23 different areas that may indicate a thought disturbance.
• Scale for the Assessment of Thought, Language, and Communication (TLC): One of the most widely used thought disorder assessments. It involves making observations and giving them a severity rating based on definitions of different aspects of thought disorders.

Many medical conditions can also impact verbal and written language performance. These may include:

• Autism spectrum disorder
• Attention deficit hyperactivity disorder (ADHD)
• Endocrine disorders
• Hearing loss
• Infections
• Intellectual disabilities
• Metabolic disorders
• Substance use
• Traumatic brain injury
• Vitamin deficiencies

Before diagnosing a thought disorder, a doctor will need to rule out underlying medical factors that might be causing a person's symptoms. In addition to evaluating the individual’s speech, a doctor may also give the individual a physical exam and conduct lab tests to look at overall health and check for other medical conditions.

Language abnormalities are common in everyday speech and often result from stress and lack of sleep. Johns Hopkins Medicine notes that the severity and frequency of symptoms are important factors to consider when making a diagnosis.

What Causes a Thought Disorder?

The exact causes of thought disorders are not known. However, it is believed that a number of variables may play a contributing role including genetics, brain abnormalities, and environmental factors.

Disorganized thought can be seen in a number of mental health conditions, including schizophrenia. In the case of schizophrenia, some research has suggested that the condition is linked to abnormalities in the brain's semantic system.

Types of Thought Disorders

Each type of thought disorder has its own set of symptoms that interfere with the thought process. However, in each case, there is a disruption to the organization and expression of ideas and thoughts. 

Some of the many different types of thought disorders include:

• Alogia: This thought disorder is characterized by poverty of speech and is commonly seen in people with schizophrenia or dementia. Responses are often abrupt and incomplete. 
• Blocking: People with thought disorders may stop speaking mid-sentence and pause for an extended period. When they resume speaking, it is often on an entirely different topic.
• Circumstantial thinking: This type of disorganized thinking involves including a lot of unnecessary detail that is often indirect or even unrelated to the main point of the conversation.
• Clanging: This involves using words based on their sounds rather than their meaning. This includes rhyming words or puns.
• Echolalia: This involves repeating back the speech of other speakers. They may often repeat sounds or words that they hear from others.
• Neologism: This involves coining new words spontaneously. These words are meaningless and unrecognizable but incorporated into speech.
• Tangentiality: This type of disordered thought involves moving from one idea to another. The ideas are connected superficially but never get to the main point.
• Word salad: This involves a mixture of random words and phrases that are unintelligible. 
  

Treatment for Thought Disorders

Having a thought disorder can be disruptive, but there are treatments that can help people manage the symptoms. Some treatment strategies that may be used are discussed below.

Psychotherapy

Therapy may be useful for helping people who are also experiencing symptoms of delusional or distorted thoughts. Types of therapy that might be utilized depending on the individual's symptoms include:

• Cognitive-behavioral therapy (CBT) can help people identify and change distorted thoughts.
• Family therapy can help families learn what they can do to support their loved one who has a thought disorder.
• Group therapy can be a useful treatment for practicing skills and finding support.

Medications

Medications may sometimes be prescribed to help treat symptoms associated with schizophrenia or psychotic disorders. Such medications may include antipsychotics, antidepressants, and mood stabilizers.

Tips for Coping With a Thought Disorder

Professional treatment is needed to manage thought disorder associated with conditions like schizophrenia. In addition to therapy and medications, people with thought disorders can also benefit from life skills training and social support:

• Social skills training: Because problems with disorganized thinking affect communication, it can create relationship challenges. Learning and practicing social skills can help people with thought disorders find ways to improve their communication abilities in ways that benefit their relationships.
• Social support: Social support is also essential for people with disorders that impact thought organization. Family therapy and support groups may be helpful for both people with this condition and their family members and other loved ones.
• Stress management: Relaxation techniques may also be helpful since stress can sometimes worsen the symptoms of conditions such as schizophrenia. 

Takeaways

If you are experiencing symptoms of a thought disorder that are affecting your ability to communicate, you should talk to your doctor. They can evaluate your symptoms and make a diagnosis. Getting the right diagnosis is the best way to ensure that you receive an appropriate treatment that can help you manage the symptoms that you are experiencing.