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HUBERT KAIRUKI MEMORIAL UNIVERSITY. DEPARTEMENT OF BEHAVIOURAL SCIENCE. TOPIC: DISORDERS OF THINKING. FACILITATOR: DR. ISAAC LEMA. PRESENTORS: 1. Samha Nassor Hemed 2. Rose Remmy Shundi 3. Muzdalifa Tawakal Kombo 4. Jurnberth Mujuni Mazima 5. Kelvin Harold Mariki 6. Mercy Anyitike Mwakasagule 7. Stephen Timka John 8. Emmanuel Francis Massawe OBJECTIVES At the end of this discussion, you should; • Understand the disorders of stream of thoughts • Understand disorders of the possession of thoughts • Understand disorders of content of thoughts • Understand disorders of form of thoughts. • • • • • Definition of terms Disorder: refers to a state of mental or behavioural ill health. Prepotent: greater power on influence in something. Schizophrenia: is a long term disorder that effects how a person thinks, feels, and behaves. Think: Is the use of one’s mind actively to form connected ideas about someone or something. Sexual deviancy: is the sexual behaviour in which one is diverging from usual or accepted standards or moral sexual behaviour eg homosexuality,rape,prostitution etc CLASSIFICATION OF DISORDER Disorder of thinking Is the disorganized thinking as evidence by disorganized speech. It’s classified into the disorder of control of thinking. In which one can’t control of his thought which may be foreign to him. It is divided into: i. Stream of thought ii. Possession of thought iii. Content of thought iv. Form of thought Disorder of the Stream of Thought It is divided into tempo and continuity a. Disorder of tempo/ Flight for ideas it describes excessive speech at rapid rate that involves casual association between ideas, links of ideas may involves usage of ideas, usage of puns or rhymes. Examples sound of birds chimping. Circumstantially an inability to answer a question with out giving excessive unnecessary details. Its explained as the formal thought disorder result of weakness of judgement and egocentricity. Retardation of thinking It is associated either spontaniously or in response to an internal stimulus from the topic track onto another which is obliquely related or unrelated. Disorder of continuity of thinking. Are disorders which do not change or stop as time passes Types of Disorders of Continuity 1. Disorder of perseveration 2. Disorder of blocking Disorder of Perseverations This is a repetition of particular response such as a word, phrase or gesture despite the absence or cessation of a stimulus. b. This situation arise from a failure of the to either inhibit prepotent response of allow its usual progress to different behaviour and includes impairment in set shifting and task switching in social and other context. Eg. During conservation, if any issue has been fully explored and discussed to a point of resolution, it is not uncommon for something to trigger the reinvestigation of the matter. It can happen at any time during conservation. It occurs due to BRAIN TRAUMA, INJURY OR DAMAGE. Symptoms can be; lacking ability to transition or switch ideas appropriately with the social context. Disorder of blocking. This is the arrest of train of thought. It occurs when a person’s speech is suddenly interrupted by silence that may last seconds to a minute or longer. It is normally brought on by discussing or questioning something of particular large personal significance and when the person begins speaking again after the block they will often speak about a subject unrelated to what was being discussed when blocking occurred. Disorders of the possession of thought i. Obsession and compulsion Obsession: recent persistent thought impulse or image that enter the mind despite the person’s efforts to exclude them. For example there are obsession of: Thoughts, Rumination, Doubts, Impulses. Compulsions are repetitive impulse or cognitive acts which are used to control anxiety secondary to obsessions. Most common are; Cleaning, Counting, Checking locks. There are five truth about obsessive compulsive disorder. a. Obsession are not just worries they are more than that. Eg when you stand with OCD suffer near the train way she/he can push you toward on coming train Compulsive habits can be subtle* Eg Counting loud, washing out hands until they bleed, cleaning in the kitchen over and over again *Subtle means so delicate or precise as to be difficult to analyze or describe b. c. Not all suffers have compulsive habits related to cleanless or organisation. Others are self harm, violence, and sexual deviency. d. e. Obsessive compulsive disorder is more common. For example according to the research done, 2.3% of american population is affected by obsessive compulsive disorder. Adults population suffers/experience either obsessive or compulsion at some point in their lives Obsessive compulsive disorder does not have a cure, it can only be treated effectively No medication or therapy that can cure OCD however its highly treatable. Include exposure and response therapy mindfulness. It allows the suffer to overcomes their unwanted thoughts by exposing them to situation and objects that triggers such thoughts. It trains them to be open and accepting of their unwanted thoughts despite the discomfort that it cause ii. Thought allienation a. Thought insertion; delusion that some thought has been implanted by outside agency. b. Thought withdraw; delusion that thoughts have taken out of his/her mind (may explain/accompany thought block). c. Thought broadcast; delusion that his unspoken thoughts are known to other people (others are participating in their thinking). Disorder of content of thinking. Delusion is commonly defined as a false belief and is used in everyday language to describe a belief that is either false, fanciful or derived from deception. Also, according to Carl Jaspers, A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despites incontrovertible and obvious proof or evidence to the contrary. Jaspers described 4 types of primary delusion: i. Delusional intuition, where delusions arrive “out of blue” without external cause. ii. Delusional perception, where a normal percept is interpreted with delusional meaning. Eg, a person sees a red car and knows that this means their food is being poisoned by the police. Delusional memory, where a delusional belief is based upon the recall of memory or false memory for a part experience. Eg, a man recalls seeing a woman laughing at a bus stop several weeks ago and now realizes that this person has laughing because the man has animals living inside him. iv. Delusional atmosphere, where the world seems subtry altered, uncanny, portentous or sinister. This resolves into delusion usually in a revelatory fashion which seems to explain the unusual feeling of anticipation. iii. Secondary Delusions. Sometime called delusion like ideas. Are considered to be at least in principle, understandable in the context of a persons life history, personality, mood state or presence of others. Psychopathology eg, a person becomes depressed, suffers very low mood and self esteem and subsequently believes they are responsible for some terrible crime which they did not commit. Categories of Delusion Delusions are categorized into four different groups i. Bizarre delusion: Such delusions are deemed bizarre. If they are clearly impossible and not understandable to some culture peers and do not derive from ordinary life experience. Example; Named DSM-5 is a belief that someone replaced all of ones of internal organs with someone else’s without leaving near. They are false and not possible. ii. iii. Non-Bizzare delusion: a delusion that though false at least is possible. Example, the affected person’s mistakenly believes that he is under constant police surveillance. Mood- congruent delusion: any delusion with content consistence with either depressive or manic state. Example. A depressive person of him or a person in manic state believe she is a powerful deity. iv. Mood- vevtoal delusion: a delusion that does not relate to the suffer’s emptional state. For example, a beliefe that an exra lin is growing out of the back of one’ss head is neutral to either depression or manic. Themes/Contents of Delusion In addition to their categories, delusion often manifest according to constitent theme. Some common delusion themes are: Delusion of control- False belief that another person of group of people controls one’s general thoughts, feelings, impulses or behaviour Cotard delusion- False belief that one does not exist or has died Delusion of jelousy- False belief that a spouse or lover is having an affair with no proof to backup their claim Delusion of thought insertion- Belief that another thinks through the mind of the person Delusion of reference- False belief that insignificant remarks events or objects in ones environment have personal meaning or significant Erotomania- False belief that another person is in love with them. Disorders of form of thinking Also known as formal thought disorder (FTD). It is a synonym for disorders of conceptual or abstract thinking which occur in schizophrenia (psychosis) and in coarse brain disease. According to Cameron, symptoms of FTD were grouped into incoordination, interpenetration, fragmentation and overiconclusion. Schizophrenia FTD can be: Negative; where by a patient lost his previous ability to think but do not produce any unusual concepts. Positive; where by a patient produces false concepts by blending together incongruous elements. Bleuler regarded schizophrenia as disorder of association (lack of connection between associations). He believed that the results of schizophrenia were due to: Condensation of symbols; 2 ideas with something in common are blended in false concept) Displacement of symbol; one idea is used for an associated idea Misuse of symbols; using concrete aspects of the symbol instead of symbolic meaning. Schneider claimed that the features of FTD could be • Derailment, where by thoughts slides on to a subsidiary thought. • Substitution, a major thought is substituted by a subsidiary one. • Omission, which consists in the senseless omission or part of it. • Fusion, heterogeneous elements of thoughts are interwoven with each other. • Drivelling, there is disorder intermixture of constituent parts of one complex thought. Schneider also suggested 3 features of healthy thinking which are: a. Constancy: This is the characteristic persistence of a completed thought whether or not it is simple or complicated in its contents. b. Organization: The contents of thought are related to each other in consciousness and do not blend with each other, but are separated in an organized way. c. Continuity: There is a continuity of the sense continuum. So that even the most heterogeneous subsidiary thoughts, sudden ideas or observations which emerge are arranged in order on the whole content of consciousness. SUMMARY AND CONCLUSION The thought disorder concept has been criticized as being based on circular or incoherent definition. Circular- Speech that brings or convey meaning to listens. Incoherent- The speech that is unconnected and conveys no meaning to the listener. RECOMENDATION Individuals with autism spectrum disorder show/ display language disturbances. Children and Adolence with autism specrum show significantly more illogical thinking and loose associations than control subjects, where, Illogical thinking is related to cognitive functioning and executive control. Loose association is related to communication symptoms in adults is related to stress and axiety. REFERENCES • A.C.P. Sims & W.I.Hume lecture notes on behavioural science. • Fish’s Clinical Psychopathology • Oxford english dictionary (11th edition) • www.wikipedia/thoughtdisorders.com