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Disorders of thought processes. What are the types of thinking disorders? Thinking disorder: causes, symptoms, classification

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Thinking is one of the highest mental functions, a generalized form of perception and reflection of cognizable objects. The thinking process occurs as a result of the reaction of the cerebral cortex to external stimuli. In mental disorders caused by certain diseases, there is a disturbance in thinking, expressed in various forms. Signs of such disorders require mandatory consultation with a psychiatrist.

There are the following types of thinking disorders:

  • Disturbances in the dynamics of thinking.
  • Violations of the operational side of thinking.
  • Disturbances in the motivational component of thinking.

The following manifestations are characteristic of disturbances in the dynamics of thinking:

Leap of ideas or acceleration of thinking

The thinking disorder occurs in the form of a continuous flow of associations and verbal expression. The thought process and speech are constantly jumping, they are incoherent. Associations, images and conclusions arise spontaneously, they are superficial and can be caused by any stimulus. A person talks without stopping, as a result of which he may even become hoarse and lose his voice. However, in contrast to the incoherence of thinking, a certain meaning can be traced in the statements.

Accelerated thinking is characterized by such manifestations as:

  • fast, chaotic associations;
  • increased distractibility, spontaneous responses;
  • expressive gestures and facial expressions;
  • awareness of actions, understanding of mistakes and the ability to correct them;
  • ability to analyze, meaningful actions.

Inertia of thinking

Characteristic signs of this thinking disorder are a slowdown in the associative process, general inhibition, and the absence of any independent thoughts. The person finds it difficult to answer the question, the delay in the speech reaction differs significantly from the norm, the answers are short and monosyllabic. It is difficult to switch the thought process to new topics.

Inertia of thinking is characteristic of the following diseases:

  • epilepsy and epileptoid psychopathy;
  • manic-depressive syndrome;
  • apathetic and asthenic states;
  • mild confusion of consciousness.

Inconsistency of judgment

This deviation is characterized by instability of judgment. When performing associative tasks, a person can alternate between correct and incorrect methods. There is instability of associations. At the same time, the ability to generalize, assimilate instructions, and analyze is preserved.

A similar thinking disorder occurs in diseases such as:

  • cerebrovascular diseases;
  • brain injuries;
  • manic-depressive psychosis;
  • schizophrenia in remission.

Responsiveness

This disorder is expressed in increased responsiveness to any stimuli from the outside world, both related to the person and not addressed to him. Patients weave surrounding objects into their speech, simply naming objects that fall into their field of vision. There is a fluctuation in mental achievements. It is possible to transfer the properties of an object to its image. Characterized by loss of orientation in time and place. Patients do not remember names, dates and important events. There is a violation or incoherence of speech, absurd behavior.

Responsiveness is characteristic of people suffering from severe forms of vascular diseases of the brain.

Slipping

This thinking disorder is characterized by sudden deviations from the main line of reasoning, slipping into random associations. In the future, it is possible to return to the main topic without correcting errors. Such manifestations are episodic, sudden in nature. Often these violations are detected when performing tasks on the associative series. Random comparisons are observed, associations are replaced by consonances (for example, “stick-daw”).

Slipping is typically seen in schizophrenia.

When there are violations of the operational side of thinking, the following deviations occur:

Reducing the level of generalization

This type of disorder is characterized by difficulty generalizing symptoms. A person is not able to select properties and attributes that characterize concepts in general. Generalizations are replaced by individual features, random aspects of phenomena, and specific connections between objects.

This deviation occurs in the following diseases:

  • mental retardation;
  • epilepsy;
  • encephalitis.

Distortion of the generalization process

This thinking disorder manifests itself as an inability to establish a defining, basic connection between objects. A person notices only random aspects of a phenomenon, secondary connections between objects. There are no culturally accepted generalizations for the patient. Objects can be grouped together by color, material or shape, regardless of their purpose or other basic functions.

A similar violation is typical for diseases such as:

  • schizophrenia;
  • psychopathy.

When the motivational component of thinking is disrupted, the following manifestations are observed.

Diversity of thinking

This type is characterized by a lack of purposefulness of actions. A person is not able to classify objects and phenomena and identify common features. At the same time, such mental operations as comparison, generalization, discrimination are preserved, instructions are perceived, but not carried out. Judgments about objects and phenomena proceed on different planes and are characterized by inconsistency. Classification and selection of objects or phenomena can be made on the basis of personal characteristics of perception, tastes, and habits. There is no objectivity of judgment.

Reasoning

This type is characterized by meaningless, empty verbosity. A person embarks on long, endless discussions that have no specific goal and are not supported by any specific ideas. The speech of a person suffering from reasoning is characterized by fragmentation, the thread of reasoning is constantly lost. Often, individual statements in lengthy deliberations are not connected with each other and do not carry any semantic load. As a rule, the object of thought is also absent. The nature of the statements is rhetorical; the speaker does not require the attention or response of the interlocutor.

This pathology of thinking is typical for patients with schizophrenia.

Non-criticality

A pathology characterized by superficiality and incomplete thinking. The thinking process ceases to be purposeful and does not regulate a person’s actions and actions.

Rave

This thinking disorder manifests itself as conclusions, ideas or ideas that are not related to information received from the outside world. The correspondence of a delusional conclusion to reality does not matter to the patient. A person is guided by such conclusions and, thus, withdraws from reality, moves away from reality into a delusional state. It is impossible to dissuade the patient of the fallacy of delusional ideas; he is firmly convinced of their truth. The content of nonsense is extremely diverse.

Modern medicine describes several groups of delusional states, united by a common theme. The most typical of them are the following groups:

  • delusions of persecution;
  • religious delirium;
  • delusions of litigiousness;
  • delirium of jealousy;
  • delirium of poisoning;
  • delusion of origin;
  • hypochondriacal delirium and some other plots.

Anorexia, an illusion of excess weight accompanied by a manic desire to lose weight, is also a common delusional condition.

Delusions differ from the delusions characteristic of a healthy person in that the patient is absolutely convinced of his ideas, correction and dissuading are impossible, delusional ideas are of extreme significance for a person and determine the nature of his behavior.

Obsessive states

This pathology is characterized by thoughts, experiences or phobias that involuntarily arise in a person’s mind. This condition cannot be meaningfully controlled and is also characterized as a personality disorder. Obsessive thoughts, as a rule, lead to certain rituals (for example, the thought of the uncleanliness of the world around us makes a person wash his hands after touching any objects).


Thinking is considered to be a person’s ability to reflect in his consciousness the world around him with all existing connections and internal patterns. A distinctive feature of the thinking process is that thanks to it a person not only observes, but understands his surroundings. However, the thinking process is often characterized by certain disturbances, the consequences of which are incorrect conclusions about the environment.

The thinking process is expressed through language and speech. The language used by a person consists of a set of concepts that are elements of thinking. Concepts are developed categories that reflect the essential characteristics of phenomena and objects.

The concepts are conventionally divided into two groups:

  • specific: names of objects, phenomena, actions;
  • abstract: characteristics and qualities common to many objects and phenomena.

For the thinking process, associations are also an important point - establishing connections between concepts. If disorders arise in the associative process, they will certainly lead to disturbances in the way of thinking, which makes it inferior, chaotic and unproductive.

Speech, as an expression of thinking, is statements about objects and phenomena, which are called judgments. Judgments are compared with each other and are accompanied by logical conclusions called inferences.

Judgments and conclusions are the content of thinking.

Disorders of the association process include a number of disturbances in ways of thinking, which are expressed in changes in harmony, direction, mobility and pace. Thinking disorders manifest themselves in the following forms:


Thinking disorders in form can exist independently, or they can accompany more severe mental disorders. In any case, if they occur, you need to seek help from a specialist to determine an accurate diagnosis and prescribe treatment.

They include delusional, overvalued and obsessive ideas.

Rave– false conclusions arising on a painful basis, inaccessible to criticism and dissuadment.

Patients with delusions are absolutely convinced of the validity of their judgments, and this naturally leads to an incorrect assessment of the situation, behavioral disorders and maladjustment.

The plot of delirium- the main content of a delusional concept can take a wide variety of forms.

Plots of delirium:

    Delusions of persecution(persecutory delusion) consists of the patient’s belief that imaginary pursuers are following on his heels, watching his life from the windows of neighboring houses, entering the apartment in his absence, checking his business papers and letters, following him wherever he goes. he didn't move.

    Delirium of influence differs in that, according to patients, the persecution is carried out through complex technical means (rays, devices, tape recorders, microprocessors, electromagnetic fields) or through distant psychological influence (hypnosis, telepathy, witchcraft, extrasensory influences). Delirium of influence is an important component of the syndrome of mental automatism and is especially significant in the diagnosis of schizophrenia.

Clinical example: The patient reports: “There is a criminal group that, using special devices, constantly keeps me under laser beams. They steal my thoughts, burn my insides, put me in a bad mood.”

    Patients with delirium of poisoning They are sure that poison is being put into their food or poisonous gases are being brought into their apartment. This is often accompanied by gustatory or olfactory hallucinations. Delusions of poisoning occur not only in schizophrenia, but sometimes occur in patients with involutional psychoses.

    Delirium of material damage, expressed in thoughts that the pursuers allegedly steal food, spoil things, break dishes, and undermine furniture. Some patients turn to various authorities with complaints and demands (litigious delirium). In young patients, such ideas practically do not occur.

    Delirium meaning(of special significance) - random facts of reality are perceived as important signs, symbols that carry a great meaning and are directly related to the patient’s life. In this case, the smile on the face of a random passerby, the barking of a dog, the appearance of a new car in the yard - everything convinces the patient of the presence of danger, ill will, and sometimes an immediate threat to his life.

Clinical example: The patient, seeing a photograph of a tiger in a cage on the table, confidently declares: “Everything is clear. They put this photograph on purpose to suggest that they would soon transport me to prison.”

    Delirium of staging(intermetamorphosis) also more often accompanies acute psychosis. He expresses himself in the belief that people around the patient are trying to deceive him, pretending to be doctors, patients, colleagues, although in reality they are secret service workers in disguise or relatives whom he has not seen for a long time.

    Delirium of jealousy often too difficult to identify, since its bearers persistently hide suspicions, believing that in the eyes of others, jealousy is an unworthy feeling. Patients are quite sure of their spouse’s infidelity and are constantly busy collecting evidence of infidelity.

Clinical example: A patient reports: “Every morning my wife goes out onto the balcony ostensibly to water the flowers, but in fact she signals these people from the house opposite when I won’t be at home” or “The doormat has been moved to the side, it’s clear that without me there was someone else here, because both my wife and I are very neat.”

    Depressive delirium is directly related to the dominant feeling of melancholy and depression in patients, and is often the cause of suicidal behavior. Variants of depressive delusions are delusions of self-accusation, self-abasement, sinfulness, guilt.

    Hypochondriacal delirium- patients are sure that they have a shameful or serious, life-threatening disease - cancer, AIDS, syphilis, so they constantly turn to doctors, demanding examination and treatment. Negative examination results further convince patients that doctors are hiding the true diagnosis from them or are not competent enough.

    Nihilistic delirium(Cotard's delirium) is a variant of hypochondriacal delusion, expressed in erroneous conclusions of a megalomaniac, hypochondriacal nature about one's health. Patients are convinced that they have a serious, fatal disease (syphilis, cancer), “inflammation of all the insides,” they talk about damage to individual organs or parts of the body (“the heart has stopped working, the blood has thickened, the intestines have rotted, food is not processed and comes from the stomach through lungs to brain”, etc.). Sometimes they claim that they have died, turned into a rotting corpse, perished.

    Dysmorphomaniac(dysmorphophobic) rave- patients are convinced that they have a physical defect (deformity). A special case of dysmorphomanic delusion is the patient’s confidence in the presence of an unpleasant odor emanating from him. At the same time, patients consider it shameful to discuss their thoughts with others, hide them from family, friends and acquaintances, and are extremely reluctant to admit such thoughts to a doctor.

    Delusions of grandeur usually accompanied by an elevated, joyful or calm, complacent mood. Patients in this case are usually tolerant of the circumstances that constrain them, friendly, and not prone to aggression. Some patients take credit for the works of famous authors or claim that they themselves have created a new device that will radically transform the future of humanity. Ideas of greatness manifest themselves most clearly as part of paraphrenic and manic syndromes.

A disorder of thinking in a person is a disorder of information processing processes, the identification of relationships connecting various phenomena or objects of the surrounding reality, deviations in the reflection of the essential properties of objects and in determining the connections that unite them, which gives rise to the emergence of false ideas and imaginary judgments about objectively existing reality. There are several types of disorders of the thinking process, namely a disorder of the dynamics of thought processes, pathology of the operational functioning of thinking and disorders of the motivational and personal component of mental activity. In most cases, it is practically impossible to classify the peculiarities of each patient’s mental operation within the framework of one type of disturbance of the thinking process. Often, in the structure of pathologically altered mental activity of patients, combinations of various types of deviations are noted, which are in unequal degrees of severity. So, for example, a disorder of the generalization process in a number of clinical cases is combined with pathologies of the purposefulness of mental operations.

Thinking disorders are one of the most common symptoms of mental illness.

Types of thinking disorders

Disorder of the operational function of mental activity. Among the main operations of thinking there are: abstraction, analysis and synthesis, generalization.
Generalization is the result of an analysis that reveals the basic relationships connecting phenomena and objects. There are several stages of generalization:
- categorical stage, consists of assignment to a species based on essential features;
- functional - consists of assignment to a species based on functional characteristics;
- specific - consists of assignment to a species based on specific characteristics;
- null, that is, there is no operation - consists of listing objects or their functions without the intention of generalization.

The pathologies of the operational side of mental functioning are quite diverse, but two extreme options can be distinguished, namely a decrease in the level of generalization and deformation of the generalization process.

In the reasoning of patients, with a decrease in the level of generalization, direct ideas about objects and events prevail. Instead of emphasizing generalized properties, patients use specific situational compounds; they have difficulty abstracting from specific elements. Such disorders can occur in mild, moderate and severe forms. Such disorders are usually observed in mental retardation, severe encephalitis, and organic pathology of the brain with.

We can talk about a decrease in the level of generalization only in the case when such a level was previously, and then decreased.

When the operational processes of generalization are distorted, patients are guided by overly generalized properties that are inadequate to the actual connections between objects. There is a prevalence of formal, fleeting associations, as well as a departure from the substantive aspect of the task. Such patients establish exclusively formal, verbal connections; true differences and similarities do not serve as a test for their judgment. Similar disorders of mental activity are found in individuals suffering.

Of much greater clinical significance is the inertia of thought processes with inhibition of comprehension, comparative poverty of associations, leisurely and laconic impoverished speech.

Inertia in mental activity makes it difficult for sick children to master the school curriculum, since they are not able to learn at the same pace as healthy children.

Disruption of mental functioning is revealed in the lack of purposefulness of mental activity; the relationships established between objects or ideas are disrupted. The order of mental operations is distorted, while sometimes the grammatical structure of phrases can be preserved, which transforms speech devoid of meaning into an externally ordered sentence. In cases where grammatical connections are lost, mental activity and speech are transformed into a meaningless set of words.

The illogicality (inconsistency) of reasoning is manifested in the alternation of correct and incorrect methods of performing exercises. This form of disturbance in mental activity can be easily corrected through focused attention.

The responsiveness of mental functioning in children is manifested by variability in the ways of performing exercises.

Researchers have not yet decided what constitutes a thought process. It is believed that it should be understood as one of the highest mental functions, through which a person perceives and generalizes information about the reality around him.

However, under the influence of external factors, people can partially or completely lose this ability. Thinking disorders are both temporary and permanent, and can be a consequence of mental and other disorders.

About thinking

Thinking is a specific feature that a person possesses. Through mental activity, people establish existing relationships between various external objects and phenomena. This process also allows us to determine a person’s subjective attitude towards objects and events in the real world. As a result, through thinking, a certain perception of the surrounding reality (point of view) is formed, which people can express through speech.

In essence, this process allows a person not only to get an idea of ​​the real world, but also to understand it. Moreover, mental activity is associated not only with concrete objects, but also with abstract concepts.

In the latter case, we are talking about the process of generalizing current realities: natural disasters, furniture, and so on. In the course of evolutionary development, humans have developed the ability to combine several objects or phenomena according to a certain characteristic. Such skills are called abstract thinking.

The formation of pictures of the internal and external world occurs through the analysis of cause-and-effect relationships. At the same time, a person, relying on his own abilities, subjects the results obtained during the thought process to verification, basing his judgments on previously acquired experience. For example, if a child, approaching the edge of the bed, fell, then in the future, having reached the same point, he will be able to imagine the further development of events and make an appropriate decision.

A thought disorder is diagnosed if a person does not meet the following criteria:

It is important to note that the criteria given are general. That is, non-compliance with one of them cannot be considered a deviation within the framework of accepted empirical, logical and other grounds.

For example, it has been established that eating after 9 pm is harmful to health. If most people comply with this rule, and a few people refuse, then the behavior of the latter is not considered a sign of mental disorders.

In medical practice, it is customary to distinguish the following types of thinking disorders:

  • dynamics of thinking;
  • logical (personal) thinking;
  • associative (operational) thinking.

Due to the fact that thinking is a complex process that is subject to changes under the influence of many factors, it is not always possible for even an experienced specialist to determine the presence of violations.

Features of disorders of mental dynamics

Violation of the dynamics of thinking manifests itself in the form of the following processes.

Increasing the speed of the thought process

This thinking disorder is characterized by racing ideas. A person cannot stop and constantly produces them through speech, releasing a huge stream of associations into the world around him. Moreover, the speech itself remains incoherent and spasmodic. Any conclusions arise unexpectedly under the influence of any external or internal stimulus. Judgments about objects are superficial. Due to the endless flow of information, a person with this type of disorder often loses his voice.

These symptoms are supplemented by the following symptoms:


An important feature of this type of disorder is that in the patient’s statements, despite their surface, a certain meaning is hidden. A person with a violation of dynamic thinking is aware of his actions and understands the mistakes he makes. He retains the ability to eliminate them.

Inertia of thinking

This type of thinking disorder is characterized by the following symptoms:

  • slow process of association formation;
  • the presence of inhibition;
  • lack of ability to form one's own thoughts.

The person retains the ability to speak, but answers to questions will be short and monosyllabic. The patient with serious difficulties moves on to a new topic of conversation.

Lack of consistency in judgment

With such a deviation, an unstable nature of judgments and associations is observed. However, the patient can analyze the current situation quite well, perceive and generalize the information received. This type of thinking disorder occurs against the background of mental disorders, as well as with brain pathologies (trauma, vascular diseases).

The emergence of responsiveness

Responsiveness refers to behavior that is uncharacteristic of a healthy person, in which the patient constantly and incoherently includes visible objects in his speech. In addition, patients experience disorientation in space and time, they may forget certain dates, names and events. The patient's speech becomes incoherent.

Mostly, responsiveness is diagnosed in people with vascular pathologies of the brain.

Slipping

This effect manifests itself in the form of an unexpected departure from the current topic of discussion. Moreover, the person slips into incoherent associations. Over time, the patient returns to the initial topic. Slipping occurs sporadically and suddenly. This effect is most often observed in schizophrenic disorders.

Disorders of personal thinking

Violations of logical thinking include the following phenomena.

Inability to generalize thoughts

Diversity of thinking is characterized by a lack of purposefulness in the patient’s actions. The latter is simply not able to generalize several objects by identifying one or more features in them. At the same time, the patient retains the ability to classify objects, but carries out such actions based on personal preferences: habit, taste sensations, etc. There is no objective judgment in the patient's conclusions.

Reasoning

A characteristic feature of reasoning is incoherent and lengthy reasoning that is conducted without a specific goal. The logic of judgments in speech is completely or partially absent. Words and phrases have no visible connection with each other. A person does not need a listener at the moment when he makes a speech. It doesn’t matter to him whether anyone responds to the thoughts he expresses. The patient needs to speak out. Reasoning is often observed in people suffering from schizophrenia.

Delirium

A delusional state is a disorder of the thought process in which the information expressed by the patient is abstract.

That is, in the spoken words and phrases there is no visible connection with objective reality and the environment. Moreover, the person himself is completely confident that his conclusions are true. It is not possible to convince him otherwise. An example of such phenomena is the state of anorexia. A person “sees” excess weight and strives to get rid of it in every possible way.

Lack of critical thinking and obsession

The lack of critical perception leads to the fact that the patient’s actions lose purposefulness. The patient is unable to regulate his actions.

A characteristic sign of an obsessive state is phobias.

As this problem develops, it leads to a gradual personality disorder.

Disorders of associative thinking

Disorders of associative thinking manifest themselves in the form of:


It was already noted above that disturbances in the thought process arise for many reasons. Moreover, today there is no consensus on the relationship between individual diseases and pathological changes. The violations in question often arise due to the following problems:

  1. Cognitive disorders. A decrease in intellectual abilities occurs against the background of the development of dementia, Alzheimer's disease, and schizophrenia. With such violations, a person is not always and not fully aware of what is happening, and loses the ability to control his actions. Depending on the area of ​​brain damage, there is a possibility that the patient will begin to perceive the surrounding reality in a distorted form.
  2. Psychoses. Psychoses negatively affect a person’s thought processes, as a result of which the latter ceases to adequately respond and perceive the world around him. His judgments often do not correspond to generally accepted logic. The patient expresses incoherent thoughts.

Methods for studying violations

A psychologist studies thinking disorders. If the presence of such pathological changes is suspected, instrumental methods are initially used to diagnose them:


Instrumental research methods make it possible to establish the presence of a lesion in the brain and identify pathologies that can lead to impaired thinking. After completing this diagnostic stage, a psychologist works with the patient.

In order to establish the nature of the changes and the form of pathological disorders, various tests are carried out. In particular, for disorders of operational thinking and disorders, the following techniques are used:

  • classification;
  • exceptions;
  • formation of analogies;
  • defining concepts by comparing several objects;
  • identifying the figurative meaning of established expressions (proverbs, metaphors);
  • drawing pictograms.

Each of these methods makes it possible to assess a person’s ability to generalize incoming information, form an idea about it, and other important factors on the basis of which the final diagnosis is made.

Disturbances in a person’s thinking abilities occur mainly due to mental disorders and diseases that affect the structure of the brain. Such disorders manifest themselves in the form of incoherent expression of one’s own thoughts, incorrect judgments about objects and processes in the real world. To make an accurate diagnosis and identify the true nature of thinking disorders, psychological testing of the patient will be required.