“Hi Everyone, so this is a short video to try to help you to better understand thought disorder as a concept within mental health. So thought disorder is present in many different mental health disorders for example, bipolar particularly in the manic phase or schizophrenia and it’s most easily identified in speech, so through conversation with other people. Thought disorder is a broad term for psychopathological phenomena which includes the main kind of 5 I am labelling now. So, you’ve got circumstantiality, tangentiality, there’s clang association, flight of ideas and derailment and within derailment we talk also about knights move. They’re really just both loosening of associations and we’ll talk a bit more about those with the diagrams in a moment. Alongside these kind of main 5 there’s also other key terms. These can be poverty of speech, so when we have poverty of speech, we find that there is empty of vague discussion with very little information really being obtained. We then have word salad, so that’s kind of random words almost thrown out without any kind of real logic as opposed to neologisms which are actually new words which don’t exist and are quite hard to identify sometimes. We then have perseveration, so that’s repetition of their response and echolalia which is more of a repetition of the statement that you have made.”
Today we're looking at the mental health act as a real quick overview. This is relevant for England as of 2020.
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“So, of those key five then, the first one that we’ll focus on is flight of ideas. So here I’m marking X as kind of the answer they meant to give and actually their trajectory instead is kind of going really off topic its almost distracted, veering off topic, there is accelerated thinking and a lack of goal direction. So, despite the fact there are kind of some connections they never really answer your question in the way that you would expect. This is quite similar to clang association, which is almost a severe form of this in this case you tend to find that the person will jump between statements and that’s based not on the content of the statement itself but on the kind of sound of it so the word choice is often therefore linked by rhyme, puns those kind of things and both flight of ideas and clang association tend to be seen more in manic illness. The next one we will think about then is derailment and as I said previously that is linked in with knights move that’s a type of association loosening and what that essentially means is that each statement they have is disconnected so where in clanging or flight of ideas there is a tenuous connection between the statements in derailment they seem completely unconnected. This is much more common in schizophrenia and can be very difficult to follow and difficult to kind of understand what purpose they are trying to relay to you.”
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“So, this time we are now thinking about circumstantial thinking and tangentiality. So, in tangentiality here similar to flight of ideas the topics are really kind of veering off and the purpose is never reached. The difference really here is that it’s not accelerated as in flight of ideas and comparatively in circumstantiality which is quite often difficult to differentiate from tangentiality they will eventually get to the answer that they were trying to give you but on the way to that will give you a wide variety of extra detail that isn’t really relevant. But they will get there if you kind of give them enough time and listen”.
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“So, I hope that you’ve found this helpful. What I’ll do now is just draw those diagrams for you again. What that means is that you can kind of think about which one might be which and I will shut up for a moment while you kind of consider and digest that information.”
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