Derailment (thought disorder)

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In psychiatry, derailment (also loosening of association, asyndesis, asyndetic thinking, knight's move thinking, or entgleisen) is a thought disorder characterized by discourse consisting of a sequence of unrelated or only remotely related ideas. The frame of reference often changes from one sentence to the next.[1][2]

In a mild manifestation, this thought disorder is characterized by slippage of ideas further and further from the point of a discussion. 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.[1] In some studies on creativity, knight's move thinking, while it describes a similarly loose association of ideas, it is not considered a mental disorder or the hallmark of one; it is sometimes used as a synonym for lateral thinking.[3][4][5]

Examples[edit]

  • "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[6]
  • "The traffic is rumbling along the main road. They are going to the north. Why do girls always play pantomime heroes."—given by Carl Schneider[2]
  • "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.[7]

History[edit]

Entgleisen (derailment in German) was first used with this meaning by Carl Schneider in 1930.[2] The term asyndesis was introduced by N. Cameron in 1938, while loosening of association was introduced by A. Bleuler in 1950.[8] 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 schizophrenics fail to suppress divergent associations.[3] Derailment was used with this meaning by Kurt Schneider in 1959.[8]

See also[edit]

References[edit]

  1. ^ a b P.J. McKenna, Schizophrenia and related syndromes, Psychology Press, 1997, ISBN 0-86377-790-2, pp. 14-15
  2. ^ a b c 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
  3. ^ a b Robert Spillane, John Martin, Personality and performance: foundations for managerial psychology, UNSW Press, 2005 ISBN 0-86840-816-6, pp. 239-243
  4. ^ Tudor Rickards, Creativity and problem solving at work, Edition 3, Gower Publishing, 1997, ISBN 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. ^ Andreasen NC. Thought, language, and communication disorders. I. A Clinical assessment, definition of terms, and evaluation of their reliability. Archives of General Psychiatry 1979;36(12):1315-21. PMID 496551. [1]
  7. ^ Elyn Saks: "A tale of mental illness — from the inside." TEDGlobal 2012. Recorded in June 2012. [2]
  8. ^ a b Tony Thompson, Peter Mathias, Jack Lyttle, Lyttle's mental health and disorder, Edition 3, Elsevier Health Sciences, 2000, ISBN 0-7020-2449-X, pp. 136, 168-170