Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-26T16:46:54.409Z Has data issue: false hasContentIssue false

Ordering Thoughts on Thought Disorder

Published online by Cambridge University Press:  02 January 2018

John McGrath*
Affiliation:
Clinical Studies Unit, and Senior Lecturer, Department of Psychiatry, University of Queensland, Australia
*
Wolston Park Hospital, Wacol, Queensland 4076, Australia

Abstract

A common denominator can be found permeating thought disorder at various levels – the lack of executive planning and editing. With data available from aphasiology and neuropsychology, certain features of thought disorder can be reinterpreted as being consistent with dysfunction of the frontal lobe. It is hypothesised that thought disorder may reflect a dysfunction of the cortical–subcortical loops that project into the pre-frontal cortex. The hypothesis predicts that thought-disordered patients will have impaired performance on tests of frontal lobe function, regardless of diagnosis.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1991 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexander, G. E. Delong, M. R. & Strick, P. L. (1986) Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience, 9, 357381.Google Scholar
Alexander, M. P. Benson, D. F. & Stuss, D. T. (1989) Frontal lobes and language. Brain and Language, 37, 656691.CrossRefGoogle ScholarPubMed
Allen, H. (1983) Do positive symptoms and negative symptom subtypes of schizophrenia show qualitative differences in language production? Psychological Medicine, 13, 787797.Google Scholar
Andreasen, N. (1979) Language, thought, and communication disorders: 1. Clinical assessment, definition of terms, and evaluation of their reliability. Archives of General Psychiatry, 36, 13151321.Google Scholar
Andreasen, N. Hoffman, R. E. & Grove, W. M. (1985) Mapping abnormalities in language and cognition. In Controversies in Schizophrenia. Changes and Constancies (ed. Alpert, M.), pp. 199226. New York: Guildford Press.Google Scholar
Barr, W. B. Bilder, R. M. Goldberg, E. et al (1989) The neuropsychology of schizophrenic speech. Journal of Communication Disorders, 22, 327349.Google Scholar
Benes, F. M. Davidson, J. & Bird, E. D. (1986) Quantitative cytoarchitectural studies of the cerebral cortex of schizophrenics. Archives of General Psychiatry, 43, 3135.Google Scholar
Berman, K. F. (1987) Cortical “stress tests” in schizophrenia: regional cerebral blood flow studies. Biological Psychiatry, 22, 13041326.Google Scholar
Cameron, N. (1944) Experimental analysis of schizophrenic thinking. In Language and Thought in Schizophrenia (ed. Kasanin, J.). Berkeley: University of California Press.Google Scholar
Chaika, E. (1974) A linguist looks at “schizophrenic” language. Brain and Language, 1, 257276.Google Scholar
Cohen, B. D. (1976) Referant communication in schizophrenia: the perseverative-chaining model. Annals New York Academy of Sciences, 270, 124140.Google Scholar
Cozolino, L. J. (1983) The oral and written productions of schizophrenic patients. Progress in Experimental Research, 12, 101152.Google Scholar
Critchley, M. (1964) The neurology of psychotic speech. British Journal of Psychiatry, 110, 353364.Google Scholar
Cromwell, R. L. & Dokecki, P. R. (1968) Schizophrenic language: a disattention interpretation. In Developments in Applied Psycholinguistics (eds Rosenberg, S. & Koplin, J. H.). New York: Macmillan.Google Scholar
Crosson, B. (1985) Subcortical functions in language: a working model. Brain and Language, 25, 257292.Google Scholar
Crosson, B. & Hughes, C. W. (1987) Role of the thalamus in language: is it related to schizophrenic thought disorder? Schizophrenia Bulletin, 13, 605621.Google Scholar
Deese, J. (1978) Thought into speech. American Scientist, 66, 314321.Google Scholar
Docherty, N. Schnur, M&Harvey, P. D. (1988) Reference performance and positive and negative thought disorder: a follow-up study of manics and schizophrenics. Journal of Abnormal Psychology, 97, 437442.Google Scholar
Early, T. E. Posner, M. I. Reiman, E. M. et al (1989 a) Hyperactivity of the left striato-pallidal projection. Part I: Lower level theory. Psychiatric Developments, 2, 85108.Google Scholar
Early, T. E. Posner, M. I. Reiman, E. M. et al (1989 b) Left striato-pallidal hyperactivity in schizophrenia. Part II: Phenomenology and thought disorder. Psychiatric Developments, 2, 109121.Google Scholar
Fraser, W. I. King, K. M. Thomas, P. et al (1986) The diagnosis of schizophrenia by language analysis. British Journal of Psychiatry, 148, 275278.Google Scholar
Frith, C. D. (1989) Psychosis, second-order representations and the brain (abstract). In VII World Congress of Psychiatry (eds Stefanis, C. N. Soldatos, C. R. & Rabavilas, A. D.), p. 330. International Congress Series 899. Amsterdam: Excerpta Medica.Google Scholar
Fuster, J. M. (1980) The Prefrontal Cortex, Anatomy, Physiology and Neuropsychology of the Frontal Lobe. New York: Raven Press.Google Scholar
Gerson, S. N. Benson, D. F. & Frazier, S. H. (1977) Diagnosis: schizophrenia versus posterior aphasia. American Journal of Psychiatry, 134, 966969.Google Scholar
Goldman-Rakic, P. S. (1987) Circuitry of primate prefrontal cortex and regulation of behaviour by representational memory. In Handbook of Physiology, vol. 5, pp. 373417. Bethesda: American Physiological Society.Google Scholar
Hamilton, M. (1985) Fish's Clinical Psychopathology, Bristol: Wright.Google Scholar
Harrow, M. Lanin-Kettering, I. & Miller, J. G. (1989) Impaired perspective and thought pathology in schizophrenic and psychotic disorders. Schizophrenia Bulletin, 15, 605623.CrossRefGoogle ScholarPubMed
Harvey, P. D. (1983) Speech competence in manic and schizophrenic psychoses: the association between clinically rated thought disorder and cohesion and reference performance. Journal of Abnormal Psychology, 92, 368377.Google Scholar
Harvey, P. D. & Brault, J. (1986) Speech performance in mania and schizophrenia: the association of positive and negative thought disorders and reference failures. Journal of Communication Disorders, 19, 161173.Google Scholar
Hoffman, R. E. Stopek, S. & Andreasen, N. C. (1986) A comparative study of manic vs schizophrenic speech disorganization. Archives of General Psychiatry, 43, 831838.Google Scholar
Kaczmarek, B. L. J. (1984) Neurolinguistic analysis of verbal utterances in patients with focal lesions of the frontal lobes. Brain and Language, 21, 5258.Google Scholar
Kaczmarek, B. L. J. (1987) Regulatory function of the frontal lobes: a neurolinguistic perspective. In The Frontal Lobes Revisited (ed. Perecman, E.), pp. 225240. New York: The IRBN Press.Google Scholar
King, K. Fraser, I. W. Thomas, P. et al (1990) Re-examination of the language of psychotic subjects. British Journal of Psychiatry, 156, 211215.CrossRefGoogle ScholarPubMed
Konow, A. & Pribram, K. H. (1970) Error recognition and utilization produced by injury to the frontal cortex in man. Neuropsychologia, 8, 489491.Google Scholar
Leenders, K. L. Frackowiak, R. S. J. Quinn, N. et al (1986) Brain energy metabolism and dopaminergic function in Huntington's disease measured in vivo using positron emission tomography. Movement Disorders, 1, 6977.CrossRefGoogle ScholarPubMed
Levelt, W. J. M. (1981) The speaker's linearization problem. Philosophical Transactions of the Royal Society of London, B295, 305315.Google Scholar
Lewis, S. W. (1989) Congenital risk factors for schizophrenia. Psychological Medicine, 19, 513.Google Scholar
Liddle, P. F. (1987) Schizophrenic syndromes, cognitive performance and neurological dysfunction. Psychological Medicine, 17, 4957.Google Scholar
Liddle, P. F. Friston, S. R. Hirsch, S. R. et al (1990) Regional cerebral metabolic activity in chronic schizophrenia (abstract). Schizophrenia Research, 3, 2324.CrossRefGoogle Scholar
Luria, A. R. & Homskaya, E. D. (1964) Disturbances in the regulative role of speech with frontal lobe lesions. In The Frontal Granular Cortex and Behavior (eds Warren, J. M. & Akert, K.), pp. 353371. New York: McGraw Hill.Google Scholar
Manschreck, T. C. Maher, B. A. Rucklos, M. E. et al (1979) The predictability of thought disordered speech in schizophrenic patients. British Journal of Psychiatry, 134, 595601.Google Scholar
Manschreck, T. C. Maher, B. A. & Rucklos, M. E. (1980) Cloze procedure and written language in schizophrenia. Language and Speech, 23, 323328.CrossRefGoogle ScholarPubMed
Manschreck, T. C. Maher, B. A. & Ader, D. N. (1981) Formal thought disorder, the type-token ratio, and disturbed voluntary motor movement in schizophrenia. British Journal of Psychiatry, 139, 715.Google Scholar
Manschreck, T. C. Maher, B. A. Hoover, T. M. et al (1985) Repetition in schizophrenic speech. Language and Speech, 28, 255268.Google Scholar
Manschreck, T. C. Ames, D. Maher, B. A. et al (1987) Impoverished written responses and negative features of schizophrenia. Perceptual and Motor Skills, 64, 11631169.CrossRefGoogle ScholarPubMed
McGhie, A. & Chapman, J. (1961) Disorders of attention and perception in early schizophrenia. British Journal of Medical Psychology, 34, 103116.Google Scholar
Mentis, M. & Prutting, C. A. (1987) Cohesion in the discourse of normals and head-injured adults. Journal of Speech and Hearing Research, 30, 8898.Google Scholar
Metter, E. J. Mazziotta, J. C. Itabashi, H. H. et al (1985) Comparison of glucose metabolism, x-ray CT, and postmortem data in a patient with multiple cerebral infarcts. Neurology, 35, 16951701.Google Scholar
Metter, E. J. Riege, W. H. Hanson, W. R. et al (1988) Subcortical structures in aphasia: an analysis based on (F-18)-fluorodeoxyglucose, positron emission tomography, and computed tomography. Annals of Neurology, 45, 12291234.Google Scholar
Morice, R. (1986) Beyond language – speculation on the prefrontal cortex and schizophrenia. Australian and New Zealand Journal of Psychiatry, 20, 710.Google Scholar
Morice, R. & Ingram, J. C. L. (1982) Language analysis in schizophrenia: diagnostic implications. Australian and New Zealand Journal of Psychiatry, 16, 1121.Google Scholar
Novoa, O. P. & Ardila, A. (1987) Linguistic abilities in patients with prefrontal damage. Brain and Language, 30, 206225.Google Scholar
Perlmutter, J. S. (1988) New insights into the pathophysiology of Parkinson's disease: the challenge of positron emission tomography. Trends in Neurosciences, 11, 203208.Google Scholar
Persons, J. B. (1986) The advantages of studying psychological phenomena rather than psychiatric diagnoses. American Psychologist, 41, 12521260.Google Scholar
Pylyshyn, Z. (1970) Clinical correlates of some syntactic features of patients' speech. Journal of Nervous and Mental Disease, 150, 307316.Google Scholar
Ragin, A. B. & Oltmanns, T. F. (1987) Communicability and thought disorder in schizophrenics and other diagnostic groups. A follow-up study. British Journal of Psychiatry, 150, 494500.Google Scholar
Rochester, S. (1980) Thought disorder and language use in schizophrenia. In Applied Psycholinguistics and Mental Health (ed. Rieber, R. W.), pp. 1167. New York: Plenum Press.Google Scholar
Rochester, S. Martin, J. R. & Thurston, S. (1977) Thought-process disorder in schizophrenia: the listener's task. Brain and Language, 4, 95114.Google Scholar
Schwartz, S. (1978) Language and cognition in schizophrenia: a review and synthesis. In Language and Cognition in Schizophrenia (ed. Schwartz, S.), pp. 237276. New Jersey: Lawrence Erlbaum Associates.Google Scholar
Shallice, T. (1982) Specific impairments of planning. Philosophical Transactions of the Royal Society of London, 298, 199209.Google Scholar
Siegel, A. Harrow, M. Reilly, F. et al (1976) Loose associations and disordered speech patterns in chronic schizophrenia. Journal of Nervous and Mental Disease, 162, 105112.CrossRefGoogle ScholarPubMed
Simpson, D. M. & Davis, G. C. (1985) Measuring thought disorder with clinical rating scales in schizophrenic and nonschizophrenic patients. Psychiatry Research, 15, 313318.Google Scholar
Stuss, D. T. & Benson, D. F. (1984) Neuropsychological studies of the frontal lobes. Psychological Bulletin, 95, 328.Google Scholar
Taylor, T. J. & Cameron, D. (1987) Analysing Conversation. Rules and Units in the Structure of Talk. Oxford: Pergamon Press.Google Scholar
Walsh, K. (1987) Neuropsychology. A Clinical Approach. Edinburgh: Churchill Livingstone.Google Scholar
Warrington, E. K. & Weiskrantz, L. (1982) Amnesia: a disconnection syndrome? Neuropsychologia, 20, 233248.Google Scholar
Weinrich, M. Ricaurte, G. Kowall, J. et al (1987) Subcortical aphasia revisited. Aphasiology, 1, 119126.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.