Idiosyncratic Thinking Research Articles

Language disturbance and functioning in first episode psychosis

Language disturbance has a central role in the presentation of psychotic disorders however its relationship with functioning requires further clarification, particularly in first episode psychosis (FEP). Both language disturbance and functioning can be evaluated with clinician-rated and performance-based measures. We aimed to investigate the concurrent association between clinician-rated and performance-based measures of language disturbance and functioning in FEP. We assessed 108 individuals presenting to an Early Intervention in Psychosis Service in Ireland. Formal thought disorder (FTD) dimensions and bizarre idiosyncratic thinking (BIT) were rated with structured assessment tools. Functioning was evaluated with a performance-based instrument, a clinician-rated measure and indicators of real-world functioning. The disorganisation dimension of FTD was significantly associated with clinician-rated measures of occupational and social functioning (Beta=−0.19, P<0.05 and Beta=−0.31, P<0.01, respectively). BIT was significantly associated with the performance-based measure of functioning (Beta=−0.22, P<0.05). Language disturbance was of less value in predicting real-world measures of functioning. Clinician-rated and performance-based assessments of language disturbance are complementary and each has differential associations with functioning. Communication disorders should be considered as a potential target for intervention in FEP, although further evaluation of the longitudinal relationship between language disturbance and functioning should be undertaken.

Testing the Hypothesis That Formal Thought Disorders Are Severe Mood Disorders

It was recently hypothesized by Lake (Schizophrenia Bulletin 2008; 34: 109-117) that Formal Thought Disorder (FTD) can be accounted for by a single disorder that is currently diagnosed as bipolar disorder. This study aimed to analyze the underlying dimensions of FTD and to examine to what extent FTD factors can be accounted for by clinical distractibility, attentional impairment, severity of mania, and familial liability of bipolar disorder and schizophrenia. Six hundred and sixty inpatients were assessed using a semistructured interview, and FTDs were assessed with the Thought, Language, and Communication scale. "Inattentiveness during Mental Status Testing" item of the Scale for the Assessment of Negative Symptoms scale and a composite mania score were used. The Family History-Research Diagnostic Criteria was used. FTD is a multidimensional construct comprised at least 5 dimensions: disorganization, verbosity, poverty of speech, idiosyncratic thinking, and blocking. Clinical distractibility loadings split in 2 factors, disorganization and blocking, but it did not load on the mania-related (verbosity) factor. Attentional disturbance was significantly associated with each FTD factor except for idiosyncratic thinking, and these associations were largely independent from the severity of mania. The associations of FTDs with mania and attentional disturbances were independent from each other. FTD factors were not significantly associated with familial liability to bipolar or to schizophrenia. Disorganization was the main FTD component. Distractibility was a core feature of FTD factors but it was not specifically accounted for by mania-related attentional impairment. The hypothesis of mutual interdependence between mania and attentional disturbance leading to FTDs could not be confirmed.

EVALUATION OF BIZARRE-IDIOSYNCRATIC THINKING SCALE AS A MEASURE OF THOUGHT DISORDER IN CHILDREN AND ADOLESCENTS WITH SEVERE PSYCHIATRIC DISORDERS

To investigate the prevalence of thought disorder and the possible appropriateness of the Bizarre–Idiosyncratic Thinking Scale for children and adolescents with severe psychiatric disorders, 96 child and adolescent inpatients and day hospital patients, ages 6 to 18 years, at a state psychiatric hospital were rated by review of retrospective records using Marengo and Harrow's 1986 Evaluation of Bizarre–Idiosyncratic Thinking Scale for the presence of thought disorder in the Thematic Apperception Test and Rorschach Inkblot Test responses. Although the Evaluation of Bizarre–Idiosyncratic Thinking Scale had not been previously used with children and adolescents, the analysis suggested possible indications of thought disorder in several diagnostic groups. No significant differences were found on the Rorschach between patients with Schizophrenia and Psychosis, Not Otherwise Specified and those with Attention Deficit Hyperactivity Disorder, Major Depression, and Conduct Disorder. On the basis of the Thinking Scale ratings, the Thematic Apperception Test responses showed significantly higher ratings of thought disorder for patients with Schizophrenia and Psychosis, Not Otherwise Specified. There was no general relation between thought disorder and age or IQ, but schizophrenic patients, aged 13 and older, had more thought disorder than schizophrenic patients who were younger than 13.

Using students' statistical thinking to inform instruction

This study designed and evaluated a teaching experiment in data exploration for second grade students. A research-based framework that incorporated a description of elementary students' statistical thinking on four constructs and across four levels of thinking informed the hypothetical learning trajectory for the teaching experiment. Qualitative evidence from four target students revealed that: (a) experiences with different kinds of data reduced children's idiosyncratic descriptions; (b) categorical data were more problematic than numerical data; (c) technology stimulated and influenced children's thinking in relation to organizing and representing data; (d) children displayed multifaceted conceptual knowledge of center and spread; and (e) children's contextual knowledge was a key factor in being able to analyze and interpret data. By the end of the intervention, the class data as a whole showed that at least 84% of the students was exhibiting Level 2 thinking or better on all constructs, i.e., they were no longer exhibiting idiosyncratic thinking.

Patterns of thought disorder associated with right cortical damage, schizophrenia, and mania.

The authors used the Thought Disorder Index to measure thought disorder in 23 patients with unilateral right hemisphere cortical damage, 20 patients with bipolar mania, and 25 patients with schizophrenia. There were no differences in the total amount of thought disorder in these groups, but each showed a unique pattern of thought disorder. Patients with right hemisphere damage displayed fragmented thinking, manic patients displayed playful thinking, and schizophrenic patients displayed idiosyncratic thinking. These findings support the view that thought disorder is manifested in different forms that are relatively specific to psychiatric or neurological condition.

Borrowing and Artistic Behavior: A Case-Study of the Development of Bruce's Spontaneous Drawings from Six to Sixteen

This paper presents findings from a longitudinal, participant-observation study of one boy's spontaneous drawings from pre-adolescence to adolescence. Themes related to adolescent developmental psychology emerge in the drawings. Feeling, humor, divergent thinking, and love of incongruity characterize the drawings and indicate artistic behavior. Drawing from memory and borrowing image, style, or technique were distinguished from drawing from pictures and replication. The former strategies provide technique, yet permit free ideation which the latter restricts. While artistic behavior in drawing may include borrowing, it also involves idiosyncratic expression, imagination, restructuring, and metaphorical thinking.

Abstract and concrete thinking in schizophrenia during the prechronic phases.

Ninety-five psychiatric inpatients (25 schizophrenic, 23 borderline, and 47 nonschizophrenic patients) were assessed on six indices of abstract and concrete thinking, during two stages of their disorder (acute phase and phase of partial recovery). The level of abstract and concrete thinking in nonchronic patients was influenced by several factors. (1) During the prechronic phases diagnosis (schizophrenic vs nonschizophrenic) exerted some influence, but was not the most prominent factor. Evidence suggested, however, that during later chronic phases schizophrenic subjects may be extremely concrete. (2) Process schizophrenics tended to be less abstract than reactive schizophrenics. (3) The phase of the disorder exerted some influence (during active or acutely disturbed stages patients were less abstract). (4) The most powerful influence on the abstract-concrete dimension was intelligence. (5) Idiosyncratic thinking was an important negative influence on ability to abstract.

Idiosyncratic thinking and personally overinvolved thinking in schizophrenic patients during partial recovery

The present research investigated the importance of idiosyncratic thinking and personally overinvolved thinking in schizophrenia and evaluated changes in these factors over two phases of the disorder (the acute phase and the phase of partial recovery). Five indexes of thinking derived from two tests were administered to 25 acute schizophrenic patients, 23 borderline patients, and 47 nonschizophrenic psychiatric patients at week one and week eight of hospitalization. Schizophrenic patients evidenced a significantly higher level of idiosyncratic thinking than nonschizophrenic patients at the acute phase ( p < 0.001). As patients emerged from the acute phase, schizophrenics still tended to score higher on idiosyncratic thinking than nonschizophrenics. However, the differences had diminished considerably and on some indexes were no longer significant. In addition, all patients manifested less idiosyncratic thinking as the acute phase diminished, with this decrease being especially prominent among the schizophrenic group. This suggests that some aspects of disordered schizophrenic thinking are at least in part a function of the acute or active phase. There were no significant differences between the schizophrenic and non-schizophrenic patients in the level of personally overinvolved thinking at either time period. Although exhibiting less personally overinvolved thinking after the acute period, most of these hospitalized patients still showed a moderate amount of personalizing even during partial recovery. The results suggest that idiosyncratic thinking is an important characteristic of the acute schizophrenic thought disorder and is a useful parameter in differentiating acute schizophrenics from acute nonschizophrenics.

Predictors of posthospital adjustment in schizophrenia. Thought disorders and schizophrenie diagnosis.

The present research was designed to investigate the prognostic significance of thought disorders among mental patients in general, and schizophrenics in particular. The research also attempted to study differences in outcome between schizophrenic and nonschizophrenic patients, to determine in which specific areas they differ (e.g., work, social, symptomatology) and to determine whether a schizophrenic diagnosis is more predictive of posthospital functioning than the presence of thought disorders. A standardized battery of psychological tests assessing various types of thought disorders was administered to 101 acute psychiatric patients (33 classical schizophrenics, 24 latent schizophrenics and 44 nonschizophrenic patients) within the first 10 clays of hospitalization. These included the Rorschach Test to assess autistic logic, overspecificity, contaminations, fabulized combinations, primary process drive content and poor form quality; and the Object Sorting Test to rate conceptual overinclusion and idiosyncratic thinking. The 101 patients were followed up 11 months later to assess posthospital adjustment. The follow-up included several symptom scales, a structured interview to assess work and social functioning, subjective complaints, and rehospitalization. The results indicated that during the acute stage schizophrenics were significantly more thought disordered than nonschizophrenics. A series of nonsignificant correlations failed to support hypotheses about a strong relationship between the extent of thought disorders at the acute stage and subsequent outcome for the schizophrenic sample considered alone and for the total sample of patients. The results on diagnosis and posthospital functioning suggest a consistent trend for the schizophrenics to perform more poorly in almost all areas, with significant differences on some outcome indices and nonsignificant trends in the same direction on other indices. While modern treatment methods have resulted in fewer schizophrenics showing extreme deterioration, their outcome is still relatively poor in comparison to other diagnostic groups. The significant results on diagnosis as a predictor of outcome, considered together with the more mixed results on thought disorders as prognostic indices, raise questions about the role played by primary or fundamental symptoms in schizophrenia.

Disordered cognition and stimulus processing.

The perceptual style of processing stimuli (kinesthetic figural aftereffects) by 53 acute psychiatric inpatients was related to disorders in their perceptual experience of the environment and in their formal thought processes (overinclusive and idiosyncratic thinking). Psychiatric patients who reduced incoming stimuli also manifested greater abnormal perceptual experiences and thought disturbances. At the time of hospitalization the schizophrenics reduced incoming stimuli to a greater extent than did the nonschizophrenics and latent schizophrenics.

Concrete and idiosyncratic thinking in acute schizophrenic patients.

The present research investigated the importance in schizophrenia of concrete thinking, personally overinvolved thinking, and idiosyncratic or bizarre thinking. Seven indices of thinking were derived from three tests administered individually to 45 acute schizophrenics and 47 nonschizophrenic psychiatric patients. Although the concrete thinking of the schizophrenic has been emphasized by some, the present data do not support this factor as a pervasive feature in relatively early acute schizophrenia. Schizophrenics tended to be more concrete than nonschizophrenics. Concreticity, however, was not a frequent characteristic among any of the major diagnostic groups. Schizophrenic patients had significantly more idiosyncratic thinking than nonschizophrenic patients (P