What controls the internal processes of the body. How the human endocrine system regulates internal processes in the body. One mechanism is excessive cortisol production.

According to Vygotsky: speech is always disturbed along with thinking (Vygotsky “Thinking and Speech”). Often, in speech, as a person speaks, how he clearly builds his thoughts, we can say how he thinks directly.

Stand out in psychiatry:

1. Disorders of the associative process (this is a way of thinking that speaks of its focus, harmony, mobility).
2. The content of thinking is a conceptual apparatus (inferences, etc.).

Associative Process Disorders
  They include a number of violations of the way of thinking, expressed in changes in pace, mobility, harmony and focus. The following clinical phenomena are distinguished:

1. The first phenomenon - accelerated thinking. It is characterized by the abundance and speed of emerging associations, while their superficiality is easily distracted from any topic (any association gives rise to the following association), speech takes on an inconsistent character (the so-called “jumping”), any remark of the interlocutor gives rise to a new stream of associations and speech takes on pressure (speed and the power of speech). Sometimes it comes to such speed, then we hear individual cries and this is called the “leap of ideas”. Naturally, this is characteristic of patients in a manic state, when taking psychostimulants. And when this state ends (or the manic phase or the action of psychostimulants), then thinking becomes common for this person and criticism arises (“What did I say that?”).

2. There is always a certain opposite. slow thinking. It is expressed in slow, monosyllabic speech. There are no detailed explanations and definitions. Poverty associations. If you ask some sort of “difficult” question (“What is your name and how did you get here?”), It is difficult to comprehend complex questions. Their speech is slow and poor in associations. Sometimes, due to the fact that they themselves understand that they somehow say something wrong, patients may give the impression of being stupid, but this is not so. This is characteristic of depression and it is a temporarily reversible syndrome, which, after the care of this phase goes away and criticism arises.

3. Pathological circumstance (or viscosity) manifested in the stiffness of thinking. The patient speaks with depth not only slowly, stretching words, but also very verbose. It dwells on every detail and all the time in its speech makes insignificant refinements. If you ask a question, then such a patient decides that you did not understand him and begins his speech again. And so, with a complex plexus, it still comes to the topic that he is trying to cover. This thinking is also called "labyrinth." Pathological circumstance or viscosity is characteristic (and observed) in organic brain diseases, especially in epilepsy and always, unlike the previous two phenomena, indicates a long course of the disease and this is an irreversible symptom. And the reason for such a conversation lies precisely in the fact that the patient cannot distinguish the main thing from the secondary. And then these clarifying details become also important for him.

Details, repetitions, diminutive suffixes, “as if”, “so that”, “roughly speaking”, always indicate a certain impoverishment of thinking.

4. Resonance   verbosity is also manifested, but thinking here loses all purposefulness. Speech abounds in complex logical constructions, elaborate abstract concepts, terms that are often used without understanding and without context. With resonance, it does not matter at all whether they listen to him and ask him questions, he oppresses his line. Thinking becomes amorphous, devoid of a clear content, any everyday things are considered from the point of view of philosophy, religion, etc. Older psychiatrists called this speech "metaphysical intoxication." This way of thinking is characteristic of patients with schizophrenia.

If you have a good relationship and really want to listen to him, you need to tell him all the time "I do not understand, I do not understand you ..." . And then he can get together and say everything is normal. Which is completely unusual for organics.

Secondary disturbance of thinking, also resonance when memory is impaired. Fanciful strange speech arises here not because I think so, but because words disappear. Resonance here as a way of thinking will be secondary, and memory impairment will be primary.

5. Tear or schizophasia   also characteristic of patients with schizophrenia in very long stages. Associations and some words are picked up by the patient in general by chance. Intonationally correct speech, listening carefully you understand that this is just a set of words that is logically built.

Kreppelin:   “Do not seek schizoid among the people ...”

6. Incoherence or incoherence   - This is a gross decay of the whole process of thinking. The grammatical structure has already been violated here. There are no completed phrases. You can hear only fragments of phrases or meaningful sounds. In this case, the patient is not at all accessible to the contact. As a rule, this is connected with motor things, like rocking ("I’m lying, I’m lying ..."). This happens with autism, with the catatonic form of schizophrenia (catatonic stupor, motor disorder) and against the background of a severe disorder of consciousness (dying option).

7. Speech stereotypes.   this includes standing revolutions (“here,” “as it were,” “roughly speaking”). It is always organic and impoverished in thinking. Or individual phrases are endlessly repeated (if you develop the topic, you will leave in the labyrinthine thinking and it will be even worse). But it is always organic. Speech stereotypes include perseveration. What it is?

Alzheimer's patient is asked to list the seasons, she lists. And then she is asked to list the fingers that she bends. And again she begins to repeat the month. The second task is not assimilated and the first perseveres (perseveration is a replacement).

Standing revolutions are always a sign of a decrease or empty mind.

8. Rush of thoughts   It is expressed by the patient’s burdensome state of a chaotic stream of thoughts running through the head, usually arising in the form of an attack. As if the whole head is bursting from some thoughts. The patient falls silent, sits for a moment and then says: “Fuf, let it go!” And at the same time he cannot “grab” any of his thoughts. It’s distracting, he can quit his job, distract from what he was doing. The influx of thoughts is very often the initial violation in schizophrenia (as well as the loss of thoughts).

9. Breaks in thinking, stopping, blockage of thinking. Here, on the contrary, as if all thoughts had flown out of my head ( "Thought, thought and stumbled into the wall ..." ) If we feel that we have a thought, some physical substance and we feel its break. And always, that the influx, that the break in thoughts is precisely violent, unpleasant in nature, which is understood by the patient as an invasion of his head.
  Just an empty head - asthenia. And a lot of thoughts are anxiety.

10. Autistic thinking   (in this context, “autistic” is used as a detachment from reality). It is expressed in isolation, isolation from reality. Patients are not interested in the practical significance of their things.

Hegel: "If my ideas do not add up to reality, so much the worse for reality."

But the fantasy world is extremely developed. This is more and more connected with his reflection, with internal sensations. At the same time, he can speak absolutely colorless, his experiences come out only on paper or, if he is located towards you, he can let you read and even share some thoughts on this issue. Autistic thinking is characteristic of patients with schizophrenia, but more characteristic of schizoids, as a separation from reality. This does not mean that they do not understand this reality, it is simply not significant for them.

11. Symbolic thinking   here, in general, thinking in general is abundant in neologisms and fictitious words.

12. Paralogical thinking   - violation of a certain logic, substitution of logic. Patients, through complex logical fabrications, come to conclusions that are clearly contrary to reality. There is a shift in concepts, the so-called "slipping". Substitution of the direct and figurative meaning of words, violation of causal relationships.

For example: People die and grass dies. So people are grass.

Paralogical thinking as a transition to a violation of judgment.

6.2. Thinking disorders

Thinking   - this is the function of cognition, with the help of which a person analyzes, connects, generalizes, classifies. Thinking is based on two processes: analysis(decomposition of the whole into its component parts in order to distinguish the main and secondary) and synthesis(creation of a holistic image from separate parts). Thinking is judged by a person’s speech and sometimes by actions and deeds.

Associative Process Disorders

Accelerated Pace (Tachyphrenia)   - thinking is superficial, thoughts flow quickly, easily succeed each other. Characterized by increased distractibility, patients constantly skip over to other topics. Speech is accelerated, loud. Patients do not correlate the strength of the voice with the situation. Statements are interspersed with poetic phrases, singing. Associations between thoughts are superficial, but nevertheless they are understandable.

The most pronounced degree of accelerated thinking is leap of ideas(fuga idiorum) There are so many thoughts that the patient does not have time to speak them, unfinished phrases and speech are excited. It is necessary to differentiate with torn thinking, in which associations are completely absent, the pace of speech remains normal, there is no characteristic emotional saturation. An accelerated rate of thinking is characteristic of manic syndrome and for intoxication with stimulants.

Mentism - subjective sensation, when in the head there is a mass of thoughts that are not interconnected. This is a short-term condition. Unlike accelerated thinking, it is extremely painful for the patient. The symptom is characteristic of Kandinsky-Clerambo syndrome.

Slow pace (bradyphrenia).Thoughts with difficulty arise and for a long time remain in consciousness. Slowly replace one another. The speech is quiet, poor in words, answers with delays, phrases are short. Subjectively, patients describe that thoughts, appearing, overcome resistance, “toss and turn like stones”. Patients consider themselves intellectually untenable, stupid. The most severe form of slow thinking is monoidism, when one thought holds in the patient’s mind for a long time. This type of disorder is characteristic of depressive syndrome, organic brain damage.

Sperung   - clippings of thoughts, "blockage of thinking", the patient suddenly loses the thought. Most often, subjective experiences may not be noticeable in speech. In severe cases - sudden termination of speech. Often combined with mental influxes, resonance, observed with clear consciousness.

Slipping thinking   - rejection, slipping of reasoning to secondary thoughts, the thread of reasoning is lost.

The fragmentation of thinking.With this disorder, there is a loss of logical connections between individual thoughts. Speech becomes incomprehensible, the grammatical structure of speech is preserved. The disorder is characteristic of a distant stage of schizophrenia.

For incoherent (incoherent) thinkingcomplete loss of logical connections between individual short statements and individual words (verbal okroshka) is characteristic, speech loses grammatical correctness. The disorder occurs with a disturbed consciousness. Incoherent thinking is included in the structure of amenable syndrome (often in a state of agony, with sepsis, severe intoxication, cachexia).

Resonance   - empty, barren, vague reasoning, not filled with concrete meaning. Idle talk. It is noted in schizophrenia.

Autistic thinking   - reasoning is based on the subjective attitudes of the patient, his desires, fantasies, errors.

Often there are neologisms - words invented by the patient himself.

Symbolic thinking   - Patients give special meaning to random objects, turning them into special characters. Their content is not clear to others.

Paralogical thinking   - reasoning with “crooked logic”, based on a comparison of random facts and events. It is characteristic of a paranoid syndrome.

Duality (ambivalence) - the patient affirms and denies at the same time the same fact, often occurs with schizophrenia.

Persistent thinking   - stuck in the mind of one thought or idea. The repetition of one answer to various subsequent questions is characteristic.

Verbigeration   - a characteristic violation of speech in the form of repetition of words or endings with their rhyming.

Pathological thoroughness of thinking.In the statements and reasoning there is excessive detail. The patient is “stuck” on circumstances, unnecessary details, the topic of reasoning is not lost. It is characteristic of epilepsy, paranoia syndrome, psycho-organic syndromes, paranoia delirium (especially noticeable when the delusional system is justified).

Disorders of the semantic content of the associative process

Superb ideas   - thoughts closely connected with the patient’s personality, determining his behavior, having a basis in a real situation, arising from it. Criticism of them is flawed, incomplete. The content distinguishes overvalued ideas of jealousy, invention, reformism, personal superiority, substantive, hypochondriacal content.

The interests of patients narrow down to overvalued ideas, which occupy a dominant position in the mind. Most often, overvalued ideas arise in psychopathic individuals (overly confident, anxious, suspicious, with low self-esteem) and in the structure of reactive states.

Crazy ideas   - false conclusions arising on a painful basis, the patient is not critical to them, can not be persuaded. The content of crazy ideas determines the behavior of the patient. The presence of delirium is a symptom of psychosis.

The main signs of delusions: absurdity, incorrect content, a complete lack of criticism, the impossibility of dissuasion, a determining influence on the patient's behavior.

According to the mechanism of occurrence, the following types of delirium are distinguished.

Primary delirium   - Delusions arise primarily. Sometimes present in the form of a monosymptom (for example, with paranoia), as a rule, systematized, monothematic. The presence of successive stages of formation is characteristic: delusional mood, delusional perception, delusional interpretation, crystallization of delirium.

Secondary nonsense   - sensual, arises on the basis of other mental disorders.

Affective nonsense.Closely associated with severe emotional pathology. It is subdivided into holotim and catatym.

Holotimny deliriumoccurs with polar affective syndromes. With euphoria - ideas with increased self-esteem, and with melancholy - with reduced.

Catatonic nonsensearises in certain life situations, accompanied by emotional stress. The content of delirium is associated with the situation and personality traits.

Induced (inspired) delirium.It is observed when the patient (inductor) convinces those around him of the reality of his conclusions, as a rule, arises in families.

Depending on the content of delusions, there are several characteristic varieties of delirium.

Persecutive forms of delirium (delusions of exposure)At delusions of persecutionthe patient is convinced that a group of people or one person pursues him. Patients are socially dangerous because they themselves begin to harass suspected individuals whose circle is constantly growing. Need in-patient treatment and long-term follow-up.

Raving relationships   - patients are convinced that others have changed their attitude towards them, have become hostile, suspicious, constantly hinting at something.

Bullshit of special significance   - patients believe that television programs are specially selected for them, everything that happens around it has a certain meaning.

Delirium poisoning   - the name itself reflects the essence of delusional experiences. The patient refuses food; olfactory and taste hallucinations are often present.

Delirium of exposure   - the patient is convinced that the alleged pursuers in some special way (evil eye, spoilage, special electric currents, radiation, hypnosis, etc.) affect his physical and mental state (Kandinsky-Clerambo syndrome). Delirium of exposure can be inverted when the patient is convinced that he himself acts and controls others (inverted Kandinsky-Clerambo syndrome). Often, delirium of love influence is separately allocated.

Delusions of material damage(robbery, robbery) are characteristic of involutional psychoses.

Delusions of greatness.The delirium of greatness includes a group of different crazy ideas that can be combined in the same patient: delirium of power(the patient claims to be endowed with special abilities, power); reformist(ideas for rebuilding the world); inventions(conviction of a great discovery); special origin(the conviction of patients that they are descendants of great people).

Manichaean delirium   - the patient is convinced that he is at the center of the struggle between the forces of good and evil.

Mixed forms of delirium

Delusions of dramatization.Patients are convinced that those around them are playing a performance specifically for them. Combined with delirium of intermetamorphosis, which is characterized by delusional forms of false recognition.

Symptom of a negative and positive double (Karpg syndrome).With a symptom of a negative double, the patient takes close people for strangers. False recognition is characteristic.

With a symptom of a positive double, strangers and strangers are perceived as friends and relatives.

Symptom Fregoli - it seems to the patient that the same person appears to him in various reincarnations.

Nonsense of self-incrimination(convince sinners).

Delusions of megalomaniac content   - the patient believes that all of humanity is suffering because of him. The patient is dangerous for himself, extended suicides are possible (the patient kills his family and himself).

Nihilistic nonsense(nonsense of denial) - patients are convinced that they do not have internal organs, there is no possibility of the safe functioning of organs, patients consider themselves living corpses.

Hypochondriacal delirium   - patients are convinced that they have any physical illness.

Delusions of physical disability (dysmorphomania delirium)characteristic of adolescence. Patients are convinced that they have external ugliness. In contrast to dysmorphophobia (which was described in the framework of depersonalization syndrome), behavioral disorders are very significant, combined with raving attitudes and depression.

The delirium of jealousyis often ridiculous content, very resistant. Patients are socially dangerous. It is characteristic of the elderly, sometimes associated with the extinction of sexual function.

Rare options for the content of crazy ideas

Retrospective (introspective) delirium   - delusions relate to a past life (for example, delirium of jealousy after the death of a spouse).

Residual nonsense   - observed in patients after exiting psychosis, a state of altered consciousness.

Delusional Syndromes

Paranoid syndrome   - the presence of monothematic primary systematic delirium. One theme is typical, usually delusions of persecution, jealousy, invention. Primary nonsense, since nonsense is not associated with hallucinatory experiences. Systematized, as the patient has a system of evidence that has its own logic. It develops slowly, gradually, for a long time. Prognostically unfavorable.

Paranoid syndrome - nonsense versatile, several variants of nonsense (attitude, special significance, persecution). The structure of this syndrome often includes perceptual disorders (hallucinatory-paranoid syndrome - delusions are diverse, the content of delirium is secondary, often determined by the content of hallucinations). The content of crazy ideas is changing dynamically. Something else joins the delirium of persecution. It is accompanied by an affective state (fear, anxiety, longing). Characteristic of delusional behavior and delusional perception of the world and current events.

An acute course (acute paranoid) is characteristic of schizoaffective psychoses, paroxysmal schizophrenia, organic brain diseases, intoxications.

The chronic course occurs in the paranoid form of schizophrenia, a common option is the hallucinatory-paranoid Kandinsky-Clerambo syndrome.

Paraphrenic syndrome.The structure of this syndrome includes delusions of power and persecution, hallucinatory experiences, fragmentation of thinking. The content of crazy ideas is constantly changing (often completely ridiculous and fantastic), the system is completely absent, the plot changes depending on the emotional state. The mood is either complacent or apathetic. The above syndromes (paranoid, paranoid and paraphrenic) are a kind of stages of development of delirium in the paranoid form of schizophrenia. There are two variants of the syndrome: expansive and confabulary.

Kotar's syndrome.It is observed with involutional psychoses. Delusional ideas of nihilistic content are accompanied by an anxious and depressive affect.

Dysmorphomanic syndrome.Delirium of external ugliness, delirium of a relationship, depression. Patients actively visit doctors, insist on plastic surgery. Suicidal thoughts and actions are possible.

Obsessions.Obsessive thoughts (obsessions) - memories, doubts, unnecessary thoughts, experiences, alien personalities of the patient, arising in the patient's mind against his will. The patient is critical of such extraneous thoughts, realizes their painful nature, struggles with them.

Contrasting obsessive desires - desires to perform actions that do not correspond to the moral precepts of the person, are never realized.

The syndrome of obsessive states (obsessive-compulsive-phobic) occurs in case of neurosis (neurosis of obsessive states), decompensation of asthenic psychopathy, in the initial stages of low-grade schizophrenia.

Options for obsessions:

1) thoughts of blasphemous content;

2) arithmomania - an obsessive account;

3) phobias - obsessive fears (a huge number of options, which is why the list of phobias received the unofficial name "garden of Greek roots"):

but) nosophobia   - obsessive fear of getting sick, as cardiophobia (fear of a heart attack) and carcinophobia (fear of cancer) are often found as private options;

b) phobias of the state, agoraphobia   - fear of open spaces and claustrophobia   - fear of confined space;

in) erythrophobia   - fear of blushing in people;

d) scoptophobia   - fear of being ridiculous;

e) pettophobia   - fear of losing intestinal gas;

e) lysophobia (maniophobia)   - fear of going crazy;

g) phobophobia   - fear of phobia.

At the height of the experience of obsessive fears in patients, pronounced autonomic disorders, often motor (panic) agitation, are noted.

Compulsions are obsessive desires (for example, craving for narcotic drugs without physical dependence phenomena).

Rituals are special obsessive protective actions that are always combined with phobias.

Habitual obsessive movements (not having a protective component for the patient) - biting nails, hair, finger sucking.

Features of delusions in childhood and adolescents

1. Hallucinogenicity - in adults more often primary delusions, and in children secondary, based on hallucinatory experiences.

2. Katatimost (affectogenicity) - topics of crazy ideas are associated with read books, computer games, watched films, which made a strong impression on the child.

3. Fragmentation (fragmentaryness) - vague unfinished delusional constructions.

4. Delusional mood - manifested in a sense of distrust of relatives, educators. The child becomes withdrawn, alienated.

5. The younger the child, the more primitive the delirium. The delirium of foreign parents is typical, delirium of pollution (they constantly wash their hands before maceration), hypochondriac delirium, dysmorphomania. The ideas of monothematic content are close to paranoid delirium.

Thinking- the highest stage of cognitive activity, which is based on the processing of the received information (sensations and perceptions), their analysis and synthesis. 2 types of disturbances in the thought process: quantitative and qualitative.

Quantitative Disorders of Thinking   manifest themselves in the form of a restriction of mental activity or its underdevelopment with a delay in mental development ( ZPR) or mental retardation ( oligophrenia) In adolescents and adults, the breakdown of mental activity - dementiaobserved with chronically ongoing mental processes.

Quality disorders   mental activity observed in various neuroses and psychoses and are manifested in a disorder in the pace of mental activity, obsession and delirium.

Violation of the pace of mental activity   due to the predominance of excitation or inhibition in the cerebral cortex.

Accelerated flow of thoughts   up to the fragmentation of thinking. In these cases, the formation and change of associations is accelerated, one image is replaced by another, there is an influx of thoughts. The sequence is broken, the loss of logical connections between parts of sentences is growing. The process of thinking is characterized by disorder, and statements become incomprehensible, absurd. The accelerated pace of thinking is combined with excited behavior, which fits into a certain manic syndrome.

Slow motion of the thought process   observed with a predominance of inhibition in the cerebral cortex. Patients complain of a lack of thought, "there is some kind of emptiness in my head." Slowing the pace of mental activity is observed in depressive states.

Another form of frustration is the thoroughness of thinking - detail, in which the patient leaves the given topic, speaks in detail, repeats himself and cannot switch to the continuation of the main topic. Overly thorough thinking, stuck and poor switchability, the viscosity of thinking are characteristic of children and adults with organic lesions of the central nervous system (epilepsy, psycho-organic defect).

One form of impaired thinking is resonance, in which the patient does not answer the question, but begins to reason, teach the interlocutor. In this case, the patient’s verbal production is voluminous and distant from the essence of the issue. Such features of speech utterance can be observed with psychoses, with hydrocephalus.

One form of mental disorder can be perseveration and stereotyping, which are characterized by a repetition of the answer to the first question asked. At the same time, there is a prolonged dominance of any one thought, one idea, which is based on jamming of associations. Such states of inhibition are observed in patients with cerebral hemorrhages or brain tumors.

Unbridled, torn thinking is characteristic of a number of infectious diseases that occur with high fever, as well as in patients with schizophrenia. At the same time, thoughts do not unite among themselves, but represent separate fragments in which there is no analysis and synthesis, there is no ability to generalize, speech is meaningless.

Autistic thinking   characterized by the fenced off of the subject from the outside world, its isolation, immersion in their own experiences, not sufficiently consistent with reality.

Thinking disorders include obsessive thoughts (obsessive syndrome).   These are thoughts from which the patient cannot be freed, although he understands their uselessness. Obsessive thoughts can occur in practically healthy people, in neurotics, and in the mentally ill. Obsessive thoughts in neurotics are more complex and persistent. This is also a hotbed of stagnant arousal, but deeper. The patient is critical of his condition, but cannot get rid of his experiences. Obsessive thoughts in neurotics can be of a different nature and manifest themselves in the form of irresistible desires, drives and fears.

Obsessive fears, or phobiasare diverse and difficult to overcome. A thought may arise, and with it fear, before performing any task or action, especially in an environment of excitement, tension. Children have a fear of punishment for poorly completed homework or an unsatisfactory grade received at school. The same thoughts, and with them fears, may appear in a teenager or adult performing a difficult task in an unfavorable environment. Sometimes logoophobia   (fear of speech) is manifested in the presence of one person, a strict teacher or teacher at school, while in the presence of another person who is calm and friendly to the child, these thoughts and fear are absent.

Obsessive thoughts in mentally ill people are persistent, patients are not critical to them and do not seek help. In their clinical picture, obsessive thoughts in mentally ill patients are close to delusional ideas and can not be persuaded.

Superb ideas   observed in adolescence and are characterized by certain characteristics. If emotionally brightly colored thoughts prevail in a person’s consciousness, then they speak of the presence of supervaluable ideas. These thoughts are not ridiculous, but the patient gives them such great importance that they objectively do not have. Overvalued ideas are not accompanied by a painful sense of imposition and the desire to free oneself from the wrong way of thinking.

Delusions and delusions arise as a result of a brain disease. Delirium can occur against a background of frustrated consciousness during infection or intoxication, at the height of a painful condition (high temperature or alcohol poisoning), when patients pronounce separate words or short phrases that are not related to the environment.

Crazy ideas   - these are incorrect, untrue judgments, conclusions, which cannot be dissuaded. Patients are influenced by the thoughts that have arisen in them, ideas that change their behavior. Delusions are systematized, pronounced against a background of intact consciousness, accompany a mental disorder, and can be observed for a long time. Delusions can be combined with hallucinations.

Delusions vary in content.: ideas of attitude, persecution, poisoning, jealousy, greatness and enrichment, invention, reformism, litigation, and others.

Most common forms of delusions: ideas of attitude and ideas of persecution. At crazy ideas enrichment   patients talk about their infinite wealth. At crazy ideas of greatness   they call themselves the names of great people. At crazy ideas of invention   patients design various devices. At crazy ideas of litigation   patients write complaints to various organizations; they endlessly sue for any rights. One of the types of crazy ideas is characterized by an underestimated assessment of his personality, the patient is convinced of his worthlessness and uselessness, inferiority (crazy ideas of self-humiliation). In these cases, patients experience a depressive state in which they consider themselves to be bad, insignificant. Hypochondriacal delirium   characterized by unfounded beliefs and statements of the patient that he has an incurable disease and he must die soon.

Along with the primary delirium, sensory (figurative) delirium is possible, which is characterized by a disorder of sensory cognition, develops against the background of other mental disorders, is of a visual nature with many images perceived fragmentarily, folding into images, conjectures, fantasies, which explains its incoherence and absurdity. Allocate various forms of sensual delirium.

Nonsense of self-incrimination   manifested in the fact that the patient ascribes to himself various errors, misconduct, which were actually or significantly increased, up to the crime. Such conditions occur in adolescents who have suffered a skull injury or encephalitis. With delusions of exposure the patient believes that his thoughts, actions, actions are due to extraneous effects of hypnosis, radio waves, electric current. Delusions of persecution   lies in the fact that the patient considers himself surrounded by enemies who seek to destroy him or harm him, and therefore takes various precautions to prevent this from happening. Among the forms of sensory delirium are also described. nonsense of self-abasement, damage, nihilistic, expansive, fantastic, religious, erotic, jealousy, cosmic influence, etc. Unsystematic delirium, called paranoid, is incoherent in nature, based on conjectures and assumptions.

Researchers still have not decided what constitutes a thought process. It is believed that it should be understood as one of the higher mental functions by which a person perceives and summarizes information about reality surrounding him.

However, under the influence of external factors, people can partially or completely lose this ability. Violations of thinking are both temporary and permanent, and may be the result 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. Also, this process allows you to determine the subjective attitude of a person to objects and events of the real world. As a result, due to thinking, a certain perception of the surrounding reality (point of view) is formed, which people can express through speech.

In fact, this process allows a person not only to make an idea of \u200b\u200bthe real world, but also to understand it. Moreover, mental activity is associated not only with specific objects, but also with abstract concepts.

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

The formation of pictures of the inner and outer world is due to the analysis of causal relationships. At the same time, a person, relying on his own abilities, subjects the results obtained in the course of the thought process to verification, based on 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 violation of thinking is diagnosed if the person does not meet the following criteria:

It is important to note that these criteria 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 was found that eating after 9 pm is harmful. If most people comply with this rule, and several 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 impaired thinking:

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

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

Features of disturbance in 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 violation of thinking is characterized by leaps of ideas. A person cannot stop and constantly produces them through speech, giving out to the surrounding world a huge stream of associations. 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 violation often gets a voice.

The indicated 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 made. He retains the ability to eliminate them.

Inertia of thinking

A violation of this type of thinking is characterized by the following features:

• slow process of forming associations;
• the presence of inhibition;
• lack of ability to form their own thoughts.

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

Lack of consistency in judgment

With such a deviation, the unstable nature of judgments and associations is observed. However, the patient can analyze the current situation quite well, perceive and summarize the information received. A violation of this type of thinking occurs against the background of mental disorders, as well as in brain pathologies (injuries, vascular diseases).

The appearance of responsiveness

Response refers to behavior that is not characteristic of a healthy person, in which the patient constantly and incoherently includes visible objects in his speech. In addition, patients have disorientation in space and time, they can forget certain dates, names and events. The patient's speech becomes incoherent.

Mostly, response 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 reasoning. Moreover, a person slides to incoherent associations. Over time, the patient returns to the initial topic. Sliding occurs sporadically and suddenly. Most often, this effect is noted in schizophrenic disorders.

Personality disorder

Violations of logical thinking include the following phenomena.

Inability to generalize thoughts

The diversity of thinking is characterized by a lack of focus in the actions of the patient. The latter is simply not able to generalize several objects, highlighting one or more features in them. In this case, the patient retains the ability to classify objects, but carries out such actions based on personal preferences: habit, taste, and more. In the conclusions of the patient there is no objective judgment.

Resonance

A characteristic sign of resonance is incoherent and lengthy reasoning, which 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 when he makes a speech. He doesn’t care if someone responds to his thoughts. The patient needs to speak out. Resonance is often observed in people suffering from schizophrenia.

Delirium

The delusional state is a violation of the thought process in which the information expressed by the patient is abstract in nature.

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

Lack of critical thinking and intrusiveness

The lack of critical perception leads to the fact that in the patient’s actions focus disappears. The patient is not able to regulate his actions.

A characteristic sign of an obsessive state are phobias.

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

Disorders of associative thinking

Associative thinking disorders manifest themselves in the form of:

It has already been 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. Considered violations 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, schizophrenia. With such violations, a person does not always and does not fully realize what is happening, loses the ability to control with his actions. Depending on the area of \u200b\u200bbrain damage, there is a chance that the patient will begin to perceive the surrounding reality in a distorted form.
2. Psychoses. Psychoses negatively affect the mental processes of a person, as a result of which the latter ceases to adequately react and perceive the surrounding world. His judgments are often not consistent with generally accepted logic. The patient expresses incoherent thoughts.

Methods of research violations

A psychologist is engaged in the study of impaired thinking. If you suspect the presence of such pathological changes, initially instrumental methods are used to diagnose them:

Instrumental methods of research allow us to establish the presence of a lesion in the brain and identify pathologies that can lead to impaired thinking. After this stage of diagnosis is completed, 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, violations, the following methods are used:

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

Each of these methods makes it possible to evaluate a person’s ability to generalize incoming information, form an idea of \u200b\u200bthem, and other important factors on the basis of which a final diagnosis is made.

Violations of a person’s mental abilities occur mainly with 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 of the real world. To make an accurate diagnosis and identify the true nature of thinking disorders, psychological testing of the patient will be required.

A violation of human thinking is a disorder of information processing processes, the identification of relationships connecting various phenomena or objects of surrounding reality, deviations in the reflection of the essential properties of objects and in the determination of the relationships that unite them, which gives rise to false ideas and imaginary judgments about objectively existing reality. There are several types of disturbances in the thinking process, namely, a disturbance in the dynamics of thought processes, a pathology of the operational functioning of thinking, and a disorder in the motivational-personal component of mental activity. In most cases, it is practically impossible to qualify the features of the mental operation of each patient within the framework of one type of violation 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 an unequal degree of severity. So, for example, a disorder of the generalization process in a number of clinical cases is combined with pathologies of purposefulness of mental operations.

Impaired thinking are some of the most common symptoms of mental illness.

Types of Thinking Disorder

Disorder of the operational function of mental activity. Among the main operations of thinking distinguish: abstraction, analysis and synthesis, generalization.
Generalization is the result of analysis, which reveals the basic relationships between phenomena and objects. There are several stages of generalization:
  - categorical stage, is to be classified, based on the essential features;
  - functional - is to be classified as based on functional features;
  - specific - is to be classified, based on specific characteristics;
  - zero, that is, there is no operation — consists in listing objects or their functions without intentions to generalize.

The pathologies of the operational side of mental functioning are quite diverse, but two extreme options can be distinguished, namely lowering 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 the generalized properties, patients use specific situational compounds, they have difficulty in abstracting from specific elements. Such disorders can occur in a mild form, moderately expressed and severely expressed degree. Such disorders are usually observed in cases of mental retardation, severe encephalitis, and organic brain pathology.

We can talk about lowering the level of generalization exclusively in the case when this level was earlier, and then decreased.

If the operational processes of generalization are distorted, patients are guided by overly generalized properties that are inadequate to the actual connections between objects. The prevalence of formal, transient associations, as well as a departure from the substantive aspect of the task, is noted. Such patients establish exclusively formal, verbal connections, the true difference and similarity are not for them a test of their judgments. Similar disorders of mental activity are found in individuals suffering.

Of much greater clinical importance is the inertia of thought processes with inhibition of comprehension, the comparative scarcity of associations, unhurried and laconic impoverished speech.

Inertia of mental activity leads to the difficulty of learning the school curriculum by sick children, as they are not able to learn at the same pace with healthy kids.

The rupture of mental functioning is revealed in the absence of purposefulness of mental activity, the relations established between objects or representations are violated. The order of mental operation is distorted, and sometimes the grammatical structure of phrases can be preserved, which transforms speech, which is meaningless, into an outwardly ordered sentence. In cases where grammatical connections are lost, mental activity and speech are converted into a meaningless verbal set.

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

The responsiveness of mental functioning in children is manifested by the variability of the way exercises are performed.