Formal Thought Disorder and Self-Disorder: An Empirical Study

Background: Formal thought disorder was constitutively linked to the original concept of schizophrenia and has since been one of central features supporting its diagnosis. Bleuler considered formal thought disorder as a fundamental symptom of schizophrenia among other fundamental symptoms, including...

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Main Authors: Julie Nordgaard, Mette Gravesen-Jensen, Marlene Buch-Pedersen, Josef Parnas
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-04-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2021.640921/full
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author Julie Nordgaard
Julie Nordgaard
Mette Gravesen-Jensen
Marlene Buch-Pedersen
Josef Parnas
Josef Parnas
author_facet Julie Nordgaard
Julie Nordgaard
Mette Gravesen-Jensen
Marlene Buch-Pedersen
Josef Parnas
Josef Parnas
author_sort Julie Nordgaard
collection DOAJ
description Background: Formal thought disorder was constitutively linked to the original concept of schizophrenia and has since been one of central features supporting its diagnosis. Bleuler considered formal thought disorder as a fundamental symptom of schizophrenia among other fundamental symptoms, including ego disorders. The contemporary concept of self-disorder represents a more developed, nuanced, and systematic approach to disturbances of self-experience than the Bleulerian concept of ego disorders. As fundamental symptoms, on Bleuler's account, are persistently present in every case, an association between these symptoms could be expected. The purpose of this study was to examine the association between self-disorder and formal thought disorder.Methods: A sample of 94 diagnostically heterogeneous patients was examined for formal thought disorder using clinical rating and a proverb test. The proverb test was analyzed for two different aspects of formal thought disorder: literal responses and bizarre responses. The sample was comprehensively assessed for psychopathology, including self-disorder as measured with the Examination of Anomalous Self-Experience scale.Results: The patients, who provided bizarre responses, had a higher level of self-disorder, more negative symptoms, lower level of social functioning, and lower level of intelligence. Bizarre answers aggregated in patients diagnosed within the schizophrenia spectrum compared with patients outside the schizophrenia spectrum. We found moderate correlations between the two measures of formal thought disorder (clinically rated and bizarre responses) and self-disorder (0.454 [p < 0.01] and 0.328 [p < 0.01]). Literal responses did not differ between diagnostic groups and also did not correlate with bizarre responses. Specificity of bizarre responses for a diagnosis within schizophrenia spectrum was 86.89%, whereas sensitivity was 40.85%.Conclusion: The close relation between formal thought disorder and self-disorder further adds to the notion of self-disorder as a unifying psychopathological core beneath the apparently heterogeneous symptoms of schizophrenia.
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spelling doaj.art-9bc0f250f286408d9ed17bf7561489ae2022-12-21T22:51:36ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-04-011210.3389/fpsyt.2021.640921640921Formal Thought Disorder and Self-Disorder: An Empirical StudyJulie Nordgaard0Julie Nordgaard1Mette Gravesen-Jensen2Marlene Buch-Pedersen3Josef Parnas4Josef Parnas5Mental Health Centre Amager, Copenhagen, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkEarly Psychosis Intervention Centre, Psychiatry East, Roskilde, DenmarkEarly Psychosis Intervention Centre, Psychiatry East, Roskilde, DenmarkMental Health Centre Glostrup, Copenhagen, DenmarkCenter for Subjectivity Research, University of Copenhagen, Copenhagen, DenmarkBackground: Formal thought disorder was constitutively linked to the original concept of schizophrenia and has since been one of central features supporting its diagnosis. Bleuler considered formal thought disorder as a fundamental symptom of schizophrenia among other fundamental symptoms, including ego disorders. The contemporary concept of self-disorder represents a more developed, nuanced, and systematic approach to disturbances of self-experience than the Bleulerian concept of ego disorders. As fundamental symptoms, on Bleuler's account, are persistently present in every case, an association between these symptoms could be expected. The purpose of this study was to examine the association between self-disorder and formal thought disorder.Methods: A sample of 94 diagnostically heterogeneous patients was examined for formal thought disorder using clinical rating and a proverb test. The proverb test was analyzed for two different aspects of formal thought disorder: literal responses and bizarre responses. The sample was comprehensively assessed for psychopathology, including self-disorder as measured with the Examination of Anomalous Self-Experience scale.Results: The patients, who provided bizarre responses, had a higher level of self-disorder, more negative symptoms, lower level of social functioning, and lower level of intelligence. Bizarre answers aggregated in patients diagnosed within the schizophrenia spectrum compared with patients outside the schizophrenia spectrum. We found moderate correlations between the two measures of formal thought disorder (clinically rated and bizarre responses) and self-disorder (0.454 [p < 0.01] and 0.328 [p < 0.01]). Literal responses did not differ between diagnostic groups and also did not correlate with bizarre responses. Specificity of bizarre responses for a diagnosis within schizophrenia spectrum was 86.89%, whereas sensitivity was 40.85%.Conclusion: The close relation between formal thought disorder and self-disorder further adds to the notion of self-disorder as a unifying psychopathological core beneath the apparently heterogeneous symptoms of schizophrenia.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.640921/fullschizophreniaschizotypyproverbbizarreliteralself-disorder
spellingShingle Julie Nordgaard
Julie Nordgaard
Mette Gravesen-Jensen
Marlene Buch-Pedersen
Josef Parnas
Josef Parnas
Formal Thought Disorder and Self-Disorder: An Empirical Study
Frontiers in Psychiatry
schizophrenia
schizotypy
proverb
bizarre
literal
self-disorder
title Formal Thought Disorder and Self-Disorder: An Empirical Study
title_full Formal Thought Disorder and Self-Disorder: An Empirical Study
title_fullStr Formal Thought Disorder and Self-Disorder: An Empirical Study
title_full_unstemmed Formal Thought Disorder and Self-Disorder: An Empirical Study
title_short Formal Thought Disorder and Self-Disorder: An Empirical Study
title_sort formal thought disorder and self disorder an empirical study
topic schizophrenia
schizotypy
proverb
bizarre
literal
self-disorder
url https://www.frontiersin.org/articles/10.3389/fpsyt.2021.640921/full
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