- sudden stop in speech or train of thought, lasts several seconds to a minute
- speech is blocked and then begins again on unrelated topic
- includes many unnecessary, tedious details before arriving at the main idea; usually requires prompting from interviewer to keep client on track
- thoughts veer from main idea and never get back - irrelevant topics are introduced
- expressed ideas are inconsistent, irrational, self contradictory
unconsciously fills in memory gaps with imagined material - common in alcoholism
Flight of ideas
- racing thoughts with some connection - common in mania
- rapid, tense, strained, difficult to interrupt - typically present with flight of ideas
- client unaware that there is no apparent relationship between thoughts - "We wanted to take the bus but the airport took all the traffic. Driving is the ticket when you want to get somewhere. No one needs a ticket to heaven. We all have it in our pockets."
- usually rhyming, "Very cold, cold and bold, gold has been sold."
- complete disorganization, "Most forward action grows life double plays circle uniform."
- repetition of own words or words of others, sometimes in sing-song fashion
- repetition of own words, phrases, ideas - common in dementia
- invents new words not understood by others, "She gave me a ride in her uniphonum."
Poverty of speech
- restricted amount of speech, limited details - common in dementia
- literal interpretation of words such as proverbs, or expressions like "climbing the walls."
Absence of abstract thinking
- causes inability to generalize, evaluate consequences