Analyse the following speech sample and choose the appropriate description. ‘The whirl of Susan’s life, it’s me... and I want to whirl happily. Stop all medicine, I will get more whirl every night. No doctor has the whirl to help…always liars... This whirl is full of mad people. ’
E. Neologism refers to making up a totally new word that is not in dictionary or using a known word with a completely different meaning, for example ‘inkur’ for pen (here a new word is created) or ‘roast’ for pen (here a known word is employed different to normal usage). Metonyms are word approximations, for example paperskate for pen. Stock words are either newly synthesized or already known words but used in an idiosyncratic way repeatedly, often with many meanings and in different contexts, sometimes dominating a discourse, as in this example. The word ‘whirl’ here stands for ‘meaning’, ‘to live’, ‘to sleep’, ‘nature’ etc. Neologisms, stock words, and metonyms together constitute private symbolism noted in schizophrenia.
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Which of the following psychopathological features could be diagnosed using sorting tests?
A. In overinclusive thinking ideas that are only remotely related to the concept under consideration become incorporated in the patient’s thinking. Normal conceptual boundaries are lost in overinclusive thinking. This is used to explain the thought disorders in schizophrenia and is different from the mechanism in flight of ideas. Sorting tests can be used to test overinclusion. It occurs in nearly 50% of schizophrenia patients, especially when they are acutely ill.
Analyse the following speech sample and choose appropriate description. ‘Q: How many legs does a dog have? A: Five. Q: What comes after Saturday? A: Tuesday. ’
A. Vorbeireden (‘talking past the point’) is often used interchangeably with vorbeigehen (‘going past the point’). Vorbeigehen was originally defined as part of the ‘Ganser syndrome’ whereby some criminals would give incorrect answers (‘approximate answers’) to simple questions. The incorrect answers themselves suggest that the question was well comprehended and the correct answer was known (e.g. Question: How many legs do dogs have? Answer: Five).
Which of the following is associated with circumstantiality?
A. In circumstantiality, thinking proceeds slowly, with many unnecessary details and digressions, before returning to the point. It is seen in some patients with temporal lobe epilepsy or alcohol-induced persisting dementia, learning difficulty, and in obsessional personalities. It is a formal thought disorder where figure ground differentiation apparently fails. It is not due to affective changes such as mania. It is not the same as tangentiality – the patient never reaches the point in tangentiality, whereas they do reach the point in circumstantiality. Imagine a spiral that eventually touches its centre, while tangent scrapes through the edge and never reaches the centre. Circumstantiality may be related to loosened associations and usually develops within the setting of a delusional mood in schizophrenia; it may be due to an impairment of a central filtering process that normally inhibits external sensations and internal thoughts that are irrelevant to a given focus of attention.
In pure word deafness, which one of the following is impaired?
D. In pure word deafness the patient can speak, read, and write fluently, but comprehension of speech is impaired. In pure word dumbness the disturbance is limited to an inability to produce and repeat words at will. In pure word blindness (alexia) speech and writing are normal but the patient cannot read. Comprehension of spoken words is preserved in pure word blindness.
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