Psychopathology of thought (II/III)

Joaquín Díaz Atienza

1. Alterations in thought content:
   • Obsessive/phobic ideas
   • Overrated ideas
   • delusional ideas
   • Delusional ideas
   • Fantastic ideas
2. Alterations in the experiences of self and ownership:
   1. Theft
   2. Dissemination
   3. Tax
   4. Menting

INTRODUCTION

In this section, we deal with alterations in the content or quality of thought. The associative mechanisms of thought are usually normal. What fails is the content. Some authors define the tone of thought such as its ability to remain organized and coherent, placing the alterations studied in this section as the result of the loss of tone.

Authors such as Arráiz (2016) divide alterations of thought content into obsessive, delusional and fantastic.

Alterations in thought content

Obsessive/phobic ideas

Definición:

These are thoughts that repeatedly intrude on the individual and escape their control, causing distress. Their clinical significance is determined by the degree of interference they cause and, naturally, by the level of success or failure in controlling them. Most often, in their struggle to cope with obsessive thoughts, individuals establish a series of behaviors to minimize anxiety: these are obsessive rituals.

We call the thoughts or images that are imposed on the subject obsessionsWe call the behaviors implemented to mitigate the anxiety that it may produce in them obsessive rituals.

Characteristics of obsessions:

Table 1.

Characteristics of obsessions

These are misconceptions The subject is aware that they are She experiences them as imposed upon her, being unable to escape them. They are accompanied by anxiety or distress They are recurrent They are accompanied by avoidance behaviors (obsessive rituals or compulsions) When accompanied by fearful obsessions, they are called obsessive fears of the obsessions.

 

Rituals are highly varied and frequently express the content of obsessive thoughts. Obsessive psychopathology has been given many names: Disease of doubt, anancastic parapathyWhen anxiety predominates, it has been called obsessive-compulsive disorder And if it is fear, obsessive-phobic disorder.

 Overrated ideas:

These are ideas that carry a strong emotional charge. Because of this strong emotional charge, they acquire a decisive place in the individual's life, standing out from other thoughts. The individual's conviction is more emotional than rational. Not all overvalued ideas are pathological, although they are always the foundation of fundamentalisms.

Delusional ideas:

These are false ideas resulting from other psychopathological states (therefore, they are not primary), such as the idea of ​​ruin and guilt in severe depressive episodes. They are easier to refute when counterarguments are presented by the therapist.They may be affective (depression/mania), self-referential (feelings of persecution or of being observed and rejected). The latter are usually found in subjects with inferiority complexes.

Delusional ideas:

Definitions:

For a thought to be considered delusional, it must meet a series of requirements:

• Let it be false.
• To be irreducible to all logical argumentation.
• It is established through a pathological mechanism. Therefore, magical thinking or religious beliefs do not apply here.
• They are primary. That is, they are not a consequence of other psychopathological disorders.

The origin of delusional ideas can be of perceptual type, interpretive, delusional occurrences and false ideas in the strict sense (Arráiz, 2016).Other concepts have been described, some of which remain relevant while others are losing relevance:

Delusional system:

It would be the construction of a plot of delusional thoughts that end up building a story (López Sánchez, 1980). The subject mixes normal thoughts with delusional ones, which then feed back into each other. The subject organizes their life around their delusional ideas. They are very difficult to resolve.

Delirious humor:

It consists of an expectant, fearful state of mind and a subjective feeling that something terrible, apocalyptic, is about to happen. The situation completely overwhelms a person who is distressed, paralyzed, or, conversely, agitated.

Delusional representation or update:

It was described by Jaspers and consists of giving a delusional meaning to one or more events or experiences that occurred in the past. Hence, it is also called delusional update.

Most frequent themes in delusions:

Self-referential: The patient refers to certain facts, comments, and even events concerning himself.

Of harm: He feels persecuted, harassed, the target of a conspiracy…

Nihilists: They are usually related to the body: denial of certain parts, even of radical bodily changes, as in the so-called Cotard's syndrome.

Jealous: Conviction of infidelity.

Of significance: The subject finds a special meaning in the events.

Transformation: They express feeling changed. Here, denial or loss of bodily aspects is not predominant.

Fantastic ideas

This involves a grand display of fantasy, improbable ideas, and unrealistic notions that manifest in the individual in a delusional manner. It commonly occurs in people with a history of significant deprivation and a need for the approval of others. When these fantasies reach the level of delusion, they are also called delusions. paraphrenics.

In the next topic we will address the Alterations in the experiences of self and ownership

the bibliography It is explained at the end