Thought broadcasting
Thought broadcasting | |
---|---|
Other names | Thought diffusion[1] |
Usual onset | Early adulthood (16-30 years)[2] |
Duration | Usually chronic among the elderly population[3] |
Differential diagnosis | Echo de la pensée,[4] thought withdrawal and thought insertion[5] |
Frequency | 6% among individuals with schizophrenia in one study |
Thought broadcasting is a type of
Thought broadcasting is considered a severe delusion and it induces multiple complications, from lack of insight to social isolation. The delusion normally occurs along with other symptoms. Thought broadcasting is considered rare. In one study, for instance, it had a prevalence of 6% among individuals with schizophrenia.
Thought broadcasting is linked with problems of self-other control (the capacity to distinguish oneself from others). This type of delusion can be treated with the use of antipsychotic and psychotherapy. The delusion is part of the Schneider's first-rank symptoms of schizophrenia. The diagnosis of the condition can be made using the DSM-5 or the ICD-11.
Definition
Various interpretations of thought broadcasting exist in the literature, but three primary definitions have been recognized. Under the first definition, thought broadcasting occurs when an individual hears their own thoughts spoken aloud. This definition suggests an auditory hallucination is experienced by the individual. It was first noted in Kraepelin's book, Dementia Praecox and Paraphrenia. The second definition involves an individual sensing their thoughts silently escaping from their mind, without necessarily being audible to others. This contrasts with thought withdrawal, a similar phenomenon, as thoughts passively dissipate outwards rather than being actively removed. The third and final definition posits that thought broadcasting happens when others think in union with the individual, without the need for the thoughts to be audible. It was first described by Schneider in 1959 and is considered to be the most important definition.[1][6]
Signs and symptoms
Thought broadcasting is the persistent, distressing belief that one's thoughts are accessible by others, that continues even when evidence to the contrary is presented.
Thought broadcasting is often paired with lower functioning, quality of life, magical thinking and lack of insight and judgment. It can also contribute to symptoms of depression and anxiety.[2][20][note 1] Thought broadcasting recurrently leads to changes in mental privacy, location, and agency. It can also blur ego boundary.[21] It can be considered a manifestation of autonetic agnosia, that is, a deficit in the ability to identify self-generated mental events, along with thought insertion and others.[22]
This type of delusion influences both speech production and speech perception. Over time, thought broadcasting can shape how one thinks. If someone says a word or phrase similar to what the patient may have been thinking, it could catalyze the delusion, especially if it happens fairly frequently.[23]
Association with obsessive-compulsive disorder
There is a very high comorbidity between obsessive-compulsive disorder (OCD) and schizophrenia.[24] This may result from obsessive-compulsive symptoms that initially present or worsen with the use of atypical antipsychotics, a common treatment modality for schizophrenia.[25] Intrusive thoughts—involuntary and unwanted thoughts, ideas, and images—constitute a central symptom of OCD.[26] When these intrusive thoughts are coupled with thought broadcasting, it causes a special concern that these could be apprehended by others, resulting in increased anxiety and shame, leading to social isolation—a safety behavior. The relief given by isolation then reinforces the belief that the individual needs to stay away from others.[27][28]
Causes
Auditory hallucinations are often depicted as malicious voices that possess knowledge about the person's private and shameful thoughts or actions, which the individual would prefer to keep hidden. In these situations, thought broadcasting arises as an inability to conceal one's own thoughts.[29] This type of delusion is also believed to be linked with problems in self-other control, that is, when an individual adjusts the representation of oneself and others in social interactions.[note 2][30] Methamphetamine abuse can induce psychosis, including thought broadcasting.[31] One theory suggests that when the two hemispheres of the brain are not effectively integrated, the left hemisphere may fail to identify the source of feelings and thoughts originating in the right hemisphere. As a result, individuals may experience the mistaken belief that these thoughts and emotions are either being inserted into (thought insertion), removed from (thought withdrawal), or transmitted out of their own head (thought broadcasting).[32]
Treatment
Individuals with thought broadcasting have a lower acceptance of treatment.
Diagnosis and classification
Thought broadcasting was initially described by Emil Kraepelin in his 1913 work, Psychiatrie. In the mid-1900s, Kurt Schneider classified thought broadcasting as typical of schizophrenia, encompassing it as a first-rank symptom along with 7 others. From then, the delusion has been incorporated into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11) diagnostic criteria.[1] The DSM-5 outlines eleven categories of delusions, among which thought broadcasting is included. The ICD-11 characterizes it as in experiences of influence, passivity, and control, along with thought insertion and withdrawal. The DSM-5 specifies thought broadcasting as a belief that one's thoughts are transmitted and consequently perceived by others. It also classifies it as bizarre—a delusion of implausible and incomprehensible nature.[26][38] In contrast, the ICD-11 provides a broader description, stating that an individual's thoughts are accessible to others, enabling them to know the content of those thoughts.[8][26] Furthermore, it includes thought broadcasting as one of the core symptoms for diagnosing schizophrenia.[39]
See also
- Thought withdrawal – Delusional belief that thoughts have been taken out of one's mind
- Thought insertion – Delusional belief that thoughts have been inserted into one's mind
- Imaginary audience – Concept in developmental psychology
- Telepathy
Notes
- ^ For example, if a person believes that whenever they go in public, that their thoughts are being broadcast, it may cause the person to become socially withdrawn out of fear of others' hearing embarrassing thoughts.
- ^ For example, when empathizing with others, one's own mental and emotional state are temporarily put aside. Conversely, representations of others are suppressed when performing actions to avoid imitation.
References
- ^ S2CID 2284544.
- ^ ISBN 978-1-5063-5322-7.
...thought broadcasting can occur at any time, but it most often emerges between the ages of 16 and 30 years.
- ISBN 978-1-5063-5322-7.
thought broadcasting can occur at any time, but it most often emerges between the ages of 16 and 30 years....In elderly populations, positive symptoms such as thought broadcasting tend to be present as a more chronic form of the disorder developed earlier in life.
- PMID 32308031.
- ^ PMID 35918110.
- ISBN 978-1-904671-32-9.
- ^ "Self Portrait Series 13th June 1991 Copyright © 2017 Bryan Charnley – Creative Commons BY-SA 3.0 clearance. – Bryan Charnley". Retrieved 2023-08-24.
- ^ a b "ICD-11 for Mortality and Morbidity Statistics". icd.who.int. World Health Organization. Archived from the original on 2023-09-13. Retrieved 2023-09-13.
The experience that one's thoughts are accessible by others so that others know what one is thinking.
{{cite web}}
: CS1 maint: bot: original URL status unknown (link) - ISBN 978-0-8018-5815-4.
- S2CID 33309933.
- PMID 9777276.
We have shown that thought broadcasting delusions are typical of paranoid schizophrenia...
- ISBN 978-0-7020-2716-1.
These experiences [possession of thought] are usually indicative of a psychotic illness...
- S2CID 39188800.
- PMID 21927084.
For example, the probability of patients with thought broadcast to be allocated to the three different diagnostic classes were as follows : 0.97 probability for schizophrenia, 0.02 for manic psychosis and 0.01 for depressive psychosis (WHO, 1973).
- S2CID 251369942.
...when controlling for diagnosis, sex, and race we show that the diagnostic group and race are not key factors in explaining the occurrence of thought insertion, thought withdrawal, thought broadcasting...
- ISBN 978-91-628-9479-5.
Schneiderian first-rank symptoms (such as thought broadcasting and thought echo) are very rare...
- S2CID 251369942.
...thought broadcasting are usually regarded as some of the most severe types of delusions due to their phenomenological features, and impact on mental health.
- S2CID 7420162.
Thought broadcasting was recorded in 76 patients (6%)
- S2CID 251369942.
The symptom constellation of thought broadcasting included auditory verbal hallucinations, somatic hallucinations, delusions of thought dissemination (mind-reading), fantastic delusions, sexual delusions, and depersonalization.
- PMID 9777276.
In particular, we found that thought-broadcasting delusions correlated with...lack of judgment and insight...
- S2CID 251369942.
delusions...show fundamental changes in the way in which thoughts are experienced during psychosis...including alterations in their paradigmatic phenomenal character, sense of ego boundaries, mental privacy, mental location, and mental agency.
- ISBN 978-0-19-852568-4, retrieved 15 September 2023,
These symptoms are referred to as manifestations of autonoetic agnosia, meaning literally "the inability to identify self-generated mental events". These symptoms include poor insight, hallucinations, and various forms of delusions, such as thought insertion, thought withdrawal, thought broadcasting...
- PMID 8451607.
- PMID 30745688.
Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Symptoms (OCS) are known to be highly comorbid with bipolar disorder and schizophrenia.
- PMID 15488245.
Reports of OCD induction or exacerbation were limited to individuals with a primary psychotic disorder taking atypical antipsychotics. It is possible that psychotic individuals who develop OCD symptoms on atypical antipsychotics have an underlying biologic predisposition to the co-occurrence of OCD and schizophrenia
- ^ a b c Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association. 2013.
- PMID 32692132.
Harm obsessions subsequently functioned as triggering events for TB beliefs. The client's belief that others could hear his obsessive violent thoughts triggered further intense anxiety and shame, which led to extreme isolation. Isolation functioned as a safety behavior and reinforced the belief that he needed to stay away from others due to the potential danger he posed. Relief from distress served to negatively reinforce continued isolative behavior.
- PMID 24379014.
Bizarre behaviour may also act to alienate the person and reduce opportunities for social support and potential disconfirmation through social contact; or form a safety behaviour, preventing testing out of concerns.
- S2CID 20123651.
In about 70% of people with psychosis who hear voices, the voice(s) is commonly experienced as male and malevolent, as derogating and shaming, who typically issues commands is often experienced as powerful and omnipotent and 'knowing' i.e. knows of (can detect) shameful things and violations that the person would like to keep hidden. Indeed, attacking voices and experiences of thought broadcasting are often experienced as an inability to keep ' from view' (deception) one's own thoughts/experiences.
- ISSN 2632-7899.
Characteristic symptoms of schizophrenia, such as thought broadcasting...suggest a failure in distinguishing between oneself and others.
- S2CID 36416403.
The first several injections of methamphetamine induce hyperarousal and euphoria, but abuse may induce psychotic states consisting of paranoid delusions with auditory hallucination, bizarre ideas, thought broadcasting...
- PMID 3995938.
The left hemispheric consciousness is no longer inhibited from being aware that thoughts, feelings, and intentions are being imposed on it from an external source (the right hemisphere). The schizophrenic patient expresses (with his or her verbal left hemisphere) that thoughts are being inserted into, withdrawn from, or transmitted out of his or her head...
- PMID 9777276.
In particular, we found that thought-broadcasting delusions correlated with lower treatment acceptance...
- PMID 32692132.
The client endorsed considerable relief and receptivity to ERP and cognitive therapy in the context of CBT targeting psychotic and mood symptoms, including reduced distress associated with intrusive thoughts...and reduced conviction related to TB beliefs (from 95% to 25% by session 6 of ERP and 0% by the end of CBT)
- PMID 32692132.
The treatment of OCS resulted in the complete resolution of thought broadcasting.
- PMID 35918110.
...thought broadcast does not have a significant effect on outcome.
- PMID 1253591.
Taylor reported that the [first-rank] symptoms occur most commonly in [schizophrenic] patients with poor prognosis...
- ISBN 978-3-642-27772-6, retrieved 2023-08-25
- ISBN 978-1-5063-5322-7.
...the World Health Organization's International Classification of Diseases system includes thought broadcasting in a relatively short list of the "most important" phenomena or the diagnosis of schziphrenia.
External links
- Thought Broadcasting: When Your Thoughts Are No Longer Your Own, Discover Magazine, by Eric Taipale, Feb 12, 2022