Thought blocking is a

neuropsychological Neuropsychology is a branch of psychology concerned with how a person's cognition and behavior are related to the brain and the rest of the nervous system. Professionals in this branch of psychology focus on how injuries or illnesses of the brai ...

symptom Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

expressing a sudden and involuntary

silence Silence is the absence of ambient hearing, audible sound, the emission of sounds of such low sound intensity, intensity that they do not draw attention to themselves, or the state of having ceased to produce sounds; this latter sense can be exten ...

within a speech, and eventually an abrupt switch to another topic.

World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...

(2023). " Thought blocking". ''

International Classification of Diseases The International Classification of Diseases (ICD) is a globally used medical classification that is used in epidemiology, health management and clinical diagnosis. The ICD is maintained by the World Health Organization (WHO), which is the dir ...

, eleventh revision – ICD-11''. Genova �
icd.who.int
Persons undergoing thought blocking may utter incomprehensible speech; they may also repeat words involuntarily or make up new words. The main causes of thought blocking are

schizophrenia Schizophrenia () is a mental disorder characterized variously by hallucinations (typically, Auditory hallucination#Schizophrenia, hearing voices), delusions, thought disorder, disorganized thinking and behavior, and Reduced affect display, f ...

anxiety disorder Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause phys ...

s, petit mal seizures,

post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental disorder that develops from experiencing a Psychological trauma, traumatic event, such as sexual assault, domestic violence, child abuse, warfare and its associated traumas, natural disaster ...

, bradyphrenia,

aphasia Aphasia, also known as dysphasia, is an impairment in a person's ability to comprehend or formulate language because of dysfunction in specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine, but aph ...

dementia Dementia is a syndrome associated with many neurodegenerative diseases, characterized by a general decline in cognitive abilities that affects a person's ability to perform activities of daily living, everyday activities. This typically invo ...

and

delirium Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or ...

Schizophrenia

Thought blocking occurs most often in people with psychiatric illnesses, most commonly

. A person's speech is suddenly interrupted by silences that may last a few seconds to a minute or longer. When the person begins speaking again, after the block, they will often speak about an unrelated subject. Blocking is also described as an experience of unanticipated, quick and total emptying of the mind.Gelder, Mayou, Geddes (2005). Psychiatry. New York, NY; Oxford University Press Inc. People with schizophrenia commonly experience thought blocking and may interpret the experience in peculiar ways. For example, a person with schizophrenia might remark that another person has removed their thoughts from their brain. When evaluating a patient for schizophrenia, a physician may look for thought blocking. In schizophrenia, patients experience two types of symptoms: positive and negative. Positive symptoms include behavior added on to a person's daily functioning. For instance,

delusion A delusion is a fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other m ...

hallucination A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pse ...

s, disorganized speech, disorganized behavior and thought are all positive symptoms. In contrast, negative symptoms are characterized by missing parts of the average individual's persona, including flat affect,

apathy Apathy, also referred to as indifference, is a lack of feeling, emotion, interest, or concern about something. It is a state of indifference, or the suppression of emotions such as concern, excitement, motivation, or passion. An apathetic i ...

, speaking very little, not finding enjoyment in any activity, and not attending to basic acts of daily living (ADLs), such as bathing, eating, and wearing clean clothes.

Anxiety disorders

Generalized anxiety disorder (GAD) is defined as excessive worry about matters in two or more separate subjects for at least six months. When a person experiences an anxiety attack, they may become so hyperfocused on the distressing stimuli or overwhelmed with the situation that regular speech is difficult for that person to produce. The thought blocking that occurs in this instance is usually short lived because anxiety attacks are transient. After an episode occurs, a person is typically able to resume their normal way of speaking.

Seizures

Thought blocking is associated with

absence seizures Absence seizures are one of several kinds of generalized seizures. Absence seizures are characterized by a brief loss and return of consciousness, generally not followed by a period of lethargy (i.e. without a notable postictal state). Absence ...

. As such, it can be hard for people to organize their speech, resulting in thought blocking.

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can occur after a person experiences a traumatic event and is significantly handicapped because of it, and can develop inappropriate coping strategies. These maladaptive approaches can include, but are not limited to dissociation, especially

depersonalization Depersonalization is a dissociative phenomenon characterized by a subjective feeling of detachment from oneself, manifesting as a sense of disconnection from one's thoughts, emotions, sensations, or actions, and often accompanied by a feeling of ...

and

derealization Derealization is an alteration in the perception of the external world, causing those with the condition to perceive it as unreal, distant, distorted, or in other ways falsified. Other symptoms include feeling as if one's environment lacks spontan ...

. When these dissociative symptoms surface, they can be extremely intrusive and result in a person not being able to focus on their diction, or manner of speaking, and result in thought blocking. People with PTSD may find that blocking of thought occurs more often if they have not addressed the source of their PTSD.

Cognitive and motor disorders

In older adults, blocking of thought can be a feature of several cognitive and motor disorders, including underlying

and

. It is common that as a person ages, they may become forgetful and/or lose their train of thought. When it becomes more persistent and affects one's ability to carry out their ADLs (activities of daily living), a major neurocognitive disorder like

is among the possible causes. In addition, thought blocking can occur in patients with parkinsonism, a disorder that features slowing of movement, muscle rigidity, and impairment. The distinguishing feature between parkinsonism and

Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a neurodegenerative disease primarily of the central nervous system, affecting both motor system, motor and non-motor systems. Symptoms typically develop gradually and non-motor issues become ...

is that the causes of

parkinsonism Parkinsonism is a clinical syndrome characterized by tremor, bradykinesia (slowed movements), Rigidity (neurology), rigidity, and balance disorder, postural instability. Both hypokinetic features (bradykinesia and akinesia) and hyperkinetic f ...

are numerous, including drugs, toxins, metabolic disorders, and head trauma. Furthermore, a stroke can result in a disordered speech process such as thought blocking. When a stroke affects the

middle cerebral artery The middle cerebral artery (MCA) is one of the three major paired cerebral artery, cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches an ...

(MCA), it can result in damage to the

Wernicke's area Wernicke's area (; ), also called Wernicke's speech area, is one of the two parts of the cerebral cortex that are linked to speech, the other being Broca's area. It is involved in the comprehension of written and spoken language, in contrast to ...

Broca's area Broca's area, or the Broca area (, also , ), is a region in the frontal lobe of the dominant Cerebral hemisphere, hemisphere, usually the left, of the Human brain, brain with functions linked to speech production. Language processing in the brai ...

. As such, people afflicted can understand speech well but have problems saying the words they want to, or be able to speak but have nonsensical syntax and word choice. These symptoms are referred to as

s, and aphasias can present with thought blocking.

References

{{Reflist Thought disorders Symptoms or signs involving form of thought Delirium Silence Symptoms of schizophrenia Post-traumatic stress disorder Aphasias Dementia