Loosening of Association
A loss of the normal structure of thinking. The patient’s discourse seems muddled and illogical and does not become clearer with further questioning; there is a lack of general clarity, and the interviewer has the experience that the more he/she tries to clarify the patient’s thinking, the less we understand it. Loosening of associations occurs mostly in patients with schizophrenia. Earlier psychopathologists have described three kinds of loosening of association:
Knight’s move thinking (Derailment, Entgleisen):
There is a change in the train of thought. There is retained but misled determining of the objective of thought. There is a disordered intermixture of constituent parts of one complex thought.
Talking past the point (vorbeireden)
where the patient gets close to the point of discussion, but skirts around it and never actually reach it
Verbigeration (word salad, schizophasia, paraphrasia)
where speech is reduced to a senseless repetition of sounds and phrases (this is more of a disorder of thought form)
Three types of loosening of associations. Word salad is the most severe form.