Tangentiality (A guide+other thought disorders)

Tangentiality (A guide+other thought disorders)

In this article, we will talk about tangentiality, circumstantial thoughts and other thought disorders.

What is tangentiality?

Tangentiality is a disorder of thought, in which it is observed that the flow of ideas, related to each other, are outside the subject in question which is never clearly defined, nor is it resumed. It gives the observer the impression that the person talking avoided consciously or unconsciously, to touch a certain subject from which he/she is moving away. 

In tangentiality, the subject gives tangential, irrelevant answers, he or she does not really answer what it is asked. Also, derailment ideas sneak up on each other and a proper connection between sentences is missing.

Tangentiality (A guide+other thought disorders)

Examples of Tangentiality

Tangentiality implies that the patient responds in an oblique, tangential or even irrelevant way. In the past, tangentiality had been described as a loss of associations and derailment, but here it refers only to responses and not to transitions in spontaneous speech.

Example of tangentiality would be (Sarason and Sarason, 1975):

“- How old are you?

  – As many as the pyramids that are disintegrating.

  – Where do you live?

  – I exist in the world, of the world, and for the world. “

What are circumstantial thoughts?

Circumstantial thoughts is a disorder of thought, in which an abundant flow of ideas, related to each other, is observed, distancing itself from the concept that one wishes to transmit, giving multiple detours but finally managing to return to the subject. 

Excessive detail is used in this type of thinking to describe simple events. It gives the observer the impression that the patient has difficulty distinguishing the essential from the accessory.

For example,  an epileptic patient answers the following when asked about the reason for the consultation: 

For my sister, who bothers me, and she will turn red when I tell her that it is true and true and true,  when she would have said those bad things that the man has to do with the woman. True, it’s true, or not, don’t you see? 

And now look at what I said, I was washing my clothes yesterday, not in the room where everyone is here, I was washing those clothes and the lady was there, I didn’t pay attention to myself and I said to one, I don’t know her name, to her who was wearing that purple skirt and the white sweater forwards … “, 

Afterwards, the person will talk again about the fights with his sister and family, losing himself in countless details.

Tangentiality (A guide+other thought disorders)

Thought disorders

Disorders of the form of thought (organization, articulation and formation of ideas). 

Accelerated thinking (marked speed of associative processes with an abundant production of ideas).

Thought presents a marked speed of associative processes and an abundant production of ideas that follow one another without paying attention to specific contents. Thought becomes ineffective from the communicative point of view. The speech is fluid, rich, often containing jokes, puns, allusions, and rhymes.

Its maximum pathological expression is the phenomenon of running from ideas, where the contents of ideas follow one another at great speed and mutability, relating to each other in a totally superficial way, through rapid associations based on phonetic similarity, of contents, rhymes, etc. 

In the most serious forms of accelerated thinking, the speech is totally incoherent and disordered.

Accelerated thinking can be found in normal conditions (during very intense emotional states of happiness, fear or tension) and in psychopathological conditions:

  • in drug or alcohol intoxication;
  • in functional conditions of arousal (manic and hypomanic state);
  • in schizophrenic-type dissociative states (in these cases the individual perceives a multitude of ideas that are massively concentrated and compressed in the head, their associations are very fast and inexplicable, they are external and passive – these last two characteristics constitute symptomatic aspects of the basis of schizophrenia).

Slow thinking (a marked decrease in ideas – the consequence of which is a difficulty in communication – scarce and poor content, slow and ineffective associations).

There is a marked decrease in ideas – the consequence of which is a difficulty in communication – scarce and poor content, slow and ineffective associations. A type of slow thinking is inhibited thinking. In inhibited thinking, ideas proceed with difficulty, they are like braking, irregular, although the individual seems to strive to overcome this obstacle.

This slowing down of thought is usually accompanied by motor inertia and a reduction in expressive mimicry.

Its maximum pathological expression is the PSYCHOMOTOR STUPOR phenomenon, a state of complete inhibition of relational and thinking functions.

Slow thinking can be found in transitory normal conditions (fatigue, boredom, disinterest or drowsiness) and in psychopathological conditions:

  • in psycho-organic syndromes (mental confusion, dementia, organic diseases of the Central Nervous System);
  • or in functional disorders such as depression, in some types of schizophrenia (with prevalent negative symptoms) or during hysterical crises (hysterical stupor).
Tangentiality (A guide+other thought disorders)

Poor thinking (thinking reduced in quantity and quality).

It is a type of thinking reduced both from the point of view of quantity and quality. The contents of the speech are poor and the expression is repetitive and stereotyped.

In general, the individual does not speak spontaneously, only responds when asked something with very short and simple sentences. Its maximum expression is the ANALOGUE THINKING of schizophrenia (with predominantly negative symptoms), a thought poor in content and expressions, with slowed down or empty processes.

Poor thinking can be found in psychopathological conditions such as:

  • mental deficiency;
  • mental deterioration (brain damage, dementia);
  • functional syndromes such as in the processes of schizophrenia with predominantly negative symptoms.

Neat thinking (tortuous, slow, indirect, with the interference of secondary ideas).

It is a type of thinking that reaches its conceptual objective in a tortuous, slow, indirect way, with the interference of secondary ideas that interrupt the communicative efficacy of the discourse thread.

The subject introduces in her speech little useful particulars, reiterates clarifications, opens parentheses that hinder the flow of ideas.

Neat thinking is typical in organic diseases (brain injuries, oligophrenia, epilepsy).

Tangentiality (A guide+other thought disorders)

FAQ about Tangentiality

What is Tangentiality?

Tangentiality is a disorder of thought, in which it is observed that the flow of ideas, related to each other, are outside the subject in question which is never clearly defined, nor is it resumed. It gives the observer the impression that the person talking avoided consciously or unconsciously, to touch a certain subject from which he/she is moving away.

What is Tangentiality and Circumstantiality speech?

Tangentiality referred to the excessive need of the subject to relate excessive details that often are irrelevant, vehicle circumstantiality speech is a disorder of thought, in which an abundant flow of ideas, related to each other, is observed, distancing itself from the concept that one wishes to transmit,

What is echolalia and Echopraxia?

Echolalia is by definition an echo repetition of words or phrases that a child or adult with ASD has heard and stored in the past. Even if echolalia is a language disorder that often accompanies ASD, it only becomes visible when the child/adult with ASD is able to verbalize.

Echopraxia is a pathological action of automatic imitation of one’s gestures (and actions). A nervous disease characterized by the automatic imitation of one’s gestures (and actions). 

What is the loosening of associations?

The loosening of associations is a thought disorder that is expressed in a speech speech that is disconnected and fragmented. Also, derailment ideas sneak up on each other and a proper connection between sentences is missing.

What is the poverty of content?

The poverty of content is a speech problem associated with poor thinking. In general, the individual does not speak spontaneously, only responds when asked something with very short and simple sentences.

What is accelerated thinking?

In accelerated thinking, a thought disorder, the thought presents a marked speed of associative processes and an abundant production of ideas that follow one another without paying attention to specific contents. Thought becomes ineffective from the communicative point of view. The speech is fluid, rich, often containing jokes, puns, allusions, and rhymes.

Tangentiality (A guide+other thought disorders)

Conclusions

In this article, we talked about tangentiality, circumstantial thoughts and other thought disorders.

Tangentiality is a disorder of thought, in which it is observed that the flow of ideas, related to each other, are outside the subject in question which is never clearly defined, nor is it resumed. It gives the observer the impression that the person talking avoided consciously or unconsciously, to touch a certain subject from which he/she is moving away. 

Circumstantial thoughts is a disorder of thought, in which an abundant flow of ideas, related to each other, is observed, distancing itself from the concept that one wishes to transmit, giving multiple detours but finally managing to return to the subject. 

Other thought disorders that we talked about in this blog post are accelerated thinking, slow thinking, neat thinking and poor thinking. Hopefully, by now you know the differences between all of them.

If you have further questions or comments on the subject of tangentiality, please let us know!

Further reading

Disordered Thinking and the Rorschach: Theory, Research, and Differential Diagnosis, by James H. Kleiger 

Language and Thought in Schizophrenia, by J. S. Kasanin

Clinical Neurotherapy: Chapter Nine. Treating Thought Disorders, by Tanju Sürmeli 

The Center Cannot Hold: My Journey Through Madness, by Elyn R. Saks  

Into the Abyss: A neuropsychiatrist’s notes on troubled minds, by Anthony David  

Without Saying A Word: Master The Science Of Body Language And Maximize Your Success, by Kasia Wezowski 

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). American Psychiatric Publishing.

Colombo, G. (2005). Clinical psychopathology. Cleup, Padova, Italy.

Gabbard, G.O. (2009). Principles of psychodynamic psychiatry. American Psychiatric Publishing.

Gabbard, G.O., & Atkinson, S.D. (2009). Treatment of psychiatric disorders. Ars Xxi Communication Group.

World Health Organization (1992-1994). International statistical classification of diseases and related health problems tenth revision ICD-10. World Health Organization.

Tangentiality (A guide+other thought disorders)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.