Thought broadcasting explained

Thought broadcasting
Synonyms:Thought diffusion
Onset:Early adulthood (16-30 years)[1]
Duration:Usually chronic among the elderly population[2]
Differential:,[3] thought withdrawal and thought insertion[4]
Frequency:6% among individuals with schizophrenia in one study

Thought broadcasting is a type of delusional condition in which the affected person believes that others can hear their inner thoughts, despite a clear lack of evidence. The person may believe that either those nearby can perceive their thoughts or that they are being transmitted via mediums such as television, radio or the internet. Different people can experience thought broadcasting in different ways. Thought broadcasting is most commonly found among people who have a psychotic disorder, specifically schizophrenia.

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.[5] [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.[7] [8] [9] This condition is frequent among individuals with schizophrenia and is considered a positive symptom; however, it can also manifest during maniac episodes of bipolar disorder, psychotic depression, brief psychotic disorder and schizoaffective disorder.[10] [11] [12] [13] Thought broadcasting is rare and there are no significant differences in occurrence between sexes.[14] [15] This type of delusion is also regarded as one of the most severe, due to its significant effect on mental well-being.[16] Within the population of individuals with schizophrenia, thought broadcasting has a prevalence of approximately 6%, according to one study.[17] This type of delusion rarely occurs in isolation; it frequently coexists with other symptoms, including auditory verbal hallucinations, somatic hallucinations, delusions of control, delusion of guilt, sexual delusions, and depersonalization.[18]

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.[19] [20] 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.

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.[22]

Association with obsessive-compulsive disorder

There is a very high comorbidity between obsessive-compulsive disorder (OCD) and schizophrenia.[23] This may result from obsessive-compulsive symptoms that initially present or worsen with the use of atypical antipsychotics, a common treatment modality for schizophrenia.[24] Intrusive thoughts—involuntary and unwanted thoughts, ideas, and images—constitute a central symptom of OCD.[25] 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.[26] [27]

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.[28] 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.[29] [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.[33] Both antipsychotic medication and psychotherapy, specially cognitive behavioral therapy, may be useful.[4] In one case study, cognitive behavioral therapy and exposure therapy helped reduce significantly the conviction of thought broadcasting.[34] In another case study, where an individuals with schizophrenia also exhibited comorbid obsessive-compulsive symptoms (OCS), treating these symptoms helped to reduce thought broadcasting.[35] This delusion does not significantly affect the prognosis for patients with psychosis,[36] though is observed more often in schizophrenia with poor prognosis.[37]

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. 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. 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. Furthermore, it includes thought broadcasting as one of the core symptoms for diagnosing schizophrenia.[38]

See also

External links

Notes and References

  1. Book: Wenzel, Amy . The SAGE Encyclopedia of Abnormal and Clinical Psychology . 2017-03-16 . SAGE Publications . 978-1-5063-5322-7 . en. ...thought broadcasting can occur at any time, but it most often emerges between the ages of 16 and 30 years..
  2. Book: Wenzel, Amy . The SAGE Encyclopedia of Abnormal and Clinical Psychology . 2017-03-16 . SAGE Publications . 978-1-5063-5322-7 . en. 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..
  3. Jansson . Lennart . Parnas . Josef . September 2020 . 'The schizophrenic basic mood (self-disorder)', by Hans W Gruhle (1929) . History of Psychiatry . en . 31 . 3 . 364–375 . 10.1177/0957154X20915147 . 0957-154X. free . 32308031 .
  4. Magrangeas . Thibault Thierry . Kolliakou . Anna . Sanyal . Jyoti . Patel . Rashmi . Stewart . Robert . 2022-08-02 . Investigating the relationship between thought interference, somatic passivity and outcomes in patients with psychosis: a natural language processing approach using a clinical records search platform in south London . BMJ Open . 12 . 8 . e057433 . 10.1136/bmjopen-2021-057433 . 2044-6055 . 9351333 . 35918110.
  5. Pawar . Ajaykumar V. . Spence . Sean A. . October 2003 . Defining thought broadcast: Semi-structured literature review . The British Journal of Psychiatry . en . 183 . 4 . 287–291 . 10.1192/bjp.183.4.287 . 14519605 . 2284544 . 0007-1250. free .
  6. Book: Casey . Patricia R. . Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry . Kelly . Brendan . 2007 . RCPsych Publications . 978-1-904671-32-9 . en.
  7. Web site: ICD-11 for Mortality and Morbidity Statistics . https://web.archive.org/web/20230913101645/https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/10055838172 . 2023-09-13 . 2023-09-13 . icd.who.int . World Health Organization . The experience that one's thoughts are accessible by others so that others know what one is thinking. . bot: unknown .
  8. Book: Jaspers, Karl . General Psychopathology . 1997-11-27 . JHU Press . 978-0-8018-5815-4 . en.
  9. Garety . P. A. . Hemsley . D. R. . 1987-07-01 . Characteristics of delusional experience . European Archives of Psychiatry and Neurological Sciences . en . 236 . 5 . 294–298 . 10.1007/BF00380955 . 3653151 . 33309933 . 1433-8491.
  10. Dȩbowska . Grazyna . Grazwa . Anna . Kucharska-Pietura . Katarzyna . 1998-09-01 . Insight in paranoid schizophrenia—Its relationship to psychopathology and premorbid adjustment . Comprehensive Psychiatry . 39 . 5 . 255–260 . 10.1016/S0010-440X(98)90032-3 . 9777276 . 0010-440X . We have shown that thought broadcasting delusions are typical of paranoid schizophrenia....
  11. Book: Gamble . Catherine . Working With Serious Mental Illness: A Manual for Clinical Practice . Brennan . Geoff . 2006-01-06 . Elsevier Health Sciences . 978-0-7020-2716-1 . en . These experiences [possession of thought] are usually indicative of a psychotic illness....
  12. Gonzalez-Pinto . A. . Os . J. . Peralta . V. . Perez de Heredia . J. L. . Mosquera . F. . Aldama . A. . Gonzalez . C. . Gutierrez . M. . Mico . J. A. . April 2004 . The role of age in the development of Schneiderian symptoms in patients with a first psychotic episode . Acta Psychiatrica Scandinavica . 109 . 4 . 264–268 . 10.1046/j.1600-0447.2003.00272.x . 15008799 . 39188800 . 0001-690X.
  13. Raguram . R. . Kapur . R.L. . 1985 . A Study of First Rank Symptoms of Schneider in Functional Psychoses . Indian Journal of Psychiatry . 27 . 2 . 111–118 . 0019-5545 . 3011141 . 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)..
  14. López-Silva . Pablo . Harrow . Martin . Jobe . Thomas H. . Tufano . Michele . Harrow . Helen . Rosen . Cherise . 2022-08-06 . 'Are these my thoughts?': A 20-year prospective study of thought insertion, thought withdrawal, thought broadcasting, and their relationship to auditory verbal hallucinations . Schizophrenia Research . 10.1016/j.schres.2022.07.005 . 0920-9964 . 35945121 . 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.... free .
  15. Book: Sigström, Robert . Psychiatric symptoms and disorders in old age: prevalence, course and diagnostic thresholds . 2015-09-04 . Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg . 978-91-628-9479-5 . Schneiderian first-rank symptoms (such as thought broadcasting and thought echo) are very rare....
  16. López-Silva . Pablo . Harrow . Martin . Jobe . Thomas H. . Tufano . Michele . Harrow . Helen . Rosen . Cherise . 2022-08-06 . 'Are these my thoughts?': A 20-year prospective study of thought insertion, thought withdrawal, thought broadcasting, and their relationship to auditory verbal hallucinations . Schizophrenia Research . 10.1016/j.schres.2022.07.005 . 0920-9964 . 35945121 . 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.. free .
  17. Marneros . Andreas . April 1984 . Frequency of occurrence of Schneider's first rank symptoms in schizophrenia . European Archives of Psychiatry and Neurological Sciences . en . 234 . 1 . 78–82 . 10.1007/BF00432888 . 6489400 . 7420162 . 0175-758X . Thought broadcasting was recorded in 76 patients (6%).
  18. López-Silva . Pablo . Harrow . Martin . Jobe . Thomas H. . Tufano . Michele . Harrow . Helen . Rosen . Cherise . 2022-08-06 . 'Are these my thoughts?': A 20-year prospective study of thought insertion, thought withdrawal, thought broadcasting, and their relationship to auditory verbal hallucinations . Schizophrenia Research . 10.1016/j.schres.2022.07.005 . 0920-9964 . 35945121 . 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.. free .
  19. Dȩbowska . Grazyna . Grazwa . Anna . Kucharska-Pietura . Katarzyna . 1998-09-01 . Insight in paranoid schizophrenia—Its relationship to psychopathology and premorbid adjustment . Comprehensive Psychiatry . 39 . 5 . 255–260 . 10.1016/S0010-440X(98)90032-3 . 9777276 . 0010-440X . In particular, we found that thought-broadcasting delusions correlated with...lack of judgment and insight....
  20. 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.
  21. López-Silva . Pablo . Harrow . Martin . Jobe . Thomas H. . Tufano . Michele . Harrow . Helen . Rosen . Cherise . 2022-08-06 . 'Are these my thoughts?': A 20-year prospective study of thought insertion, thought withdrawal, thought broadcasting, and their relationship to auditory verbal hallucinations . Schizophrenia Research . 10.1016/j.schres.2022.07.005 . 0920-9964 . 35945121 . 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.. free .
  22. Hoffman . R. E. . McGlashan . T. H. . 1993 . Parallel distributed processing and the emergence of schizophrenic symptoms . Schizophrenia Bulletin . 19 . 1 . 119–140 . 10.1093/schbul/19.1.119 . 0586-7614 . 8451607. free .
  23. Sharma . Lavanya P. . Reddy . Y. C. Janardhan . January 2019 . Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder . Indian Journal of Psychiatry . 61 . Suppl 1 . S140–S148 . 10.4103/psychiatry.IndianJPsychiatry_527_18 . 0019-5545 . 6343407 . 30745688 . Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Symptoms (OCS) are known to be highly comorbid with bipolar disorder and schizophrenia. . free .
  24. Sareen . Jitender . Kirshner . Alla . Lander . Mark . Kjernisted . Kevin D. . Eleff . Michael K. . Reiss . Jeffrey P. . October 2004 . Do antipsychotics ameliorate or exacerbate Obsessive Compulsive Disorder symptoms?: A systematic review . Journal of Affective Disorders . en . 82 . 2 . 167–174 . 10.1016/j.jad.2004.03.011 . 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.
  25. Book: Diagnostic and statistical manual of mental disorders: DSM-5 . American Psychiatric Association . 2013.
  26. Kopelovich . Sarah L. . Wood . Keith . Cotes . Robert O. . Goldsmith . David R. . July 2020 . Integration of Clozapine-associated Harm Obsessions into Cognitive Behavioral Conceptualization and Treatment Planning for Thought Broadcasting: A Case Study . Journal of Psychiatric Practice . en . 26 . 4 . 329–336 . 10.1097/PRA.0000000000000470 . 1538-1145 . 8191597 . 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..
  27. Iyassu . Robel . Jolley . Suzanne . Bebbington . Paul . Dunn . Graham . Emsley . Richard . Freeman . Daniel . Fowler . David . Hardy . Amy . Waller . Helen . Kuipers . Elizabeth . Garety . Philippa . 2014 . Psychological characteristics of religious delusions . Social Psychiatry and Psychiatric Epidemiology . 49 . 7 . 1051–1061 . 10.1007/s00127-013-0811-y . 0933-7954 . 4173112 . 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..
  28. Gilbert . P. . Birchwood . M. . Gilbert . J. . Trower . P. . Hay . J. . Murray . B. . Meaden . A. . Olsen . K. . Miles . J. N. V. . August 2001 . An exploration of evolved mental mechanisms for dominant and subordinate behaviour in relation to auditory hallucinations in schizophrenia and critical thoughts in depression . Psychological Medicine . en . 31 . 6 . 1117–1127 . 10.1017/S0033291701004093 . 11513379 . 20123651 . 1469-8978 . 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..
  29. 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.
  30. Simonsen . Arndis . Mahnkeke . Mia Ilsø . Fusaroli . Riccardo . Wolf . Thomas . Roepstorff . Andreas . Michael . John . Frith . Chris D . Bliksted . Vibeke . 2020-01-01 . Distinguishing Oneself From Others: Spontaneous Perspective-Taking in First-Episode Schizophrenia and its relation to Mentalizing and Psychotic Symptoms . Schizophrenia Bulletin Open . 1 . 1 . 10.1093/schizbullopen/sgaa053 . 2632-7899 . Characteristic symptoms of schizophrenia, such as thought broadcasting...suggest a failure in distinguishing between oneself and others.. free . 1893/31882 . free .
  31. Ujike . Hiroshi . 2002-06-01 . Stimulant-induced psychosis and schizophrenia: The role of sensitization . Current Psychiatry Reports . en . 4 . 3 . 177–184 . 10.1007/s11920-002-0024-7 . 12003679 . 36416403 . 1535-1645 . 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....
  32. Nasrallah . Henry A. . 1985-05-01 . The unintegrated right cerebral hemispheric consciousness as alien intruder: A possible mechanism for schneiderian delusions in schizophrenia . Comprehensive Psychiatry . 26 . 3 . 273–282 . 10.1016/0010-440X(85)90072-0 . 3995938 . 0010-440X . 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....
  33. Dȩbowska . Grazyna . Grazwa . Anna . Kucharska-Pietura . Katarzyna . 1998-09-01 . Insight in paranoid schizophrenia—Its relationship to psychopathology and premorbid adjustment . Comprehensive Psychiatry . 39 . 5 . 255–260 . 10.1016/S0010-440X(98)90032-3 . 9777276 . 0010-440X . In particular, we found that thought-broadcasting delusions correlated with lower treatment acceptance....
  34. Kopelovich . Sarah . Wood . Keith . Goldsmith . David . July 26, 2021 . Integration of Clozapine-associated Harm Obsessions into Cognitive Behavioral Conceptualization and Treatment Planning for Thought Broadcasting: A Case Study . . 26 . 4 . 329–336 . 10.1097/PRA.0000000000000470 . 8191597 . 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).
  35. KOPELOVICH . SARAH L. . WOOD . KEITH . COTES . ROBERT O. . GOLDSMITH . DAVID R. . July 2020 . Integration of Clozapine-associated Harm Obsessions into Cognitive Behavioral Conceptualization and Treatment Planning for Thought Broadcasting: A Case Study . Journal of Psychiatric Practice . 26 . 4 . 329–336 . 10.1097/PRA.0000000000000470 . 1527-4160 . 8191597 . 32692132 . The treatment of OCS resulted in the complete resolution of thought broadcasting..
  36. Magrangeas . Thibault Thierry . Kolliakou . Anna . Sanyal . Jyoti . Patel . Rashmi . Stewart . Robert . 2022-08-02 . Investigating the relationship between thought interference, somatic passivity and outcomes in patients with psychosis: a natural language processing approach using a clinical records search platform in south London . BMJ Open . 12 . 8 . e057433 . 10.1136/bmjopen-2021-057433 . 2044-6055 . 9351333 . 35918110 . ...thought broadcast does not have a significant effect on outcome..
  37. McCabe . Michael S. . 1976-03-01 . Symptom differences in reactive psychoses and schizophrenia with poor prognosis . Comprehensive Psychiatry . 17 . 2 . 301–307 . 10.1016/0010-440X(76)90004-3 . 1253591 . 0010-440X . Taylor reported that the [first-rank] symptoms occur most commonly in [schizophrenic] patients with poor prognosis....
  38. Book: Wenzel, Amy . The SAGE Encyclopedia of Abnormal and Clinical Psychology . 2017-03-16 . SAGE Publications . 978-1-5063-5322-7 . en . ...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..

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