A Conceptual Model for Formal Thought Disorder and Future Directions for Research
Poster A30, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron
Eric Roche1, John Lyne2, Mary Clarke1, Susan Rossell3, Eric Tan3; 1DETECT Early Intervention in Psychosis Service, Dublin, Ireland, 2North Dublin Mental Mental Health Service, Dublin, Ireland, 3Brain and psychological sciences research centre, Swinburne University; Psychiatry St Vincent's Hospital; and Monash Alfred Psychiatry Research Centre (Alfred Hospital and Monash University), Melbourne Victoria Australia
Background: Formal thought disorder (FTD) is a core diagnostic criterion for psychotic disorders and it has been proposed as a potential target for treatment in early intervention services. However, much remains unclear or unknown in relation to its aetiology. The field has been both enriched and impeded by the diversity of FTD assessment instruments; in discussing its nosology we highlight the need for clarity of terminology and coherence of clinical assessment in FTD research. Methods: Drawing from existing literature, we present an integrated conceptual model that attempts to synthesise the diverse aetiological factors in FTD genesis. Results: Aetiological factors for FTD can be classified as individual-level or environment-level factors. Four individual-level factors described in this conceptual model include: 1) biological, which may be genetic (e.g. MEF2A regulation) or neurobiological (structural and metabolic brain changes); 2) neurocognitive (e.g. semantic and executive deficits); 3) mood-related (affective reactivity and the filter/prioritiser mechanism); and 4) personality-related (e.g. schizotypy). Three environment-level factors are described: 1) communicative context (degree of structure in communicative encounters); 2) communicative content (negative affect and the phenomenon of affective reactivity); and 3) broader social environment (e.g. social isolation). Our conceptual model describes FTD as a multi-dimensional construct with a multi-factorial aetiology, where gene-environment interplay is relevant. Conclusions: Future FTD research should be based on a consensus dimensional structure, ideally incorporating a longitudinal approach. Future FTD research should combine the evaluation of individual and environmental aetiological factors. There is potential for the development of interventions directed at FTD.
Topic Area: Diagnosis and Phenomenology