In older adults, blocking of thought can be a feature of several cognitive and motor disorders, including underlying dementia and delirium. People with PTSD may find that blocking of thought occurs more often if they have not addressed the source of their PTSD. 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. These maladaptive approaches can include, but are not limited to dissociation, especially depersonalization and derealization. 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. As such, it can be hard for people to organize their speech, resulting in thought blocking. Thought blocking is associated with absence seizures. After an episode occurs, a person is typically able to resume their normal way of speaking. The thought blocking that occurs in this instance is usually short lived because anxiety attacks are transient. When a person experiences an anxiety attack, they may become so hyperfocused on the distressing stimuli and/or overwhelmed with the situation that regular speech is difficult for that person to produce. Generalized anxiety disorder (GAD) is defined as excessive worry about matters in two or more separate subjects for at least six months. In contrast, negative symptoms are characterized by missing parts of the average individual's persona, including flat affect, apathy, 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. For instance, delusions, hallucinations, disorganized speech, disorganized behavior and thought are all positive symptoms. Positive symptoms include behavior added on to a person's daily functioning. In schizophrenia, patients experience two types of symptoms: positive and negative. When evaluating a patient for schizophrenia, a physician may look for thought blocking. For example, a person with schizophrenia might remark that another person has removed their thoughts from their brain. People with schizophrenia commonly experience thought blocking and may interpret the experience in peculiar ways. Blocking is also described as an experience of unanticipated, quick and total emptying of the mind. When the person begins speaking again, after the block, they will often speak about an unrelated subject. A person's speech is suddenly interrupted by silences that may last a few seconds to a minute or longer. Thought blocking occurs most often in people with psychiatric illnesses, most commonly schizophrenia. The main causes of thought blocking are schizophrenia, anxiety disorders, petit mal seizures, post-traumatic stress disorder, bradyphrenia, aphasia, dementia and delirium. Persons undergoing thought blocking may utter incomprehensible speech they may also repeat words involuntarily or make up new words. Thought blocking is a neuropsychological symptom expressing a sudden and involuntary silence within a speech, and eventually an abrupt switch to another topic. Not to be confused with Thought suppression.
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