Psychiatric disorders are often characterized by maladaptive thought patterns. Whereas most research focuses on the distinct contents of maladaptive thoughts, abnormalities in the process by which thoughts come to mind are often overlooked. One exception is formal thought disorder (FTD), defined as a disruption in the form and organization of thought (e.g. loose associations). FTD is considered a hallmark feature of psychosis. Furthermore, recent evidence suggests that FTDs are found in other psychiatric disorders. Despite progress in the research of FTD in the recent decades, FTD remains one of the least understood symptoms in psychosis (all the more so in other disorders), with no established treatments. One key issue is that most FTD research focuses on language and communication impairments (e.g. disorganized speech), and not on actual thoughts. The overall aim of 'Dynamics of thought and thought disorders' (DynaT) is to dissociate impairments in thought dynamics from impairments in the communication or expression of thought, without relying on introspective self-report. To deal with the challenge of measuring covert thought, DynaT will use state-of-the-art computational psychiatry methods. First, DynaT will use mathematical modelling to gain insight into the covert thoughts preceding participants' observed responses. Second, DynaT wil use machine-learning algorithms to tap thought dynamics from the participant's brain activity in real-time. DynaT will isolate and characterise several component processes of FTD in schizophrenia and across the wider, transdiagnostic psychopathological spectrum, including: a) semantic disorganization; b) impaired inhibitory control of thoughts; c) inflexible reliance on predominant, local associations. As the first investigation to dissociate (objectively measured) covert thoughts from overt speech, DynaT has the potential to significantly advance the conceptualization and understanding of FTDs across disorders.
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