The term 'thinking process' refers to the production of a thought. Disturbances of this process may be recognized and described by the patient himself or be deduced by an observer from the subject's speech.*48)
Impairments of thought production are conventionally named 'formal thought disorder' and contrast with abnormalities of the 'content of thought' observed in delusions. This distinction appears arbitrary, since the deviant reality-testing of deluded patients always involves a disturbance of the form of thinking.
Association psychology indicates that the semantic memory is organized in the form of a network. This means that each representation is linked with a number of other notions, related closely as well as distantly. In rational thinking, a 'determining tendency' (49 guides the flow of ideas in the chosen direction and excludes associations which do not conform with this goal. This procedure can be disturbed in various ways which are commonly grouped together under the heading of 'formal thought disorder'.
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