Trayectoria del trastorno formal del pensamiento, desde la observación clínica al análisis computacional / Trajectory of formal thought disorder, from clinical observation to computational analysis

La adecuada comprensión de un término psicopatológico requiere, no solo del conocimiento de la alteración descrita, sino también de los contextos y conceptos a partir de los cuales fue acuñado y de la transformación de los mismos a lo largo del tiempo. En el caso del trastorno formal del pensamiento se describe su evolución desde su incorporación a la psicopatología con fines puramente descriptivos y asociado a la influencia del asociacionismo y a la idea de una dependencia directa entre pensamiento y lenguaje hasta la actualidad, en que el uso de herramientas computacionales y de hipótesis provenientes de la lingüística han promovido su uso como instrumento diagnóstico y marcador pronóstico, al tiempo que ha significado la incorporación de nueva terminología. (AU)

Properly understanding a psychopathological term requires knowledge of the disorder described, the contexts and concepts from which it was coined, and its modification over time. In the case of formal thought disorder, we describe its evolution from its incorporation into psychopathology for purely descriptive purposes and associated with the influence of associationism and the idea of a direct dependence between thought and language to the present day, in which the use of computational tools and hypotheses from linguistics have promoted its use as a diagnostic tool and prognostic marker, while simultaneously leading to the incorporation of new terminology. (AU)

Editorial Perspective: How Sir Michael Rutter revolutionised our understanding of human development: An introduction to a systematic Digest of his life's work.

Professor Sir Michael Rutter died on 23 October 2021. He had made an unparalleled and profound contribution to the science underpinning our understanding of the origins and development of psychopathology in children and young people. The unique combination of reforming motivations, intellectual curiosity and commitment to hypothesis-driven science that made this possible are discussed in the editorial for this issue (Sonuga-Barke, Fearon & Scott, 2022). I have recently compiled a systematic and comprehensive Digest of his life's work - 546 journal papers and 52 books published [https://doi.org/10.13056/acamh.13072]. This Editorial Perspective will summarise some highlights of the main areas of his many scientific achievements.

Moreau de Tours: organicism and subjectivity. Part 2: Moreau as psychopathologist.

These two articles analyse the importance of J.J. Moreau de Tours' work and its influence on the development of descriptive psychopathology from the mid-nineteenth century to the present. The first article focused on biographical aspects and presented Moreau's main works in their social and cultural contexts. This second article critically analyses Moreau's contributions from different perspectives: epistemological, psychopathological, clinical, therapeutic, and it also discusses his role as a public figure.

Moral psychopathology and mental health: Modern and ancient.

Following three turning points in the historical development of psychology this study examines how the relation between mental health and the state of illness is linked to the concept of "passions." The first was the birth of modern psychiatry in 18th century France. The second was the development of the field of inquiry in antiquity about the psuche and its mental activities, and the third was the turn of early Christian thought about mind and soul. A comparison between early modern and ancient concepts of "the passions" reveals the moral and ethical aspects of the concept "mental health," and shows that more than for any other kind of illness, the history of mental illness and mental health is embedded within a moralistic philosophical perspective. Pathology as a field of study of "the passions," whatever their definition was, enabled thinkers to refer to mental illness and health in moral terms. Although "passions" meant different things to different authors in different times, it was used by all as means to link between inner mental activities and the way the body react to the outside world. We can see it as an obligatory element to conceptualize illness, disorder, and health in regards to mental activities. Pagan ancient authors as well as early Christian authors used it to construct new theories and praxes about mental health, while early modern psychiatrists used it to develop corporeal methods of cure. In all currents of thought the concept of "passions" and the definition of the ways in which they affected the mind were used to distinguish mental illness and mental health from any other type of illness and health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Prejudices in the psychopathologist: Karl Jaspers' heritage.

Contributions of Karl Jaspers to the discipline of psychopathology are numerous. One of his most important insights deals with the method of interviewing in psychopathology. Specifically, how an interviewer (i.e. psychopathologist) approaches and explores mental phenomena that present themselves in the person being interviewed. By cultivating a phenomenological attitude, clinicians also acquire and renew self-criticism (Selbskritik), an essential aspect of a true psychopathologist. A fundamental part of the critical attitude in descriptive psychopathology is the re-examination of prejudices present in psychopathological interviewing. This review outlines and discusses six types of prejudices, as abstracted by Karl Jaspers, and illustrates them with clinical examples. (i) Philosophical prejudice deals with deductive and inductive reasoning; (ii) theoretical prejudice addresses the modeling of understanding of mental phenomena by analogy with natural sciences; (iii) somatic prejudice addresses biological reductionism in psychopathology; (iv) psychological prejudice focuses on approaches that consist of psychological interpretations that transgress the boundaries of psychological intelligibility; (v) pictorial prejudice deals with conceptualizations of psychic life as an analogy with certain visual depictions; (vi) medical prejudice is connected with strivings towards quantity, objectivity and diagnostic precision in psychopathology. To have the ability to represent the inner life of a person, we must dispense with prejudices in the clinical encounter with our patients. With the demands of modern-day life, and requests for quick clinical assessments, the idea of examining our prejudices and performing phenomenological interviews is more important than ever.

Moreau de Tours: organicism and subjectivity. Part 1: Life and work.

This is the first of two articles analysing the importance of J.J. Moreau de Tours' work and its influence on the development of descriptive psychopathology from the mid-nineteenth century to the present. Part 1 focuses on biographical aspects and presents Moreau's main works in their social and cultural context, with special emphasis on his book Du Hachisch et de l'Aliénation mentale, published in 1845. The second article will concentrate on Moreau as a psychopathologist.

Charcot, Janet, and French Models of Psychopathology.

Jean-Martin Charcot (1825-1893), thanks to his insight as a clinician can be said to be one of the precursors of scientific psychology. Charcot's 30 years of activity at La Salpêtrière hospital display an intellectual trajectory that decisively changed the idea of human psychology by favouring the emergence of two concepts: the subconscious and the unconscious. It was his collaboration with Pierre Janet (1859-1947), a philosopher turned physician, that led to this evolution, relying on the search for hysteria's aetiology, using hypnosis as a method of exploration. Focusing on clinical psychology that was experimental and observational, Janet built a theory of psychic automatism, "the involuntary exercise of memory and intelligence" leading to "independence of the faculties, freed from personal power." From all that came the idea of the subconscious, a functioning as a passive mental mechanism, resulting from a more or less temporary dissociation of previously associated mental content.

"Escrúpulos religiosos extremos" y delirio místico - religioso: entre la devoción cristiana y la psicopatología en Colombia, 1920-1960 / "Extreme religious scruples" or mystical delirium - religious: between christian devotion and psychopathology in Colombia, 1920-1960

OBJETIVO: comprender la semiología del delirio místico-religioso y la incidencia del contenido sociocultural en la configuración de los síntomas en la psicopatología moderna en Colombia, 1920-1960. METODOLOGÍA: investigación histórico-hermenéutica, mediante análisis de una serie de historias clínicas del antiguo Manicomio Departamental de Antioquia y del Asilo Psiquiátrico San Isidro del Valle del Cauca. RESULTADOS: entre las psicopatologías más recurrentes en las que se manifestaron los delirios se encuentra el grupo de las manías, principalmente la intermitente, psicosis maniaco-depresiva y melancolía; seguido por la esquizofrenia paranoide, y también fue frecuente en la psicosis puerperal o posparto; asimismo, se presentó en la parálisis general progresiva (neurosífilis) y en el síndrome cerebral agudo o estado de confusión agudo, nosografía moderna dada al delirio. Según las historias clínicas, la exaltación de ideas religiosas confluye en un delirio polimorfo. Los síntomas más recurrentes fueron las alucinaciones visuales y auditivas, logorrea o locuacidad, insomnio, negativismo alimentario acompañado de miedo a ser envenenado, excitación psicomotora o hiperquinética, accesos de furia controlados con camisa de fuerza y otros medios de contención, intento de suicidio y tendencia a la fuga de la casa, por lo tanto, se consideraba de peligrosidad para sí mismos y para los demás

OBJECTIVE: To understand the semiotics of mystical-religious delirium and the incidence of sociocultural content in the configuration of symptoms in modern psychiatry in Colombia, 1920-1960. METHODOLOGY: hermeneutic historical, research by analysis of a series of case histories of the old Madhouse Department of Antioquia and the Psychiatric Asylum San Isidro del Valle del Cauca. RESULTS: Among the most frequent psychopathologies in which delusions demonstrated is the group of hobbies, mainly intermittent, manic depression and melancholy; followed by paranoid schizophrenia, and was also common in puerperal or postpartum psychosis; He also appeared in general paresis (neurosyphilis) and acute brain syndrome or acute confusional state, delirium given modern nosography. According to medical records, the exaltation of religious ideas comes together in a polymorph delirium. The most frequent symptoms were visual and auditory hallucinations, logorrea or talkativeness, insomnia, accompanied food negativism fear of being poisoned, psychomotor or hyperkinetic excitement, fits of rage controlled straitjacket and other means of containment, attempted suicide and trend the escape of the house, therefore it was considered dangerous to themselves and others

Bottom-Up and Top-Down Paradigms for Psychopathology: A Half-Century Odyssey.

Bottom-up paradigms prioritize empirical data from which to derive conceptualizations of psychopathology. These paradigms use multivariate statistics to identify syndromes of problems that tend to co-occur plus higher-order groupings such as those designated as internalizing and externalizing. Bottom-up assessment instruments obtain self-ratings and collateral ratings of behavioral, emotional, social, and thought problems and strengths for ages 1½-90+. Ratings of population samples provide norms for syndrome and higher-order scales for each gender, at different ages, rated by different informants, in relation to multicultural norms. The normed assessment instruments operationalize the empirically derived syndromes and higher-order groupings for applications to clinical services, research, and training. Because cross-informant agreement is modest and no single informant provides comprehensive assessment data, software compares ratings by different informants. Top-down paradigms prioritize conceptual representations of the nature and structure of psychopathology, as exemplified by psychodynamic, DSM/ICD, and HiTOP paradigms. Although these paradigms originated with observations, they tend to prioritize conceptual representations over empirical data.

História de Lino: a psicopatologia na perspectiva da fenomenologia e do existencialismo / Lino's story: psychopathology from the perspective of phenomenology and existentialism / Historia de Lino: la psicopatología desde la perspectiva de la fenomenología y el existencialismo

A partir dos anos 1950-1960 constituíram-se iniciativas, na Europa, para uma ruptura do modelo psiquiátrico hegemônico vigente até então, consolidando a antítese à lógica psiquiatrizante que se caracteriza enquanto uma psicopatologia crítica. Por meio dela, alguns psiquiatras passaram a adotar uma postura compreensiva frente ao adoecimento psíquico, em detrimento de uma busca por causalidades, entendendo o sofrimento como resultado da construção de uma personalidade no mundo. A pesquisa base deste artigo objetivou a compreensão fenomenológica e existencial da psicopatologia de Lino, um homem adulto diagnosticado com transtorno esquizoafetivo. Foi utilizado método qualitativo caracterizado como história de vida, tendo sido realizadas entrevistas narrativas para coleta de dados e empregada análise da narrativa para a composição dos resultados e discussões. Nas análises, constatou-se um processo de divisão do ser, forjado por forças sociológicas contraditórias e que constituíram a base da psicopatologia de Lino. Neste sentido, a entrada na loucura pode ser considerada como um corte com a rede de relações concretas e simbólicas significativas do sujeito e consequente perda do sentido da realidade. Pensar a psicopatologia em uma perspectiva crítica implica, assim, pensar o sujeito na totalidade de suas relações e na apropriação que faz das mediações ao longo de sua biografia.

From the 1950s-60s onwards in Europe, initiatives for a rupture with the existing hegemonic psychiatric model were established, consolidating an antithesis to the psychiatrizing logic, which can be characterized as a critical psychopathology. Thereby, some psychiatrists began to adopt a comprehensive attitude towards psychic illness instead of searching for causalities, understanding suffering as the result of the construction of a personality. The research on which this article was based aimed at a phenomenological and existential understanding of Lino's psychopathology, an adult man diagnosed with schizoaffective disorder. The life-history method was applied, several interviews were conducted for data collection, and narrative analysis was used to prepare results and discussions. In the analyses, a process of division of the being was found, forged by contradictory sociological forces, which were the basis of Lino's psychopathology. In this sense, the beginning of madness may be considered as a break with the subject's network of concrete and significant symbolic relationships and the consequent loss of his sense of reality. Therefore, thinking psychopathology from a critical perspective implies understanding subjects in their relationships as a whole, with the appropriation of mediations they do throughout their biography.

A partir de los años 1950-1960 en Europa se han tomado iniciativas para una ruptura del modelo psiquiátrico hegemónico vigente hasta aquel momento, consolidando una antítesis a la lógica psiquiatrizante, que se caracteriza como una psicopatología crítica. A través de ella, algunos psiquiatras han adoptado una actitud comprensiva frente a la enfermedad mental, en lugar de una búsqueda de causalidades, entendiendo el sufrimiento como resultado de la construcción de una personalidad. La investigación base de este artículo tuvo como objetivo la comprensión fenomenológica y existencial de la psicopatología de Lino, un hombre adulto con diagnóstico de trastorno esquizoafectivo. Fue utilizada la metodología de la historia de vida, con entrevistas para recolección de datos y la utilización del análisis narrativo para componer las discusiones. En los análisis, se ha constatado un proceso de división del ser, forjado por fuerzas sociológicas contradictorias, que constituyen la base de la psicopatología de Lino. En este sentido, el comienzo de la locura puede ser visto como una ruptura con la red de relaciones concretas y simbólicas del sujeto y la consecuente pérdida del sentido de realidad. Pensar la psicopatología en una perspectiva crítica supone comprender el sujeto en todas sus relaciones y en la apropiación que hace de las mediaciones en toda su biografía.

Award for Distinguished Scientific Contributions: Dante Cicchetti.

The American Psychological Association Awards for Distinguished Scientific Contributions are presented to persons who, in the opinion of the Committee on Scientific Awards, have made distinguished theoretical or empirical contributions to basic research in psychology. Dante Cicchetti is a recipient of the 2019 award "for groundbreaking research and leadership that forged the integrative science of developmental psychopathology. Through extraordinary vision, prodigious publication, and inspiring mentorship, Dante Cicchetti nurtured this multidisciplinary science that bridges typical and atypical development, basic and translational research, levels of analysis from genes to relationships, and diverse disciplines concerned with human development." (PsycINFO Database Record (c) 2019 APA, all rights reserved).

'Insanity in Classical Antiquity', by JL Heiberg (1913).

Heiberg's 1913 text on psychopathological concepts and terms in classical times remains important because of its freshness and historiographical value. A philologist and classical scholar, he seemed puzzled by the assumption of nosological continuity between classical categories of madness and current ones that prevailed at the time among historians of medicine and psychiatry. Heiberg's text acts as a bridge or transition between the nosological antiquarianism of the 19th century and histories of psychiatry that later warned of the dangers of an anachronistic reading of earlier medical texts. It also shows how important has been the contribution of classical philologists to the study of the history of madness. To our knowledge, this is the first rendition into English of the complete Danish work.

Editorial: The passage of time.

In this editorial, the author reflects on changes that occurred in the quality of research on developmental psychopathology over the last 35 years. This is illustrated in the increased quality of nine longitudinal studies that are included in the current issue of JCPP. Using approaches that capitalize on the passage of time, ranging from 28 days to 40 years across investigations, these studies employed multiple levels of analysis, used sophisticated statistical methods to control for confounding factors, included measurement at both the biological, cognitive, and behavioral levels, and collectively provided results that allow improved assessment of causality.

'Dementia praecocissima': the Sante De Sanctis model of mental disorder in child psychiatry in the 20th century.

The aim of this article is to describe the nosographical contribution of the Italian psychiatrist Sante De Sanctis (1862-1935) to early twentieth-century child psychiatry. De Sanctis first proposed the category of 'dementia praecocissima' in 1906, and it was recognized by Kraepelin. Dementia praecocissima has its roots in a theoretical and methodological conception of mental disorder based on 'psycho-physical proportionalism' and the 'law of circle'. This article deals with De Sanctis's model, which has so far been neglected by historiographers; it shows the pioneering role that this Italian psychiatrist played in child psychiatry in Italy.

The theory of symptom complexes, mind and madness.

Kahlbaum's seminal approach to symptom complexes, as opposed to disease entities, is still relevant. Many psychopathologists have approached mental symptom complexes without prejudging them as necessary physical deficits or diseases, favouring a broader dimensional and anthropological view of mental disorders. Discussions of symptom complexes gained prominence in psychiatry in the early twentieth century - through Hoche - and in the period leading up to World War II - through Carl Schneider. Their works, alongside those of Kraepelin, Bumke, Kehrer, Jaspers and others, are reviewed in relation to the theme of symptom complexes, the mind, and mental disorders. A particular feature of symptom complexes is their relationship to aspects of the normal mind and how this affects clinical manifestations. It is further suggested that symptom complexes might offer a useful bridge between the psychic and the biological in theories of the mind.

[The psychopathology of the Wernicke-Kleist-Leonhard School and its relevance for present-day psychiatry]. / Die Psychopathologie der Wernicke-Kleist-Leonhard Schule und ihre Bedeutung für die aktuelle Psychiatrie.

Historically, the Wernicke-Kleist-Leonhard School represents a countermovement to psychopathology as described by Karl Jaspers and Kurt Schneider. The School aimed to interlink psychopathological and neurobiological aspects. Starting from the model of different functional neuronal systems, each of which can be disturbed in the sense of a hypofunction, hyperfunction, or parafunction, it developed a comprehensive phenomenology of psychopathological symptoms and syndromes that finally culminated in Karl Leonhard's course descriptions. This school of thought can provide important impulses even today. Thus, on the one hand, the neurobiological models can serve as the basis for additional research projects and on the other hand, the psychopathological descriptions of disorders can perhaps also be interpreted in the sense of typological constructs that can contribute to pragmatic clinical decisionmaking.

Amok: a mirror of time and people. A historical review of literature.

The conceptualization of psychiatric disorders changes continuously. This study examined 'amok', a culture-bound syndrome related to sudden mass homicide, to elucidate changing and varied concepts. A historical review of 88 English articles revealed that the meanings and assumed causes of amok have changed over time. These changes appear to have been affected by social events, medical discoveries, knowledge of descriptors and occasionally, the benefit to users. In other words, the concept of amok changes depending on the history of society and the knowledge and intention of people at the time. We should consider in detail what we focus on when diagnosing a disorder.

Can psychopathology and neuroscience coexist in psychiatric classifications?

A crisis of confidence was triggered by the disappointment that diagnostic validity, an important goal, was not achieved with the publication of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The Research Domain Criteria (RDoC) project, which provides a framework for neuroscientific research, was initially conceptualized as an alternative to DSM. However, RDoC and DSM are complementary rather than mutually exclusive. From a historical perspective, this article argues that the debate opposing psychology and brain in psychiatric classification is not new and has an air of déjà vu. We go back to the first classifications based on a scientific taxonomy in the late 18th century with Boissier de Sauvages, which were supposed to describe diseases as they really existed in nature. Emil Kraepelin successfully associated psychopathology and brain research, prefiguring the interaction between DSM and RDoC. DSM symptoms remain valuable because they are the only data that are immediately and directly observable. Computational science is a promising instrument to interconnect psychopathological and neuroscientific data in the future.

El que no se haya cumplido el importante objetivo de la validez diagnóstica con la publicación del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5), ha provocado decepción y una crisis de confianza. El proyecto Research Domain Criteria (RDoC), que pro-porciona un marco para la investigación neurocientífica, se conceptualizó inicialmente como una alternativa al DSM. Sin embargo, RDoC y DSM son complementarios en lugar de excluirse mutuamente. Este artículo argumenta, desde una perspectiva histórica, que el debate entre la psicología y el cerebro en la clasificación psiquiátrica no es nuevo y tiene un aire de déjà vu. Las primeras clasificaciones del siglo XVIII (de Boissier de Sauvages) basadas en la taxonomía científica debían describir las enfermedades tal cual existían en la naturaleza. Emil Kraepelin asoció con éxito la psicopatología y la investigación del cerebro, anticipando la interacción entre DSM y RDoC. Los síntomas del DSM siguen siendo valiosos porque son los únicos datos que se pueden observar de forma inmediata y directa. La ciencia computacional es un instrumento prometedor para interconectar, en el futuro, datos psicopatológicos y neurocientíficos.

Une crise de confiance a été déclenchée par la déception que la validité diagnostique, un objectif important, n'ait pas été atteinte avec la publication du DSM 5. Le projet des critères de domaines de recherche (RDoC), qui fournit un cadre pour la recherche neuroscientifique, a d'abord été conçu comme une alternative au DSM. Cependant, le RDoC et le DSM sont complémentaires plutôt que mutuellement exclusifs. D'un point de vue historique, cet article soutient que le débat opposant la psychologie et le cerveau dans la classification psychiatrique n'est pas nouveau et a un air de déjà-vu. Nous revenons aux premières classifications fondées sur une taxonomie scientifique à la fin du XVIIIe siècle avec Boissier de Sauvages, qui étaient censées décrire les maladies, telles qu'elles existaient réellement dans la nature. Emil Kraepelin a associé avec succès la psychopathologie et la recherche sur le cerveau, préfigurant l'interaction entre le DSM et le RDoC. Les symptômes du DSM restent valables parce qu'ils sont les seules données qui sont immédiatement et directement observables. La science computationnelle est un instrument prometteur pour interconnecter les données psychopathologiques et neuroscientifiques à l'avenir.

Jaspers' Phenomenology.

Karl Jaspers published the first edition of 'General Psychopathology' in 1913. Now, coinciding with its 100th anniversary whose importance was consecrated through multiple congresses, we see a parallelism and a return to the dilemma of the 'Methodenstreit', which led Karl Jaspers to introduce the phenomenological method for psychopathology to understand the subjective manifestations of the mind. Phenomenology is part of the research and clinical methods in psychiatry and psychology as a way to capture the subjective in psychopathology. However, phenomenology is nowadays wrongly used. In this article, we attempt to rediscover and present in a clear way the origins and meaning of Jaspers' phenomenology, whose bases, although forgotten, remain current. This will be done by revising its fundamental concepts such as objective and subjective manifestations, understanding and its four types, causal explanation, empathy, intuition, presuppositions and preconceptions, phenomenological description and comprehensive 'seeing'.

Joan Miró and Cyclic Depression.

Psychopathology has been closely related with artists. A link between creativity and a tendency to affective disorders has become widely accepted. Several studies have shown that artists suffer disproportionately high rates of mood disorders, particularly manic depression and major depression. The famous twentieth century Spanish artist Joan Miró suffered from depression during the entirety of his life, as was recognized by some authors in private letters. The artist worked using several styles, as well as in ceramics and sculpture. Some of his work reflects the feelings he experienced during the Spanish Civil War and the Second World War. He contributed considerably to the world of art with works such as The Farm as the culminant work of detailism, The Harlequin's Carnival as one of the main expressions of surrealism, the Birth of the World as the precursor of abstract expressionism, or The Dutch Interiors with "mironians" shapes, among others. Whether depression was the inspiration for his work, or his work was the treatment for his depression, will never be clarified. However, he left a great legacy for humanity and his work is admired all over the world.