How to Elicit Thought Disorder During Clinical Interviews: A Practical Guide
- 1, Department of Psychiatry, , , ,
- 2Independent Researcher, the DIALOG project, Exeter, United Kingdom
- 3, the National Center of Excellence in Youth Mental Health, , ,
Abstract
The reliable assessment of Formal Thought Disorder (FTD), a collection of observable signs of suspected thinking dysfunction, is the cornerstone of interviewing a person with psychosis. A significant gap persists between the success of reliable assessments reported in published rating scales of FTD and the practical constraints of a clinical interview. Validated rating scales largely focus on operationalized criteria for describing items; the procedural aspects of how to elicit these signs often remain implicit. We synthesize the principles and procedures of FTD assessment embedded in rating scales, translating their design into a framework for routine clinical use. Systematic employment of several manoeuvres can help elicit FTD signs: conversational stimulation, cognitive loading, social modulation, and pointed clarifications to stress-test thought, language and communication processes. By making these procedures explicit, we aim to equip clinicians and trainees with a strategic, measurement theory-informed approach to the psychiatric interview when assessing for FTD.
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BibTeX
@article{palaniyappan2026elicit,
title = {{How to Elicit Thought Disorder During Clinical Interviews: A Practical Guide}},
author = {Lena Palaniyappan and Oliver Delgaram-Nejad and Eric YH Chen},
journal = {BJPsych advances},
year = {2026},
month = may,
doi = {10.1192/bja.2026.10213},
url = {https://europepmc.org/article/PMC/PMC7619686},
note = {CC BY},
}
RIS
TY - JOUR
TI - How to Elicit Thought Disorder During Clinical Interviews: A Practical Guide
AU - Lena Palaniyappan
AU - Oliver Delgaram-Nejad
AU - Eric YH Chen
PY - 2026
DA - 2026/05/28
JO - BJPsych advances
DO - 10.1192/bja.2026.10213
UR - https://europepmc.org/article/PMC/PMC7619686
AB - The reliable assessment of Formal Thought Disorder (FTD), a collection of observable signs of suspected thinking dysfunction, is the cornerstone of interviewing a person with psychosis. A significant gap persists between the success of reliable assessments reported in published rating scales of FTD and the practical constraints of a clinical interview. Validated rating scales largely focus on operationalized criteria for describing items; the procedural aspects of how to elicit these signs often remain implicit. We synthesize the principles and procedures of FTD assessment embedded in rating scales, translating their design into a framework for routine clinical use. Systematic employment of several manoeuvres can help elicit FTD signs: conversational stimulation, cognitive loading, social modulation, and pointed clarifications to stress-test thought, language and communication processes. By making these procedures explicit, we aim to equip clinicians and trainees with a strategic, measurement theory-informed approach to the psychiatric interview when assessing for FTD.
SN - 2056-4678
SN - 2056-4686
ER -