Intermediate
Technical
In the Industry Vocabulary Test
derailment
A thought disorder characterized by loose associations between ideas, making speech difficult to follow.
Full Definition
Derailment, also known as loose associations, occurs when a person's train of thought shifts from one topic to another with little or no logical connection between ideas. This formal thought disorder is commonly seen in schizophrenia and severe mood episodes with psychotic features. Unlike normal conversational tangents, derailment lacks clear associative links and can render communication incomprehensible. The listener experiences difficulty following the speaker's logic or understanding how topics relate to each other.
Usage
Usage note: Distinguish from circumstantiality (eventual return to topic) and tangentiality (never returning to topic).
In Context
- "The patient exhibited significant derailment, jumping from discussing breakfast to childhood memories to government surveillance." — Mental status examination
- "Antipsychotic medication helped reduce the derailment noted in previous interviews." — Progress note
Also known as
loose associations
thought derailment
Contrasted with
logical thought
coherent speech
goal-directed thinking
Don't confuse with
tangentiality
circumstantiality
flight of ideas