Loose Associations (it could be called derailment) is a disturbance in the organization of thought and speech in which a person’s ideas shift from one topic to another with weak, unclear, or only loosely understandable connections.
Example
Question: “What did you do today?”
Response:
“I went to the store to buy some milk. Milk comes from cows. Cows are sacred in some cultures. Culture is changing because of technology. My phone needs to be charged.”
The person may move from one idea to another, but the connections become increasingly weak or difficult to follow.
Key characteristics
- The person may begin with a relevant topic.
- The conversation gradually drifts away from the original subject.
- Connections between ideas may be difficult for the listener to understand.
- Speech may remain grammatically understandable, unlike word salad, where speech may become largely incoherent.
- The person may not realize that their thinking has become difficult to follow.
Loose Associations vs. Tangential Speech
| Feature | Loose Associations | Tangential Speech |
|---|---|---|
| Main problem | Ideas become weakly connected | Person goes off topic |
| Connection between ideas | Often unclear or very weak | May be understandable but irrelevant |
| Returns to original question? | Usually not | Usually not |
| Example | “I went to the store. Stores have cameras. Cameras are used in movies. Movies are expensive.” | “Where do you live?”: “I used to live in a house. Houses can be expensive. My neighbor had a Dog.” |
Possible Clinical Significance
Loose associations may occur in conditions involving disorganized thinking, including schizophrenia spectrum disorders, severe psychosis, mania, and sometimes substance induced psychosis. However, the presence of loose associations alone may not establish a diagnosis?
A useful way to remember it:
Loose associations:
The connections between thoughts may become loose, weak, and difficult to follow.
Shervan K Shahhian
LIBERTY PSYCHOLOGICAL ASSOCIATION 