ABSTRACT
This chapter focuses primarily on disorganization as a dimension observed through expressive speech. Most people are willing to accept the circular definition that disorganized speech is characterized by disorganization. However, it is useful to peel back the circularity and offer some operational concepts that help explain what makes speech sound disorganized. Disorganization is the essence of the historic concept of formal thought disorder. It is what the DSM-5 is now calling "Disorganized Thinking (Speech)". However, in addition to noting these familiar codes for deviant and disorganized verbalization, examiners should remain attuned to more subtle forms of disjointed verbal expression that might elude traditional categories of Deviant Verbalizations (DV) and Deviant Responses (DR). Taking a broader view of disorganization frees us from becoming overly bound to scoring categories and more attuned to how an individual is speaking and, by inference, the formal qualities of his or her thinking.
