Loose associations is a thought disorder where the stream of thought is abnormal. It occurs when patients respond to questions with unrelated answers or sentences and do not follow a logical sequence. This type of disorganized speech is a psychotic sign. But it can also be just due to stress or tiredness.

When loose associations are the result of schizophrenia, the patient’s speech seems random and may be based on sounds, rhyming, free association or puns and can be difficult to interpret. loose associations are used as a diagnosis tool for other psychotic disorders such as schizophreniform disorder and schizoaffective disorder. Psychiatrists utilize the Thought and Language Index (TLI) scale for categorizing and rating schizophrenic speech, but research in the area is lacking.

Subsets of loose association include “knight’s move thinking” (which means a chess piece can move only in certain directions), goal loss, where individuals lose track of the purpose mid-sentence, and tangentiality, where individuals are unable to return to a topic once they have been distracted. The severity of loose association can vary widely between from patient to patient, with some patients having only minor variations in language while some others becoming completely unintelligible.