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Mental Status Examination
MS
46
Social Work
Graduate
02/01/2013

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Cards

Term
The 3 Methods to Assess Mental Status
Definition
Observation, Conversation, Exploration
Term
Observation- parts
Definition
Appearance, Consciousness, Psycho-motor behavior, affect. *first 5 mins. ANY disturbances you observe are called "SIGNS"
Term
Conversation- parts
Definition
Attention and concentration
Speech and thinking
Orientation
Memory
Affect
Term
Exploration- parts
Definition
Mood, Energy level, perception, content of thinking, medically unexplained somatic symptoms, conversation, dissociation, Paroxysmal attacks ("Spells"), executive functioning, insight, judgement
Term
"Signs"
Definition
Any disturbances that you observe
Term
Conversation
Definition
Undirected, casual conversation.Good to observe now bc ct is "off guard"
Term
Exploration
Definition
tapping into the patients internal experiences that are not on display (mood/perceptions)
Term
What to look for under appearance
Definition
Sex, age, race, body type, hygiene, dress, eye contact, level of consciousness
Term
Aberrant Eye contact(wandering eyes)
Definition
revel distractibility, visual hallucinations, mania, cog. impairment
Term
Avoidance eye contact
Definition
May express hostility, shyness, or anxiety
Term
Psycho-motor Behavior
Definition
Nonverbals that give clues to alertness, affect, energy level, agitation. Note patients posture, movements (expressive/reactive) and gestures
Term
movements can be grouped into 4 categories
Definition
1. Posture
2. Psychomotor Movements
3. movements that express
4. Abnormal complex movements
Term
Posture
Definition
muscle tone and change in posture
Muscle tone reflects a persons energy level and tension. High muscle tone= agitated person. Low muscle tone= calm person
Term
Psycho-motor movements
Definition
Important to distinguish between goal-directed movements, expressive and illustrative gestures, and symbolic gestures.
Term
Goal-directed movements
Definition
movements that reach a goal
Term
expressive and illustrative gestures
Definition
hand gesture while talking. Do not duplicate the verbal message, but compliment it.
Term
Symbolic gestures
Definition
make "Ok" sign instead of words
Term
What to look for in Speech
Definition
Speed and flow
slurring
Using wrong words (paraphasic)
Term
What is word salad?
Definition
Continuous, senseless word fluency
Term
Semantic Paraphasia
Definition
The correct word is substituted for another correct word but inappropriate for the sentence. "I like to drive around in my tent"
Term
Phonemic Paraphrasia
Definition
one letter or syllable is substituted
"I wrote the letter with my len"
Term
Word Approxmination
Definition
the correct word is substitued by an incorrect word, which has a relationship with the correct word.
"I wrote the letter with my writing toy"
Term
neologisms
Definition
Newly created words.
"i wrote the letter with my zemps."
Term
Receptive Paraphasias show:
Definition
1. povery of verbs and nouns
2. abundance of conjunctions, prepositions, and interjections.
3. random, nonrepetive neologims without fixed meaning
4. isolated sentences- no gram structure
Term
Affect
Definition
The visual and audiable manifestation of the ct's emotional response to external and internal events.
ex. voice, facial expressions, grooming

*pay attention to the intensity, range and duration
Term
Concrete thinking
Definition
- what brought you here?.... I came in a car. (instead of stating the problem they are experiencing that brought them to counseling.)
Term
Overinclusiveness
Definition
Opp. of concrete thinking.
Term
Affect vs. mood
Definition
-affect lasts momentarily (1-2 seconds), mood lasts longer
- affect is attached to external/internal stimiuli and changes with them. MOOD, can change spontaneously
- Affect is forground, MOOD is the emotional background
- affect is observed by you, MOOD is reported
Term
9 affects
Definition
1. disgust
2. perplexity (surprise)
3. joy
4. anger
5. fear
6. sadness
7. interest
8. shame
9. content
Term
How to evaluate Affect
Definition
Non-Verbals- gestures and facial expressions.
Verbals- Tone of voice, selection of vocabulary
Term
4 key symptoms and signs that threaten rapid decline
Definition
S.O.A.P.
(S)uicidal and homicidal tendencies expressing immediate danger
(O)rganic conditions (GMC) that contribute to the development of cognitive disorders
(A)lcohol and other subs use leads to intoxication, withdraw, ectthat leave long term effects on brain snd other body systems
(P)sychosis- hallucinations and delusions that inturupt the ct's relationship to reality and make him a victim to irrational thinking and unrealistic perceptions
Term
MOOD- 5 dimensions
Definition
1. Quality
2. Stability
3. reactivity
4. intensity
5. duration
Term
Quality (mood)
Definition
Cannot be determined by observed affect- IT MUST BE ASKED!
"How do you feel most of the day?"
"How do you feel now?"
Term
Stability (mood)
Definition
Stable vs. Unstable vs. diurnal variation (mood disorder)
Ask: "Compare your mood in the morning to your mood in the evening. Are there any differences?"
Term
Reactivity (mood)
Definition
Can things cheer you up or not...
Term
Intensity
Definition
High vs low

A depressed mood can be intense despite their flat affect
Term
Duration (mood)
Definition
Duration gives mood its diagnostic value.
Term
Energy Level
Definition
Ask:
how long it takes them to carry out activities
- motivated or not
-new tasks?
-daily routines
Term
Conversion Symptoms
Definition
medically unexplained neurological symptoms
ie. blindness, deafness
Term
Dissociation
Definition
a disruption in the usually integrated functions of conscious memory, identity, or perception

Ask: do you switch to any other personality? do you have periods of memory loss
Term
Paroxysmal Attacks "spells"
Definition
Losing consciousness , falling asleep during the day.. dizzy, fainting
Term
Executive functioning
Definition
1. planning
2. organizing
3. sequencing
4. abstracting
Term
insight
Definition
the ct's insight of their own symptoms

Ask: do you consider this normal for you?
what are your strengths
Term
anosognosia
Definition
Lack of insight
Term
judgment
Definition
ability to choice appropriate goals and to choice socially appropriate ways to reach them.
"how does your future look to you?"
Term
Terms to describe consciousness
Definition
alert
lethargy
sleepiness
stupor
coma
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