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Social Behavioral - April > Behavioral Assessment - Boulger > Flashcards

Behavioral Assessment - Boulger Flashcards

1
Q

When are mental status exams indicated?

A
  • Patients with documented brain lesions such as tumors, trauma, vascular accidents, etc
  • Patients with suspected brain lesion because of recurrent seizure, headache, behavioral change, or head trauma
  • All psychiatric patients
  • Depression most commonly seen with frontal and temporal tumors, hydrocephalus, or cortical atrophy
  • Patients who have vague complaints - memory, concentration, declining interests, various physical complaints without organic etiology
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2
Q

What does a mental status exam in psychiatry consist of?

A
  • Presentation
    • LOC, GCS, alert, cooperative, appearance
  • Motor Behavior and Affect
    • movement, mannerisms, facial expression
  • Cognitive Status
    • attention, alertness, orientation, speech, language, memory, calculation, reasoning
  • Thought
    • coherence, insight, goals, ideations
  • Mood
    • anger, suicidality, hopelessness, guardedness, variability
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3
Q

What are the five parts of the Mini-Mental Status Exam?

A
  1. Orientation
  2. Language function
  3. Registration & Recall
  4. Attention/Simple Calculations
  5. Constructional Praxis
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4
Q

How many total points are in the MMSE?

A
  • 30 points
    • Orientation to time (5) - year, season, month, day of the week, date
    • Orientation to place (5) - where are we now, what state are we in, what country is this, what city is this, what floor are we on
    • Language - reading (1), writing (1), naming (2), comprehension (3), repetition (1)
    • Registration (3) - repeat 3 words back
    • Recall (3) - remember the 3 words
    • Attention/simple calculations (5) - serial 7s or spell world forward and backwards
    • Constructional praxis (1)
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5
Q

What MMSE score indicates normal cognition?

A

Any score greater than or equal to 27 points (out of 30) indicates a normal cognition.

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6
Q

What MMSE score is the widely accepted cut-off?

A

23 points

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7
Q

What MMSE score indicates mild cognitive impairment?

A

21-26

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8
Q

What MMSE score indicates moderate cognitive impairment?

A

11-20

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9
Q

What MMSE score indicates severe cognitive impairment?

A

0-10

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10
Q

What office screening assessment techniques can be used for depression?

A
  • Hamilton Rating Scale for Depression (Ham-D)
  • Patient Health Questionnaire (PHQ-9)
  • Geriatric Depression Scale (GDS)
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11
Q

What office screening assessment techniques can be used for anxiety?

A
  • Hamilton Rating Scale for Anxiety (Ham-A)
  • Patient Health Questionnaire (GAD-7)
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12
Q

What office screening assessment technique can be used for alcohol use?

A

Alcohol Use Disorders Identification Test (AUDIT)

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13
Q

What screening assessment techniques can be used for ADHD and Childhood Behavior Problems?

A
  • SNAP-IV Rating Scale:
    • 90 questions designed to be answered by classroom teachers
    • Also contains items to screen for Oppositional Defiant Disorder
  • Vanderbilt ADHD Diagnostic Teacher and Parent rating scale
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14
Q

What are the four levels of cognitive and neuropsychological examination measurements with varying degrees of precision and usability?

A
  • Nominal Scales
  • Ordinal Scales
  • Interval Scales
  • Ratio Scales
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15
Q

What is a nominal measurement in cognitive and neuropsychological examinations?

A
  • Least precise, assigning numbers or labels to identify categories to which individuals belong
    • Ex - diabetic or not diabetic
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16
Q

What is an ordinal measurement in cognitive and neuropsychological examinations?

A
  • Arrange or sort individuals in a series ranging from highest to lowest according to an observed characteristic
    • Ex - test scores
17
Q

What is an interval measurement in cognitive and neuropsychological examinations?

A
  • Gives numbers for which not only order but also differences between numbers are meaningful
  • No absolute zero, assignment of the zero value is arbitrary
18
Q

What is a ratio measurement in cognitive and neuropsychological examinations?

A
  • All arithmetical operations can be used - addition, subtraction, multiplication, and division
    • Highest level of measurement
    • True zero point
19
Q

What does reliability refer to in assessment techniques?

A

Consistency of predictive statements over time, over predictors, over individuals and/or over assessment techniques

20
Q

What does validity refer to in assessment techniques?

A
  • “Truthfullness”
  • Degree of accuracy of predictive (concurrent or prospective) statements
21
Q

How are intelligence tests scored today?

A

Statistically derived most commonly using:

  • Wechsler Adult Intelligence Scale (WAIS-IV for ages 17+)
  • Wechsler Intelligence Scale for Children (WISC-IV for ages 6-16)
22
Q

What is average IQ classification based on the Wechsler Adult Intelligence Scale?

A

90-109

23
Q

What are the most common examples of memory screening tests used in cognitive and neuropsychological examination?

A
  • Rey-osterreich Figure
  • Rey Auditory-Verbal Learning test
  • California Verbal Learning test

(relatively short: 15-30 minutes)

24
Q

What is the most common memory test batteries?

A

Wechsler Memory Scale (WNS-IV)

(Takes approximately 60-90 minutes to administer)

25
Q

What is the most common neuropsychological test battery?

A

Halstead-Reitan Neuropsychological Test Battery

  • contains 10 subtests
    • abstract reasoning
    • kinesthetic and sensorimotor ability
    • attention
    • auditory perception
    • sensory-perceptual ability
    • language
26
Q

How are neuropsychological test batteries useful?

A
  • many types to examine specific brain functioning
  • some very sensitive and highly accurate in assessing damage
  • used to help target brain damage before other techniques are used
  • BUT, they are very expensive to administer and are only available in larger cities and test centers
27
Q

What is the aphasia screening test?

A

A simple card can be used to simulate various types of aphasia

28
Q

What is the Rey Complex Figure used for?

A

To assess the individual’s ability to recall complex information presented visually

29
Q

What are the two types of measures in a personality assessment?

A

Objective measures

&

Projective measures

30
Q

What do projective tests show in personality assessments?

A

Reveal hidden emotions and internal conflicts via a subject’s responses to ambiguous stimuli

  • Rorschach Inkblot tests
31
Q

What do objective tests show in personality assessments?

A

Determine whether the person taking the test is responding truthfully

  • restricted response format (T/F)
  • Ex. Minnesota Multiphasic Personality Inventory (MMPI)
32
Q

What is the MMPI?

A
  • Minnesota Multiphasic Personality Inventory (MMPI)
  • Most frequently used clinical testing instrument
  • one of the most researched psychological tests in existence
  • 567 true-false items

Social Behavioral - April (20 decks)

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