Chapter 3: Biopsychosocial Assessment

Question 1

What is the definition of an assessment?

Answer 1

is a time-limited, formal process that collects information from many sources in order to reach a diagnosis, to make a prognosis, to render a biopsychosocial formulation, and to determine treatment.”

Question 2

What is a biopsychosocial psychological assessment?

Answer 2

“a structured interview that gathers information from and/or tests a person to evaluate their mental health concerns.”

Question 3

What are the characteristics important to a biopsychosocial assessment?

Answer 3

time-limited, formal, and must come up with a diagnosis

Question 4

Who are the information sources for the assessment?

Answer 4

Client, family, friends, staff, medical examinations, and tests, any other sources

Question 5

What are the 8 main steps of a comprehensive assessment?

Answer 5

Obtaining a history
Evaluating the mental status
Collecting auxiliary data
Summarizing principal findings
Rendering a diagnosis
Making a prognosis
Providing a biopsychosocial formulation
Determining a treatment plan

Question 6

What are the critical elements of an assessment of substance abuse?

Answer 6

Type of substance used
Frequency and amount of use
Duration of use
Whether the use is leading to impairment in the client’s life and functioning
Whether anyone in their life has alerted them to the impact of their abuse

Question 7

What are the critical elements of an assessment of risk for suicidal ideation?

Answer 7

Current plan for suicide (detailed plan)
Previous attempts at suicide
History of depression and/or suicide
Social isolation
Recent diagnosis of a serious/terminal illness

Question 8

What are 3 additional questions in a comprehensive assessment?

Answer 8

Why is family history relevant to client assessment?
Why is a medical assessment significant and necessary when (available)?
How would you assess spirituality and/or religious affiliation? Why would it be important to do so?

Question 9

What is a mental status exam (MSE)?

Answer 9

Describes the patient’s appearance, behavior, speech, emotions, and cognitive and perceptual processes; it is an objective report of the client’s current mental state as observed by the clinician

Question 10

T or f? The psychiatric history provided by a client is a subjective account yet the MSE is objective.

Answer 10

T

Question 11

What are the 12 most important elements to note in a mental status exam?

Answer 11

Appearance
Motivation
Judgment
Intelligence (intellectual development)
Insight (what they're experiencing currently and what could help their issue/situation)
Thought process
Perception
Attention span
Emotions (mood - affect)
Speech
Behavior (including impulse control)
Orientation

Question 12

What is the first step in conducting a mental status exam?

Answer 12

Appearance (looking at if a client is dressed appropriately for the weather or current surroundings - looking at context)

Question 13

When looking at a client’s appearance what are we looking for?

Answer 13

How does their appearance tell me something about their current mental or emotional condition

Question 14

What do we do when we are looking at speech?

Answer 14

The first element of speech is that we note the volume of the client or the speaker. How are they speaking? Is their volume appropriate/suitable for the context or the environment? The second element is the rate or the speed of their speech. Is it slow it takes them long to finish a sentence, and are they talking so fast that it is hard to keep up. What is the manner of speech? Is the client slurring?

Question 15

What is poverty of speech known as?

Answer 15

Alogia (Starting and stopping to speak)

Question 16

What is latency of speech?

Answer 16

Taking a long time for a client to speak

Question 17

What is apraxia of speech?

Answer 17

Difficulty with skilled movements even when a person has the ability and desire to do them.
Apraxia is caused by brain disease or damage. The brain is unable to make and deliver correct movement instructions to the body.
One type of apraxia affects speech. The brain struggles with lip, jaw, and tongue movements. Other types affect the accuracy of limb movements, response to verbal commands, and facial movements, such as winking.
Treatment may include physical, speech, and occupational therapy.

Question 18

When it comes to affect, a normal range is broad. T or f?

Answer 18

T

Question 19

What is the subjective experience a client is talking about what they’re feeling on the inside?

Answer 19

Mood

Question 20

T or f? The mood is what you feel on the inside, and affect is what you see on the outside. T or f?

Answer 20

T

Question 21

When we are talking about assessing a motion, what two things are we looking for?

Answer 21

Mood and affect

Question 22

T or f? Affect is what they’re showing on the outside, in their body language, in their speech, in their behaviors

Answer 22

T

Question 23

What refers to the fact that what they’re telling you that they’re experiencing subjectively is matched by their body language and by their speech.

Answer 23

mood congruency

Question 24

What does mood congruency mean?

Answer 24

It just means that whatever the client is experiencing and the mood that they’re telling you about is reflected in their affect.

Question 25

What is also referred to as depression?

Answer 25

Dysthymia

Question 26

What means normal mood in depression; everything is fine?

Answer 26

Euthymia

Question 27

What means elevated mood in depression where somebody is extremely happy, full of life, really feels they’re on top of the world?

Answer 27

Euphoria

Question 28

What, in depression, means that a person is on the other end of feeling happy, down and out, and don’t feel good about anything?

Answer 28

Dysphoric

Question 29

T or f? Most individuals who have schizophrenia start off with overvalued ideas? This then proceeds to illogical thinking, magical thinking (superstitions), and finally leads to delusions.

Answer 29

T

Question 30

A person needs medication to recover from their delusional thinking or get back to a former state where delusions were not present. T or f?

Answer 30

T

Question 31

For some people, overvalued ideas start to control their life and end up as delusions. A reality check is important in this case. T or f?

Answer 31

T

Question 32

No amount of talk therapy can help a delusional person, only medication can help. T or f?

Answer 32

T

Question 33

What is the term used to describe what a person is experiencing or sensing around them; we are talking about our five senses, smell, taste, touch, hear, and sight?

Answer 33

Perception

Question 34

What are some of the most common hallucinations?

Answer 34

Auditory

Question 35

T or f? Depersonalization and derealization are intermingled, and they are either the same thing or different things.

Answer 35

T

Question 36

What is the term used to describe the idea that a part of a person’s body does not work or exist; for ex, a person thinks they cannot lift or use their left arm?

Answer 36

Depersonalization

Question 37

What is an out-of-body experience where a person feels they’re floating above themselves and observing that’s going on in their lives? It could also feel like a person is in a dream-like haze. So everything is kind of hazy and cloudy around them, and they’re in that sort of morning dream state when you’re not fully awake or not fully asleep. But you’re not sure if it’s a dream or real.

Answer 37

Derealization

Question 38

What is the experience called where you feel like you’ve been there already or done that already? Many people experience this, but chronic episodes of these may point to something being perceptually, mentally, or emotionally.

Answer 38

Deja-vu

Question 39

What is important in diagnosing for cognitive disorders like ADHD, or learning disorders, or other related attention/concentration conditions?

Answer 39

Does the person pay attention to detail
Can the person pay attention to detail
Can he/she follow through w/instructions

Question 40

Why or what is it we are looking for one we assess if a person is aware of the time, place, activity or name/date of birth of something they are partaking in?

Answer 40

When assessing for cognitive conditions such as Alzheim’ers disease, someone under the influence of substances, alcohol, or on the autism spectrum disorder.

Question 41

What are we testing when we test for someone’s ability to recall events, experiences in their lives, both recently or in the past?

Answer 41

Memory

Question 42

What type of memory is when you recall what was said three minutes ago, numbers, or words?

Answer 42

Immediate

Question 43

What is known as distant memory, recalling events from adolescence or after a long time?

Answer 43

Distant

Question 44

What is confabuation?

Answer 44

False memory

Question 45

When is confabulation seen?

Answer 45

In dementia, and Alzeimer’s disorder/disease

Question 46

T or f?

So sometimes in the initial stages of Alzheimer’s disorder where a person is experiencing memory loss, they’re embarrassed by it. So you might ask a question like, hey, isn’t it hot out there?

And instead of answering the question, because they don’t remember what hot means or what the temperature is, they change the topic. And say, you’re talking about hot, let me tell you about how I struggled through my life. And so they distract you or change the topic.

And they’re doing it because they’re embarrassed about what was being discussed and they don’t have a recollection. Like if you’re talking about your favorite sports team and their score in the game last night, and they don’t remember. And they’re like, Jets! I hate the Jets! They don’t. But they don’t want to answer the question because they’re embarrassed. It’s like a change of topic?

Answer 46

Confabulation

Question 47

What are the last three elements of the mental status exam?

Answer 47

Judgment, intelligence, and insight