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Adult Psychopathology > Mental Status Exam > Flashcards

Mental Status Exam Flashcards

1
Q

What acronym can be used to remember the components of the mental status exam?

A

ABC STAMP LOCKER

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2
Q

What are the terms in the ABC portion of ABC STAMP LOCKER?

A
  • appearance
  • behavior
  • cooperation
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3
Q

What are the terms in the STAMP portion of ABC STAMP LOCKER?

A
  • speech
  • thought
  • affect
  • mood
  • perception
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4
Q

What are the terms in the LOCKER portion of ABC STAMP LOCKER?

A
  • level of consciousness
  • orientation
  • cognitive functioning
  • knowledge
  • endings
  • reliability
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5
Q

What features should one consider when describing

Appearance

A
  • grooming: well or poor
  • dress: neat, sloppy, disheveled
  • hygeine: clean, dirty, malodorous
  • posture: stiff, rigid, imposing
  • physical characteristics: scars, overweight/underweight, rashes
  • age appropriateness: appears stated age
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6
Q

What features should one consider when describing

Behavior

A
  • psychomotor activity: psychomotor retardation (slowed movements), agitation (fidgeting)
  • nonverbal behavior: gaits, tics, eye contact
  • physical behavior: catatonic (immobile), catalepsy (muscular rigidity), waxy flexibility (like gumby), echopraxia (involuntary physical imitation)
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7
Q

What features should one consider when describing

Cooperation

A
  • level of cooperation: open, cooperative, compliant/noncompliant, responsiveness to questions
  • attitude: friendly, upbeat, hostile, guarded, suspicious
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8
Q

What features should one consider when describing

Speech

A
  • rate: normal, pressured (consistant w/bipolar disorder), rapid, slow, latency
  • rhythm: normal, dysprosody (musical, sing-song), slurred
  • tone/volume: normal, monotone, accent, loud, soft
  • quantity: productive, impoverished
  • quality: grammar, syntax, non-interruptable (consistent w/manic state), neologisms, word salad, clanging, echolalia, perseveration
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9
Q

What are neologisms?

A

made up words, idiosyncrasies in word choice

ex: “I’m feeling very American today.”

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10
Q

What is “word salad”?

A

nonsensical, random speech

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11
Q

What is “clanging”?

A

sound associations that dictate speech

ex: rhyming

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12
Q

What is echolalia?

A

repetition of someone else’s words (copycat)

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13
Q

What is perseveration?

A

repetition of one’s own words

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14
Q

What are the two components of thought considered in a mental status exam?

A
  1. form
  2. content
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15
Q

What features should one consider when describing:

Thought (form)

A

Thought process, discerned from speech:

  • linear/nonlinear
  • concrete
  • logical/illogical
  • latency
  • poverty of thought
  • redirectability
  • organization
  • circumstantial, tangential, flight of ideas, loose associations
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16
Q

From least to greatest, rank the severity of the following: tangential thought, loose associations, flight of ideas, circumstantial thought.

A
  1. circumstantial thought
  2. tangential thought
  3. flight of ideas
  4. loose associations
17
Q

Describe circumstantial thought.

A

more detail than needed, goes off on tangents but ultimately returns to the topic being discussed

18
Q

Describe tangential thought.

A

worse than circumstantial, doesn’t return to the original issue at all

19
Q

Describe “flight of ideas.”

A

severe, irrational rapid topic jumping

20
Q

Describe “loose associations.”

A

thought stream is illogical

21
Q

What features should one consider when describing:

Thought content

A
  • worries
  • paranoia
  • preoccupations
  • ruminations
  • obsessions
  • delusions (bizarre or non-bizarre)
  • ideas of reference
  • grandiosity
  • other psychotic content
  • anything noteworthy (like self-criticism)
22
Q

What features should one consider when describing:

Affect

A

Affect is the emotional “weather”

  • expression of emotions during interview
  • range: full range, constricted
  • intensity: blunted, flat, expansive
  • change pattern: labile (rapid shift, like crying, then laughing, then crying again)
  • appropriateness: congruency with mood
23
Q

What features should one consider when describing:

Mood

A

Mood is the emotional “climate”

  • Patient’s predominant emotional state: self reported (sad/angry, etc)
  • clinical observation inferred from behavior: patient appeared angry, etc.
  • eurithmic: fine, ok
  • elevated or elated: high, over-inflated, manic
  • depressed or dysphoric: low, sad, down
24
Q

What features should one consider when describing:

Perception

A
  • Perceptual disturbances: hallucinations, illusions (errors in perception)
  • depersonalization
  • derealization
25
Q

What is depersonalization?

A

When a patient feels as if he is outside the self, watching, out of body, dream-like.

26
Q

How does derealization differ from depersonalization?

A

Derealization occurs when the patient feels that the external world is not real. Depersonalization affects the perception of self.

27
Q

What features should one consider when describing:

Levels of consciousness

A

levels of awareness of external stimuli:

  • comatose
  • dazed
  • in a stupor
  • drowsiness
  • alertness
  • hypervigilance
28
Q

What features should one consider when describing:

Orientation

A

spheres of orientation: person, place, time

Do they know who they are, where they are, when it is?

29
Q

What are the two parts of considering cognitive functioning?

A
  1. judgment
  2. insight
30
Q

What features should one consider when describing:

Cognitive functioning (judgment)

A

decision-making ability

Are goals reasonable, appropriate, good, poor?

31
Q

What features should one consider when describing:

Cognitive functioning (insight)

A

Is the patient self-aware and aware of their condition?

Anosognosia and La Belle Indifference are part of insight.

32
Q

What is anosognosia?

A

unawareness or denial of one’s disorder

33
Q

What is La Belle Indifference?

A

lack of concern about one’s own disorder

34
Q

What features should one consider when describing:

Knowledge

A

intellectual ability (inferred by clinician, not directly tested)

  • language
  • speech
  • vocabulary
35
Q

What features should one consider when describing:

Endings

A
  • suicidal ideation
  • suicidal plan
  • homicidal ideation
  • homicidal plan
36
Q

What features should one consider when describing:

Reliability

A

accuracy of patient self-report

Is the patient a reliable or poor historian?

37
Q

What are the features/purposes of the mental status exam?

A
  • clinical tool for diagnosis
  • part of a larger exam
  • used to assess and describe behavior (reported and observed)
  • used for THAT MOMENT ONLY
  • used to rate severity of signs and symptoms
  • to know if signs and symptoms are deviant
38
Q

Can you diagnose a patient from the mental status exam?

A

no

Adult Psychopathology (16 decks)

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