MSE Questions Flashcards
Mood (emotional state): Euthymic
Normal or typical mood. Upbeat, “happy.”
Mood (emotional state): Depressed/dysphoric
Down, “blue” mood. Often with decreased energy. Irritability or anxiety occurs in some people. Common to depression, anxiety, and depressed states of bipolar disorder.
Mood (emotional state): Elated/euphoric
“Up,” “on top of the world.” Often with increased energy.
Common to manic states of bipolar disorder.
Mood (emotional state): Labile
“An experiment using coke and mentos in the lab”
Capricious, unstable, quickly changing mood.
Common to rapid cycling forms of bipolar disorder in adults.
Mood (emotional state): Anhedonia
Lack of interest and withdrawal from regular and pleasurable activities that one used to enjoy. An associated symptom of depression.
Mood (emotional state): Vegetative symptoms
Almost catatonic, barely responsive
Sleep and appetite changes are most pronounced
Three types of Thought Processes
Form
Attention
Speed
Thought Processes - Form: Logical, coherent
Clear, direct connections between content. One idea flows directly into another.
Thought Processes - Form: Circumstantial
Digressions to unnecessary details in thought and speech before communicating the central idea.
Thought Processes - Form: Tangential
Oblique, digressive, irrelevant speech. The central idea is not communicated.
Thought Processes - Form: Loose associations
Little or vague connection is made between concepts; continuous tangential “rabbit-holing.” Can be a symptom of schizophrenia.
Thought Processes - Form: Flight of ideas
Each bird flies a different direction
Multiple thoughts and ideas are generated spontaneously, without obvious connection.
Thought Processes - Attention and Speed: Distractible
Squirrel!
Focus can shift quickly onto the external environment. This awareness interrupts the present dialogue. Associated symptom of anxiety, attention-deficit (ADHD).
Thought Processes - Attention and Speed: Preoccupied
Inattentive to the external environment, internally focused, seems to be thinking deeply.
Thought Processes - Attention and Speed: Rumination
Preoccupation with a single idea or theme.
Thought Processes - Attention and Speed: Latent
‘Late Response’
A prolonged period of time between a thought and its verbal expression.
Thought Processes - Attention and Speed: Racing thoughts
“Go to a Nascar race, then buy a new car, then get a new outfit, then take lessons …”
Multiple thoughts occurring in a seamless fashion. Often in list form. These thoughts have a pressured quality.
Memory: Intact memory
Normal or typical.
Appropriate short- and long-term recall.
Memory: Anterograde amnesia
Memory loss for events after the onset of amnesia
Assess confabulation (attempts to justify false response)
Memory: Retrograde amnesia
Memory loss for events before the onset of amnesia
Assess confabulation (attempts to justify false response)
Motor: Relaxed, normal
Within typical range of motor movement.
Motor: Psychomotor retardation, hypoactive
Decreased activity, slow response to environment, sluggish. For some individuals, this is typical for their personality.
Motor: Catatonic
Severe immobility
Motor: Apathetic
Indifference. Laissez-faire attitude accompanied by lack of motor impetus and dulled emotional tone.
Motor: Restless, hyperactive
A compelling need to be in constant movement.
Difficult to sit still.
Motor: Agitated
Severe anxiety and/or irritation, adrenaline response, preparation for action.
Can precipitate anger outbursts or panic attacks. Pacing or hyperventilating can occur.
Motor: Stereotypy
Continuous mechanical repetition of speech or physical activity, such as flapping hands and rocking. Associated with autism spectrum disorders.
Speech: Regular rate and rhythm
Controlled, even paced, cadenced verbal communication. Can interweave with another person’s dialogue.
Speech: Pressured speech
Uncontrollable, accelerated, excessive talking. Rapid rate and rhythm, difficult to interrupt. The person feels they cannot talk fast enough to get their words out.
Speech: Laconic speech
“Lacking details”
Terse, brief responses provided without elaboration. No unprompted information is given. “Poverty of speech.”
Speech: Disorganized speech
Disconnected, unintelligible speech.
Speech: Coprolalia
Involuntary use of vulgar or obscene language, found in Tourette’s syndrome.
Also consists of grunts and paralanguage (“hmmm,” “huh,” “ah”, “grrr,” “shhh” etc.)
Speech: Echolalia
Repeating or mirroring the speech of another person. For example, repeating back a question instead of answering the question.
Associated with autism spectrum disorders.
Interpersonal (relationally-driven behavior): Aloof
Disengagement and lack of connection with others, usually due to ego centrism.
Interpersonal (relationally-driven behavior): Avoidant
Disengagement due to anxiety and desire to escape contact.
Interpersonal (relationally-driven behavior): Contempt
A passive-aggressive style of relating to others. Rolling eyes, imitating vocal tone in a mocking manner.
The greatest predictor of divorce
Interpersonal (relationally-driven behavior): Defensive
Reacting to the input of others in a hostile manner. The person usually feels threatened and under attack.
Interpersonal (relationally-driven behavior): Dismissive
Reacting to the input of others by disregarding, rejecting, and thinking no more about it. The person doesn’t necessarily feel threatened, but thinks they know better.
Interpersonal (relationally-driven behavior): Oppositional/defiant
Intentional attempts to elicit a power struggle or argument with another person (particularly in authority).
Can involve baiting others (direct) or ignoring them (indirect).
Interpersonal (relationally-driven behavior): Guarded
Overly careful about sharing information with others, usually from lack of trust.
Closed, secretive. Infrequent self-disclosure.
Interpersonal (relationally-driven behavior): Hypervigilant
Excessive attention to external environment, stemming from heightened anxiety and fear.
Interpersonal (relationally-driven behavior): Suggestible
Uncritical acceptance and compliance with another person’s proposal or recommendation; easily influenced.
Intrapersonal (internally-driven attitudes and behavior): Ego dystonic
The individual does not consider their behavior to be consistent with their core personality.
Intrapersonal (internally-driven attitudes and behavior): Ego syntonic
The individual considers their behavior to be consistent with their core personality.
Can result in externalizing blame to others for problematic behavior.
Intrapersonal (internally-driven attitudes and behavior): Conceited
Egocentric, self-important, arrogant, proud.
Often hides deeper seated anxieties and feelings of inadequacy.
Intrapersonal (internally-driven attitudes and behavior): Grandiose, expansive
Ego inflation. Belief that a person can accomplish anything, even outrageous tasks.
Associated with manic states in bipolar disorder.
Intrapersonal (internally-driven attitudes and behavior): Intropunitive
Self-derision, punishing self for unwanted events (even if they are not responsible).
Turning anger inward.
Intrapersonal (internally-driven attitudes and behavior): Splitting
“All or nothing,” “black or white,” “good or bad.” thinking.
Perceiving events in absolute terms,
Intrapersonal (internally-driven attitudes and behavior): Catastrophizing
Dramatically predicting that the worst event is most likely to occur.
Psychosis: Delusions
A fixed belief that is experienced as odd, strange, or eccentric by others and outside the realm of realistic possibility.
Associated most commonly with schizophrenia.
Psychosis: Bizarre delusion
“My cat is my math tutor”
A fixed belief outside the realm of realistic possibility. This belief is strange, odd, eccentric to others.
Psychosis: Control delusion
“My cat tutor is forcing me to do math”
An individual’s fixed belief that their will / thoughts / feelings are being controlled by someone or something else.
Psychosis: Grandeur delusion
An individual’s fixed belief in their elevated importance, power, “specialness”
Psychosis: Infidelity delusion
An individual’s fixed belief that their partner or lover is being unfaithful to their relationship.
Psychosis: Persecution delusion
An individual’s fixed belief that they are being harassed or persecuted by others.
Psychosis: Reference delusion
An individual’s fixed belief that unrelated events in the external environment are special messages that have a direct, personal significance and relevance to them.
Psychosis: Erotomanic delusion
An individual’s fixed belief that someone else is in love with them or wants to have sexual intercourse with them. To be classified a “delusion,” this has to be unrequited.
What is meant by “Hallucination” in MSE?
A perceptual experience that is not experienced by others.
Associated with schizophrenia, bipolar disorder, depression, delirium, and substance abuse.
Psychosis / Hallucinations: Hypnogogic
When falling asleep (considered normal).
Psychosis / Hallucinations: Hypnopompic
When awakening from sleep (considered normal).
Psychosis / Hallucinations: Responding to internal stimuli
The individual seems to be attentively listening and responding to sights and sounds in their external environment that others do not see or hear.
What is meant by “Appearance” in MSE?
How a person is groomed and dressed.
Appearance: Well groomed
Appropriate grooming
For example, brushed hair, clean teeth, recent bath or shower (in past 24 hours.
Appearance: Immaculate grooming
Excessive detail is given to one’s grooming and/or make-up.
Appearance: Disheveled / unkempt grooming
Inattention to daily hygiene
The person has not brushed their hair, cleaned their teeth, or taken a recent bath/shower. If the person has unpleasant body odor, or smells of urine/feces, then unkempt grooming might be indicated.
Can be a marker of psychosis.
Appearance: Appropriate dress
The person is wearing appropriate clothing for the time of year and season.
Appearance: Underdressed
The person is wearing too little clothing for the context (e.g., time of year and season, formal nature of meeting). In some cases, the clothing worn is always inappropriate, regardless of season (e.g., wearing revealing clothing to a counseling session).
Appearance: Overdressed
The person is wearing too much clothing for the context (e.g., time of year and season, formal nature of meeting). In some cases, the clothing worn might indicate other issues (e.g., wearing long-sleeves in summer to hide cutting scars or needle marks).
Appearance: Truly bizzare
In some cases, the type of dress worn is simply bizarre. This is another potential warning sign of psychosis.
