Psychosocial Hx Intake for Adolescents

Question 1

What are the leading causes of death in US adolescents?

Answer 1

• Unintentional injuries
• Homicides
• Suicide

Question 2

What does HEADSS stand for?

Answer 2

Home, Education, Activities, Drugs, Sex, and Suicide

Question 3

What do alternatives HEEADSSS and HEADS-ED add to HEADSS?

Answer 3

HEEADSSS: Eating/body image, Safety

HEADS-ED: Emotions, Discharge resources (used in ED)

Question 4

Should parent be present during interview?

Answer 4

No

Question 5

What do you do if parent insists on staying in room during interview?

Answer 5

Ask permission from the patient (per HIPAA)

Question 6

When can MD-patient confidentiality be breached?

Answer 6

When risk arises of patient inflicting physical harm to another person or to self

Question 7

What types of questions should the MD ask?

Answer 7

Open-ended questions

Question 8

What is the goal of the Home section?

Answer 8

Determine: household structure, family structure/function, conflict-resolution within family, domestic violence, chronic family illnesses

Question 9

What are some examples of Home questions?

Answer 9

Who lives with you?

How does your family deal with conflict?

Question 10

What is the goal of the Education/Employment section?

Answer 10

Assesses: school performance, cognitive ability, learning disorders/differences

Question 11

What are some examples of Education questions?

Answer 11

What grade are you in? How do your current grades compare with your grades last quarter/semester/year? Have you ever been told you had a learning difference?
-Ask about favorite/worst subjects, career aspirations, what they would do if they got less than all A’s (if 4.0 student) to assess depression

Question 12

What is the goal of the Activities section?

Answer 12

Evaluate: social interactions, internet use, interests, self-esteem

Question 13

What are some examples of Activities questions?

Answer 13

What do you do for fun? Are you involved in school, community, religious activities?

-Also ask about eating habits, bulimia assessment, educate on exercise/diets/protective equipment

Question 14

What is the goal of the Drugs section?

Answer 14

Assess: current habits, patterns of use, genetic/environmental risk factors

Question 15

How do you determine drug/alcohol abuse disorder?

Answer 15

Two or more yes answers for CRAFFT:
Car (ridden in), Relax (use to relax), Alone (use alone), Forget (black out), Friends (tell you to cut down), Trouble (gotten into trouble)

Question 16

What is the goal of the Sex section?

Answer 16

Determine: level of sexual involvement/sexuality, use of birth control, STI protection, Hx of abuse

Question 17

What are some examples of Sex questions?

Answer 17

Have you ever been sexually involved with anyone? (don’t always assume heterosexuality!)
Have you met anyone on the internet for sexual reasons? (sex within peer group -> decreased STI risk)

Question 18

What is the goal of the Suicide section?

Answer 18

ID: serious mental health problems, distinguish from normal adolescent moodiness

Question 19

What are some examples of Suicide questions?

Answer 19

Do you feel “stressed” or anxious more than usual? Do you feel sad or down more than usual? Are you bored most of the time? Have you ever thought of hurting yourself or someone else?
-Patient Healthcare Questionnaire-9

Question 20

What is the HEADSS assessment used for?

Answer 20

• To get comprehensive psychosocial Hx of adolescent

- To assess adolescent risk factors