Week 3 Flashcards
VII. Mental Status Evaluation
General Behavior
- Cooperative, passive, withdrawn, dramatic, hostile, restless
VII. Mental Status Evaluation
Attire
- appropriate, seductive, untidy, loud, meticulous
- Be especially aware of attire change from session 1 to session 2 b/c if you are found attractive by your client, they could “swim their way through Old Spice” on the way to your second session
VII. Mental Status Evaluation
Facial expression
- unremarkable, sad, angry, perplexed, fearful, elated, immobile, grimacing
VII. Mental Status Evaluation
Posture
- rigid, erect, lump, slouchy
VII. Mental Status Evaluation
Gait
- normal erect, stooped, ataxic, rigid, shuffling, manneristic
VII. Mental Status Evaluation
Motor activity
- normal, agitated, tremor, tic, mannerisms
VII. Mental Status Evaluation
Stream of Thought
- how do they go from one thought to the next
VII. Mental Status Evaluation: Stream of Thought
Productivity
- spontaneous, verbose, pressured speech, mute
VII. Mental Status Evaluation: Stream of Thought
Progression
- normal, loose, circumstantial (going in circles),
- perseveration (everything goes back to the reason they came in, always going back to that),
- halting, blocking, incoherent, fragmented
VII. Mental Status Evaluation
Language
- normal, baby talk, peculiar expression, stilted
VII. Mental Status Evaluation: Emotional Tone and reaction
Affect
- indifferent, fearful, angry, euphoric,
- shallow (they act like they get it, but they don’t),
- blunt, flat, normal, composed, anxious, sad, tearful,
- labile (up and down)
VII. Mental Status Evaluation: Mental trend/Content of thoughts
Perception
- normal,
- auditory hallucination,
- visual hallucination,
- depersonalization (experience of being outside of yourself, observing yourself in the situation),
- illusions,
- derealization (the attribution of non-human factors to people, so others are things rather than people),
- hypochondriasis
VII. Mental Status Evaluation: Mental trend/Content of thoughts
Cognition
- obsessive and ruminative,
- preoccupied,
- self-depreciatory,
- idiosyncratic,
- stereotyped
VII. Mental Status Evaluation: Mental trend/Content of thoughts
Cognition content
- (what are you obsessed about): obsessions, phobias, compulsive rituals, religiosity, ideas of reference (belief that inanimate objects are communicating with you)
- (i.e. a news reporter says “good night” when closing their news update and a person thinks that reporter is specifically talking to them),
- passivity feelings (feelings of non-person),
- nihilistic (pessimism/vague), delusions, self-derogatory delusions, suicidal ideation, bizarre ideas (thoughts of things that couldn’t happen) vs. non-bizarre ideas (thoughts of things that realistically could have happened),
- paranoid ideation (paranoid beliefs/thoughts)
VII. Mental Status Evaluation: ● Orientation and Sensorium
Consciousness
- alert, clouded, fluctuating, stuporous, apathetic
- Patient should be “alert” when you send that bill to BCBS b/c they won’t pay for “stuporous”
VII. Mental Status Evaluation: ● Orientation and Sensorium
Orientation:
- normal, disoriented to time/place/person
VII. Mental Status Evaluation: ● Orientation and Sensorium
Memory:
- normal, impaired (remote/recent/immediate)
VII. Mental Status Evaluation: ● Orientation and Sensorium
Digit Span
- forward (good-poor),
- backward (good-poor)
VII. Mental Status Evaluation: ● Orientation and Sensorium
Disorder of:
- counting,
- calculation,
- reading,
- writing,
- apperception,
- attention,
- concentration,
- comprehension
VII. Mental Status Evaluation: ● Orientation and Sensorium
General knowledge:
- consistent w/ education,
- inconsistent,
- able to abstract, concrete
VII. Mental Status Evaluation: Orientation and Sensorium
Insight and judgment:
- good,
- poor,
- absent,
- superficial
VII. Mental Status Evaluation: General Behavior/Gait
ataxic
- an inability to coordinate voluntary muscular movements;
- symptomatic of some nervous disorders
VII. Mental Status Evaluation: Stream of Thought/Progression
loose
- difficulty staying on track
- jump from one thing to another
VII. Mental Status Evaluation: Stream of Thought/Progression
blocking
- as they speak they completely lose their train of thought.
- In order to mask this they may use confabulation
- change the conversation in a dramatic way, begin making things up
- can be related to amnesia, early dementia and korsocoff’s syndrome
VII. Mental Status Evaluation: Mental Trend, Content of Thought/Perception
depersonalization
- outside yourself
VII. Mental Status Evaluation: Mental Trend, Content of Thought/Perception
hypochondriasis
- morbid condition about health, especially about death
VII. Mental Status Evaluation: Mental Trend, Content of Thought/Perception
obsessions
- always refer to thoughts
Why the emphasis on treatment plan?
Clinicians benefit
- Forced to think analytically about what we’re doing in each case
- Objective documentation in the event ofagainslitigation
- Needs of the client are primary (not projecting your issues on them)
Why the emphasis on treatment plan?
Clients benefit
- Direction for treatment is clear (agreed upon direction of treatment)
- Outcomes are in focus and are generated FOR THE CLIENT
- Expectation of specific result
VII. Mental Status Evaluation: Mental Trend, Content of Thought/Cognition Content
compulsive rituals
- always refers to behaviors [The compulsion resolves the obsession.]
VII. Mental Status Evaluation: Mental Trend, Content of Thought/Cognition Content
religiosity
- to the extreme
VII. Mental Status Evaluation: Mental Trend, Content of Thought/Cognition Content: ideas of reference
special messages for the person
- it is all about them, ie. books, the Bible
VII. Mental Status Evaluation: Mental Trend, Content of Thought/Cognition Content
nihilistic delusions
- delusions of nothingness