Assessment Flashcards

(90 cards)

1
Q

DASS - anxiety cut off scores

A

Normal: 0-7
Mild: 8-9
Moderate: 10-14
Severe: 15-19
Extremely severe: 20+

8-10-15-20

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2
Q

DASS - depression cut off scores

A

Normal: 0-9
Mild: 10-13
Moderate: 14-20
Severe: 21-27
Extremely severe: 28+

10-14-21-28

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3
Q

DASS - stress cut off scores

A

Normal: 0-14
Mild: 15-18
Moderate: 19-25
Severe: 26-33
Extremely severe: 34+

15-19-26-34

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4
Q

K10 - cut off scores

A

10-19: likely to be well
20-24: likely to have MILD mental disorder
25-29: likely to have MODERATE mental disorder
30-50: likely to have SEVERE mental disorder

10-20-25-30

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5
Q

SDQ - Strengths and Difficulties Questionnaire

A
  1. Emotional symptoms
  2. Conduct problems
  3. Hyperactivity/ Inattention
  4. Peer relationships problems
  5. Prosocial behaviour

1+2+3+4 —> total difficulties

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6
Q

SDQ cut off score

A

Parents version:
- may be significant problems: 14-16
- substantial risk: 17-40

  • emotional: 4 —— 5-10
  • conduct: 3 —— 4-10
  • hyperactivity: 6 ——7-10
  • peer: 3 —— 4-10
  • prosocial: 5 —— 0-4

Self completed
- 16-19 —— 20-40

  • emotional: 6 —— 7-10
  • conduct: 4 —— 5-10
  • hyperactivity: 6 —— 7-10
  • peer: 4-5 —— 6-10
  • prosocial: 5 —— 0-4
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7
Q

WAIS WISC age

A

Wais - 16 to 90:11

Wisc - 6 to 16:11

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8
Q

Weschlers overview

A

Predictors of both academic and functioning in occupation

Best for making short term predictions

Assessing strengths and weaknesses

Mean score 100
Standard deviation 15
Bell curve

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9
Q

FSIQ and GAI

A

FSIQ: Less important when difference between index scores are 23 or higher

GAI:
- WAIS: verbal comprehension and perceptual reasoning
- WISC: verbal, visual and fluid reasoning
Eliminate working memory and processing speed as they are most sensitive

Calculating difference between FSIQ and GAI - determine brain, age, situation sensitive subtest could be lowering performance

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10
Q

Weschlers stages of analysis

A

Level 1: FSIQ, percentile rank, classification
Level 2: index scores, cluster groupings
Level 3: substest variability
Level 4: qualitative/ process analysis
Level 5: analyse intrasubtest variability

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11
Q

Weschlers level 2 interpetation

A

Indexes only be interpreted when there is less than 5 point subscale difference within the index.

If difference higher than this - DO NOT interpret, but investigate - look at other combinations of subtests

Strengths and weaknesses
Anything falling outside range - causing impairment

Significant difference between indexes

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12
Q

Weschlers clusters

A

Fluid reasoning: matrix reasoning + figure weights

Visual processing: blocks designs + visual puzzles

Verbal reasoning: similarities + comprehension

Lexical knowledge: vocab + similarities

General information: comprehension + information

Long term memory: vocabulary + information

Short term memory: letter number sequencing + digit span

Visual motor speed: block design, symbol search

Problem solving without visual motor speed: matrix reasoning, visual puzzle, picture completion, figure weights

Non verbal fluid reasoning: matrix reasoning, picture concepts

Quantitative reasoning: figure weights, arithmetic

General information: comprehension, information

Long term memory: information, vocab

Auditory working memory: digit span, number letter sequencing

Cognitive proficiency: digit span, picture span, symbol search, coding

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13
Q

Weschlers subtest variability

A

Clinical judgement guided by theory - specific for each case eg challenges with speed, motivation, short term memory?

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14
Q

Weschlers qualitative analysis

A

High/ low scores?
Unusual responses?

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15
Q

Weschlers intrasubtest variablity

A

Abnormal patterns
Eg person missed first item, pass other items - may suggest attentional deficit or memory loss related to retrieval difficulties

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16
Q

Crystallised vs fluid intelligence

A

Crystallised: acquired
Fluid: ability

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17
Q

Weschlers range

A

<70: extremely low
70-80: very low
80-90: low
90-110: average
110-120: high average
120-130: superior
130+: very superior

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18
Q

Verbal comprehension

A

WAIS: vocab, similarities, information
WISC: similarities, vocab

Low scores: difficulties with spoken language

Influenced by cultural factors
Professional occupation likely to have higher scores

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19
Q

Perceptual reasoning

A

WAIS: block design, matrix reasoning, visual puzzle
WISC (Visual spatial): block design, visual puzzles

Less affected by educational background

Low scores: challenges with following spatial directions, finding objects in house

Picture completion WAIS supplementary - identify missing part in the picture

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20
Q

Fluid reasoning

A

WISC only: Matrix reasoning, figure weight, picture concepts (supplemental), arithmetic (supplemental)

Less affected by cultural background

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21
Q

Working memory

A

WAIS: digit span, arithmetic
WISC: digit span, picture span

Low score: poor concentration, may also be difficulties w executive functioning

Not a diagnostic predictor for ADHD

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22
Q

Processing speed

A

WAIS: coding, symbol search
WISC: coding, symbol search

Planing and organising
Sensitive to dementia, traumatic brain injuries, adhd, learning disabilities

Those w high iq tend to have this as lowest, and verbal reasoning as highest

Cancellation- supplemental

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23
Q

FSIQ include

A

WAIS (10): Block Design, Similarities, Digit Span, Matrix Reasoning, Vocab, Arithmetic, Symbol Search, Visual Puzzle, Information, Coding

WISC (7): Block Design, Similarities, Digit Span, Matrix Reasoning, Vocab, Coding, Figure Weights

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24
Q

PAI general

A

Self report
344 items
How true a statement is - 4 point scale
18-89
PAI-A for adolescents 12-18

4 validity scales
11 clinical scales
5 treatment scales
2 interpersonal scales

Low reading level (grade 4)
Less than an hour

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25
PAI interpretation steps
4 - profile distortion (test validity) - determine appropriate reference comparision - interpret individual scales - interpret profile configurations 5 - Test validity - Analysis if Critical Items - potential of crisis situation - Full Scale - general population vs clinical sample - T > 2SD - Subscale - more meaning eg ANX-T - Configural - combining to make a meaningful clinical results (only experienced does this)
26
PAI Validity
INCONSISTENCY (ICN) 10 pairs of items with similar content 63 < T < 73: proceed with caution T > 72: Invalid - STOP interpreting INFREQUENCY (INF) 8 items (to be similarly rated) 59 < T < 76: interpretation w caution T > 75: problematic, interpret with caution NEGATIVE IMPRESSION (NIM) 83 < T < 92: negative distortion T > 91: malingering (pretend), careless - clinical judgement whether to continue — MAL index - 2-5 potential > 4 strong likelihood of malingering — RDF - similar to MAL, T > 59 purposeful malingering POSITIVE IMPRESSIONS (PIM) 56 < T < 68: denying problems, defensive T > 67: proceed with caution, under responding problems — DEF 69 - purposefully defensive — CDF 69 - reflect how they want to be portrayed rather than how they truly function
27
PAI clinical - SOMATIC COMPLAINTS SOM
Concern of physical health - presence of real medical problems - individual’s experience with their medical problems T 69: poor health T 86: preoccupied w health concerns T 94: delusion SOM-S: general complaints SOM-C: headache, fatigue, gastro - T 69 SOM-H: health concerns - T 69 believe health concerns are complex and difficult to treat
28
PAI Clinical - Anxiety ANX
Worry, tension Anxiety disorder, depression w anxiety T 69: impact daily functioning T 89: impairment Cognitive anxiety ANX-C: T 69 overly concerns Affective anxiety ANX-A: T 69 stress, worry, hard to calm down - most related to GAD Physiological anxiety ANX-P: T 69 physical symptoms and somatic (SOM should be elevated w this)
29
PAI Clinical Anxiety related ARD
Examine 3 scales separately rather than together OCD - ARD-O: T 65: impair functioning, T 74: disruptive behaviour Phobias ARD-P: T 69: fear and avoidance Traumatic stress ARD-T: T 64: trauma in the past - T 75: trauma is primary focus of concern ARD commonly elevated along with DEP and BOR Overall scale - motivation for treatment The higher the more likely to refuse treatment
30
PAI Clinical Depression DEP
T 69: significant T 79+: likelihood of MDD Cognitive DEP-C: thinking of worthless, helpless T 69 unable to meet demands of life, self esteem, self efficacy Affective DEP-A: T 69 distressed, gloomy, losing interest Physiological DEP-P: appetite, sleep, motivation, energy level T 69
31
PAI Clinical Mania MAN
T 64: irritability, grandiosity, restless, acting rashly T 74: likelihood of manic or hypomanic episode Acitvity level MAN-A: increase speed T 64: disorganised, T 74: confusing others Grandiosity MAN-G: T 70: grandiose, narcissistic Irritability MAN-I: T 70: disagreement, non-cooperative NOT often elevated with others Can be elevated w BOR Elevated - not hopeful for psych treatment
32
PAI Clinical - PAR paranoia
T 69: suspicious, hostility, monitoring threats around T 83: paranoid delusions Hypervigilance PAR-H: guardness T 70 preoccupied w potential threat - likelihood of paranoid personality Persecution PAR-P: being treated unfairly T 69: believe others making efforts to get in the way Resentment PAR-R: bitterness T 70 hold grudges, distribute personal failure on others Exam DOM and AGG for how the person would respond, aggressive or passive aggressive Elevated mean hard to form and maintain therapeutic alliance
33
PAI Clinical Schizophrenia SCZ
Subscale rather than overall T 69: blizzard/ odd thinking, impair attention and concentration Psychotic Experience SCZ-P: positive symptoms of scz, T 70: perception and beliefs that may be delusional - actively experiencing psychotic episode Social Detachment SCZ-S: T 69 tend to isolate themselves, lack of interests in relationships Thought disorder SCZ-T: T 69: confusion, loose association SCZ elevated w Paranoid, BOR, Alcohol and Drug problems
34
PAI Clinical Borderline features BOR
T 69: rapid swings of mood, easily feel hurt or betrayed T 90: likely to meet criteria for borderline personality disorder Affective Instability BOR-A: T 69: sudden, uncomfortable shifts of emotions, rapid changes to anger or negative feelings Identity Problems BOR-I: T 69: uncertain about who they are, rely on help for making decisions Negative Relationships BOR-N: T 69: stormy relationships, problem attachment, disappointed due to high expectations T 80: easily offended, extremely sensitive Self harm BOR-S: NOT suicidal tendency - T 69: act impulsively - T 85: reckless and dangerous behaviours
35
PAI Clinical Antisocial features ANT
T 69: impulsive and dangerous to themselves and others T 82: likely to meet criteria for antisocial personality disorder ANT-A: personal traits, history behaviours - T 69: rules breaking behaviour in the past, difficulties w authorities Egocentricity ANT-E: T 69: little regards for those around, exploit others, rarely feel remorseful Stimulus seeking ANT-S: T 69: potential threat to themselves and others, craving, risky, Most commonly elevated w alcohol and drug Little motivation to change, hard for therapy
36
PAI Clinical ALCOHOL ACL
T 69: struggle w alcohol abuse , likely to have problems w personal relationships and health
37
PAI Clinical Drug DRG
T 69: qualify for drug abuse, likely to have problems w interpersonal, job performance and health concerns
38
PAI Treatment Aggression AGG
T 70: angry, hostile, fully prepared to exhibit anger T 82: anger management problem impacting relationships and job Attitudes AGG-A: traits and beliefs and ability to control anger T 70: losing temper easily - if behaviour is not elevated, likely to be suppressing or passive aggressive Physical aggression AGG-P: T 70: destroying property and violence towards others High AGG: resistant, explosive in therapy Low AGG: passive, submissive, assertiveness training required
39
PAI Treatment Suicidal Ideation SUI
Warning signs only Even when Low, but DEP, STR, NON are high, still potential of suicidal ideation T 69: active ideation, MUST be followed up Potential relationships w DEP-C, BOR-S, DRG
40
PAI Treatment Stress STR
T 69: too much to handle T 84: more probe to psychopharmacology The higher and more likely to get help High score = likely to respond well with problem solving strategies, and learning coping skills
41
PAI Treatment Nonsupport NON
T 69: limited support offered T 87: no support More likely to seek help and treatment Therapy to be caring and supportive
42
PAI Treatment rejection RXR
T 59: not easy to admit problems, no need for change Difficult to engage in therapy
43
PAI Interpersonal Dominance DOM
T < 35: lack self confidence T < 45: passive, assert, uncomfortable being the centre of attention T > 59: confident T > 69: overbearing, dominating, intolerant to disagreement Can predict potential power struggle w therapist
44
PAI Interpersonal WARTH WRM
T < 35: uninterested in forming deep connections T < 45: distant in relationships T < 60: flexible in relationships T < 70: warm, empathetic, value deep relationships T > 69: overly concerned being liked and accepted, too caring, too giving, avoiding conflicts
45
PAI ADDITIONAL CLUSTER
Self-concept: MAN-G, DEP-C, BOR-I: individuals thinking and feeling about themselves and how stable this is Interpersonal style: DOM, WARM: 4 different styles Environmental perception: NON STR: how individual perceive their environment, 4 different styles Potential for dangerousness: SUI, AGG
46
PAI cutscore
Validity: - INC: 64 — 73 - INF: 60 - NIM: 73 - MAL 3+, RDF 60 - PIM: 57 - DEF 6+, DCF 66 Clinical - MAN, MAN-A 55 - BOR-A, BOR-I, BOR-N 70 - AGG, AGG-A/E/S: all 70 - The rest 60T 70T is 96th percentile
47
DASS general
21 or 42 NOT diagnostic tool Rating period: last week Progress in therapy Gaps for Aboriginal NOT recommended for below 14 years Anxiety scale - others anxiety (trembling, panicky, loss of control, worries about performance, breathing difficulties) Stress scale - GAD ( touchy, easy to upset, nerve, fidgety, unable to relax, irritable) Depression - Mood disorders (pessimistic, gloomy, unable to feel satisfied, slow, lack of initiative)
48
K10 General
Distress Score 10-50 NOT diagnostic tool - just screener Non specific psych distress eg nervousness, agitation, fatigue, depression 1-5 scale none to all the time Rating period: last 4 weeks
49
SDQ General
4-17 years Further assessment or treatment, evaluating treatment outcome 25 questions 5 scales Only one w supplement Also have follow-up questions Version for preschool teachers and parents 2-4 Self report for 4-17 Acceptable use with Aboriginal - peer problem need caution
50
WPPSI
2 - 6:7 15 subtests - Five primary index (like WISC) 24-62 mins
51
Stanford-Binet SB5
2 - 85+ Fluid reasoning Knowledge Quantitative reasoning Visual spatial processing Working memory 10 subtests make FSIQ Verbal (5) and nonverbal (5) Abbreviated Battery IQ - when time limited - estimate overall function level and can be used as screening tool - 15-20 mins Full scale: 45-60 mins
52
Wechsler Abbreviated Scale of Intelligent WASI-II
Brief measure 6 - 90:11 Clinical and educational and research setting for estimate IQ when comprehensive test is not necessary, to determine if full test is warranted, or as re-test measure. Vocab and Similarities = Verbal Comprehension Block design and Matrix Reasoning = perceptual reasoning 30 mins for 4 15 mins for 2 NOT designed for diagnosis or education support decisions
53
WJ-III cog
Cattell-Horn-Carroll therory GIA score 2 - 90 40 mins - 2 hours
54
Raven’s progressive matrice RSPM
Nonverbal estimation of fluid reasoning Can be used for culturally diverse populations or nonverabal children 4 - 90
55
WIAT - individual achievement test
9 subtests - 4 composites: - Reading - Maths - Written language - Oral language Specific learning disorder, strengths and weaknesses for intervention and education services 4-85 years 4-11 years: 45-90 mins 12+: 90-120 mins
56
ABAS-3 adaptive behaviour assessment system
Adaptive behaviour for daily functioning Strengths and weaknesses and measure effectiveness of treatment Any age 15-20 mins each form Parents: 0-5 Teacher: 2-5 Parent: 5-21 Teacher: 5-21 Adult: 16-89 General adaptive composite GAC - conceptual (communication, functional academics, self direction) - social (leisure and social skills) - practical (community, home living skills, health and safety, selfcare) - motor (only for 0-5) - work (optional)
57
Wechsler Memory Scale WMS-III
16 - 90 Logical memory Verbal Paired associcated Visual reproduction 4 new tests - Brief cognitive status exam - Designs - Spatial addition - Symbol span 5 norm-reference index scores: - auditory - visual - visual working (only for 16-69) - immediate - delayed memory Brief cognitive status exam BCSE (cognitive screen) 60 mins
58
WRAML - wide range of memory and learning
Memory deficits eg dementia, developmental disabilities 5-90 3 core indexes: - verbal - visual - attention concentration —> general memory index Optional: - working memory - delayed - recognition Screening memory for in-depth assessment Used in school, rehabilitation, vocational training, hospitals, private practice, in research 1 hour
59
Self directed search SDS
Career - identify career interest and match w suitable occupations 15+ 6 categories: - realistic R - investigative I - artistic A - social S - enterprising E - conventional C 5 sections: - occupation daydreams - list up to 5 occupation - activities (66 items like dislike) - competencies (66 items yes no) - occupations (84 items yes no) - self estimates of abilities and skills (12 items 1-7 low to high) 3 most rated letter for result eg SEC 30-40 mins
60
Strong interest inventory SII
Aid career decision making - career development, exploration and employee engagement, leadership, executive coaching, employment reintegration 260 occupational scales OSS based on the US Personal style scales PSS - work style - learning environment - leadership style - risk taking - team orientation 5 scales: - General Occupation themes (GOTs) - Hollands 6 personality Realistic, Investigative, Artistic, Social, Enterprising, Conventional. - Basic Interest scales (BIS): specific area such as art, science, athletics, social science, sales, office management Administrative indices for test error and unusual profiles
61
16PF
Self report Vocational and occupation preferences Warmth Reasoning Emotional stability Dominance Liveliness Rule consciousness Social boldness Sensitivity Vigliance Abstractedness Privateness Apprehension Openness to change Self-reliance Perfectionism Tension 5 global factors - extraversion - anxiety - tough-mindedness - independence - self-control 16+ 25-50 mins
62
NEO-PI-R
5 factor model: - neuroticism - extraversion - openness to experience - agreeableness - conscienciousness 5 domain scores 6 facet scores for each domain 17+ Version for 12+ 30-40 mins
63
Beck depression inventory BDI
Severity of depression 21 items represent symptoms of depression 13+ 5-10 mins 4 point rating 0-3 Total: 0-63 American adult: 0-13: minimal 14-19: mild 20-28: moderate 29-63: severe 0-14-20-29
64
Global assessment of functioning GAF
Axis V of DSM-IV-TR Psychological symptoms severity Social functioning Occupational impairment No longer include in DSM-5 WHODAS 2.0 is used instead Score 1-100 - the higher the healthier
65
State trait anxiety inventory STAI
Most commonly used for anxiety Trait A - tendency to respond State A - immediate threat, stimuli, temporary conditions 10 mins - sixth grade reading level 2 20 items self report State: right now, at this moment 4 point scale - 1 not at all to 4 very much so Trait: generally feel 4 point scale - frequency of feelings 1 almost never ti 4 almost always
66
WHODAS 2.0 - disability assessment
Generic assessment for health and disability used across multiple diseases 2 versions - short and long Both clinical and general population Applicable across culture for adults Direct link to ICF (international classification of functioning disability and health) 6 domain: - cognition - mobility - self care - getting along - life activities: leisure, work, domestic relationships - participation
67
WHO-QOL (quality of life)
Perception of position in life For adults 6 domains - physical - psych - level of independence - social relationships - environment - spiritual Self report - 30 mins
68
Outcome rating scale ORS
Client functioning, therapy outcomes, progress Used in clinical, counselling, community settings. 13+ - Individual - Interpersonal - Social - Overall wellbeing Over previous week 1 min to complete High scores = high level of functioning Cut off for adolescent 28
69
MMPI personality
Psychopathology, commonly used in psychiatric setting 9 validity 10 clinical 15 content 9 restructured clinical 20 supplementary 567 items total true false Clinical scale includes: content subscales, content scales, component scales, combination of all 3 18+ MMPI-A for 14+ 60-90 mins
70
PHQ9 patient health
Screening for mental health disorders: depression, anxiety, alcohol, somatoform, eating disorders Self admis - severity of depression Inform and monitor treatment Over the last 2 weeks, how often… 4 point 0-3 not at all, nearly everyday 2-3 mins Can be used to DIAGNOSE depression 5-9 mild 10-14 moderate 15-19 moderately severe 29-27 severe 5-10-15-29
71
CBCL - child behaviour checklist
Adaptive behaviour and functioning 6-18 Parent - teacher - youth (11+) forms Internalising: anxious, depressed, withdrawal, somatic complaints Externalising: rule breaking, aggressive Social, thought, attention Competency and adaptive functioning 15 mins
72
SCID - structured clinical interview for DSM
Close to DSM decision trees Open-ended questions Skip structure Clinical judgement needed, only for trained clinician Most comprehensive structured interview Assessment of clinical disorders Assessment of personality disorders Focused structured interviews
73
High risk
Follow up within 24 hours Close monitoring
74
Medium risk
Re-assessment within 1 week Contingency plan should be made
75
Low risk
Review at least monthly After discharge from in-patient unit - re-assess within 1 week
76
Low assessment confidence
Re-assess in 24 hours Impulsivity Drug and alcohol Impending court cases, child custody battles Inability to complete assessment or collateral information
77
Risk assessment considerations
Engagement in support network Be mindful of countertransference Discuss consent - breaching consent Getting emergency contact details First 28 days after discharge is critical - remain high risk for 3-6 months If someone is intoxicated - invalid risk assessment - cannot be assessed until sober
78
Brief psychiatric assessment
Psych symptoms eg depression Psych history Coping skills, capacity, supports Risk assessment include comprehensive mental health assessment eg depression, schiz, bipolar, anxiety, personality, drug use Note details risk assessment, management plans and observation on medical records
79
Increased risk factors
Aboriginal 2.8 times as many deaths Demographic: - male - 25-44 - older people - living in rural area - minority group - sexual identity conflicts - immigrants, refugees - homelessness Higher risk: - history if suicide - mental illness - abuse - domestic violence - alcohol - victims of trauma - serious physical illness - prison, police Current - at risk mental state - interpersonal crisis - major loss or trauma - alcohol intoxication - drug withdrawal - chronic pain illness - financial difficulties, unemployment - family breakdown - lack support - cultural conflicts - difficulties accessing help eg language barrier
80
Element of suicide risk assessment
Distress, psychic pain Meaning, motivation At risk mental states eg body language History of suicide Current suicide thoughts Intent, lethality Presence of suicide plan Access to means and knowledge Safety of others Coping potential or capacity Self harm behaviour
81
Assessing degree of intervention
Diagnosis Severity of illness Impulsivity Insight Safety of current situation Willingness to engage in treatment Protective factors
82
Safety plan
Warning signs Coping strategies Contacting people Contacting health care professional (business hours) Following agencies or services 24/7
83
History taking approach
1. Explain the purpose and rationale for assessment, getting consent 2. Identify the range if concerns 3. Prioritise and select issues 4. Understand the present behaviour 5. Identifying antecedents 6. Identifying consequences 7. Identifying secondary gains - what is reinforcing the behaviours 8. Exploring previous solutions 9. Identify coping skills, individual and environmental strengths and resources 10. Explore perception of concern 11. Ascertaining the intensity of concern
84
MSE general
Observation General appearance Feeling Perception Thinking Orientation Insight Speech Observe: - Mood - Physical appearance - Facial expression - Body posture - Language Ask: - Inner thoughts - Feelings - Suicidal risk and delusions MMSE - structure 11 items assessing: - orientation - registration - attention - calculation - language Score above 25 is normal Under is potential cognitive impairment
85
MSE cognitive functioning
Consciousness and attentiveness Orientation to person, place and time Attention, need for redirection, distractibility Concentration Memory Knowledge Intelligence Capacity for abstract thinking
86
MSE perception
Hallucination Depersonalisation Derealisation
87
MSE Thinking
Speech Thought content (what is said) Though form (how is it said) Suicidal and homicidal ideation Insight Judgement - problem solving
88
MSE feeling
Affect (visible emotional state) Mood (subjective emotional state)
89
MSE Behaviour
Appearance Psychomotor agitation or retardation Degree of cooperation
90
ABC STAMP LICKER
A appearence B behaviour C cooperation S speech T thought A affect M mood P perception L level of consciousness I insight and judgement C cognitive functioning K knowledge E ending (suicidal) R reliability of information