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Flashcards in Mental Status Exam Deck (38):
1

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

ABC STAMP LOCKER

2

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

  • appearance
  • behavior
  • cooperation

3

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

  • speech
  • thought
  • affect
  • mood
  • perception

4

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

  • level of consciousness
  • orientation
  • cognitive functioning
  • knowledge
  • endings
  • reliability

5

Appearance

  • 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

6

Behavior

  • 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)

7

Cooperation

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

8

Speech

  • 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

9

What are neologisms?

made up words, idiosyncrasies in word choice

ex: "I'm feeling very American today."

10

What is "word salad"?

nonsensical, random speech

11

What is "clanging"?

sound associations that dictate speech

ex: rhyming

12

What is echolalia?

repetition of someone else's words (copycat)

13

What is perseveration?

repetition of one's own words

14

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

  1. form
  2. content

15

Thought (form)

Thought process, discerned from speech:

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

16

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

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

17

Describe circumstantial thought.

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

18

Describe tangential thought.

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

19

Describe "flight of ideas."

severe, irrational rapid topic jumping

20

Describe "loose associations."

thought stream is illogical

21

Thought content

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

22

Affect

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

Mood

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

Perception

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

25

What is depersonalization?

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

26

How does derealization differ from depersonalization?

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

27

Levels of consciousness

levels of awareness of external stimuli:

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

28

Orientation

spheres of orientation: person, place, time

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

29

What are the two parts of considering cognitive functioning?

  1. judgment
  2. insight

30

Cognitive functioning (judgment)

decision-making ability

Are goals reasonable, appropriate, good, poor?

31

Cognitive functioning (insight)

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

Anosognosia and La Belle Indifference are part of insight.

32

What is anosognosia?

unawareness or denial of one's disorder

33

What is La Belle Indifference?

lack of concern about one's own disorder

34

Knowledge

intellectual ability (inferred by clinician, not directly tested)

  • language
  • speech
  • vocabulary

35

Endings

  • suicidal ideation
  • suicidal plan
  • homicidal ideation
  • homicidal plan

36

Reliability

accuracy of patient self-report

Is the patient a reliable or poor historian?

37

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

  • 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

Can you diagnose a patient from the mental status exam?

no