Mental Status Essay Assignment Exam
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Mental Status Essay Assignment Exam
Heidi Combs, MD
What it is it?
- The Mental Status Exam (MSE) is the psychological equivalent of a physical exam that describes the mental state and behaviors of the person being seen. It includes both objective observations of the clinician and subjective descriptions given by the patient.
Why do we do them?
- The MSE provides information for diagnosis and assessment of disorder and response to treatment.
- A Mental Status Exam provides a snap shot at a point in time
- If another provider sees your patient it allows them to determine if the patients status has changed without previously seeing the patient
- To properly assess the MSE information about the patients history is needed including education, cultural and social factors
- It is important to ascertain what is normal for the patient. For example some people always speak fast!
Components of the Mental Status Exam • Appearance • Behavior • Speech • Mood • Affect • Thought process • Thought content • Cognition • Insight/Judgment
Appearance: What do you see? • Build, posture, dress, grooming,
prominent physical abnormalities
- Level of alertness: Somnolent, alert
- Emotional facial expression • Attitude toward the examiner:
Cooperative, uncooperative
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Behavior
- Eye contact: ex. poor, good, piercing
- Psychomotor activity: ex. retardation or agitation i.e.. hand wringing
- Movements: tremor, abnormal movements i.e.. sterotypies, gait
Speech
- Rate: increased/pressured, decreased/monosyllabic, latency
- Rhythm: articulation, prosody, dysarthria, monotone, slurred
- Volume: loud, soft, mute • Content: fluent, loquacious, paucity,
impoverished
Mood
- The prevalent emotional state the patient tells you they feel
- Often placed in quotes since it is what the patient tells you
- Examples “Fantastic, elated, depressed, anxious, sad, angry, irritable, good”
Affect
- The emotional state we observe • Type: euthymic (normal mood),
dysphoric (depressed, irritable, angry), euphoric (elevated, elated) anxious
- Range: full (normal) vs. restricted, blunted or flat, labile
- Congruency: does it match the mood- (mood congruent vs. mood incongruent)
- Stability: stable vs. labile
Thought Process
- Describes the rate of thoughts, how they flow and are connected.
- Normal: tight, logical and linear, coherent and goal directed
- Abnormal: associations are not clear, organized, coherent. Examples include circumstantial, tangential, loose, flight of ideas, word salad, clanging, thought blocking.
Thought Process: examples • Circumstantial: provide
unnecessary detail but eventually get to the point
- Tangential: Move from thought to thought that relate in some way but never get to the point
- Loose: Illogical shifting between unrelated topics
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- Flight of ideas: Quickly moving from one idea to another- see with mania
- Thought blocking: thoughts are interrupted
- Perseveration: Repetition of words, phrases or ideas
- Word Salad: Randomly spoken words
Thought Content
- Refers to the themes that occupy the patients thoughts and perceptual disturbances
- Examples include preoccupations, illusions, ideas of reference, hallucinations, derealization, depersonalization, delusions
Thought Content: examples • Preoccupations: Suicidal or
homicidal ideation (SI or HI), perseverations, obsessions or compulsions
- Illusions: Misinterpretations of environment
- Ideas of Reference (IOR): Misinterpretation of incidents and events in the outside world having direct personal reference to the patient
- Hallucinations: False sensory perceptions. Can be auditory (AH), visual (VH), tactile or olfactory
- Derealization: Feelings the outer environment feels unreal
- Depersonalization: Sensation of unreality concerning oneself or parts of oneself
- Delusions: Fixed, false beliefs firmly held in spite of contradictory evidence • Control: outside forces are controlling actions • Erotomanic: a person, usually of higher status, is
in love with the patient • Grandiose: inflated sense of self-worth, power or
wealth • Somatic: patient has a physical defect • Reference: unrelated events apply to them • Persecutory: others are trying to cause harm
Cognition
- Level of consciousness • Attention and concentration:
the ability to focus, sustain and appropriately shift mental attention
- Memory: immediate, short and long term
- Abstraction: proverb interpretation
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Folstein Mini-Mental State Exam • 30 item screening tool • Useful for documenting serial
cognitive changes an cognitive impairment
- Document not only the total score but what items were missed on the MMSE
Insight/Judgment
- Insight: awareness of one’s own illness and/or situation
- Judgment: the ability to anticipate the consequences of one’s behavior and make decisions to safeguard your well being and that of others
Sample initial MSE of a patient with depression and psychotic features • Appearance: Disheveled,
somnolent, slouched down in chair, uncooperative
- Behavior: psychomotor retarded, poor eye contact
- Speech: moderate latency, soft, slow with paucity of content
- Mood: ”really down“ • Affect: blunted, mood congruent
MSE continued
- Thought Process: linear and goal directed with paucity of content
- Thought Content: +SI, +AH, +paranoia, -VH, -IOR, -HI
- Cognition: Alert, focused, MMSE:24- missed recall of 2 objects, 2 orientation questions, 2 on serial sevens
- Insight: fair • Judgment: poor
Summary
- By the end of a standard psychiatric interview most of the information for the MSE has been gathered.
- The MSE provides information for diagnosis and assessment of disorder and response to treatment over time.
- Remember to include both what your hear and what you see!
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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