The Mental Status Exam

Mental Status Exam

• The mental status exam involves systematic observation of an individual's behavior, often performed quickly by experienced clinicians during interviews or observations.
• The exam consists of five components:
  • Appearance and Behavior: observing overt physical behaviors, such as slow motor behavior, which may indicate severe depression.
  • Thought Processes: assessing an individual's thought processes through conversation.
  • Mood and Affect: distinguishing between an individual's predominant feeling state (mood) and their feeling state at a given point (affect).
  • Intellectual Functioning: estimating an individual's intelligence, noting any deviations from normal.
  • Sensorium: assessing an individual's general awareness of their surroundings.

Semistructured Clinical Interview

• Semistructured interviews involve carefully phrased and tested questions to elicit useful information in a consistent manner.
• This approach ensures clinicians inquire about important aspects of particular disorders.

Physical Examination

• Psychologists and mental health professionals consider medical conditions and substance abuse that may contribute to a patient's problems.
• They must determine whether a medical condition or substance abuse is merely coexisting or causal.

Behavioral Assessment

• Behavioral assessment uses direct observation to formally assess an individual's thoughts, feelings, and behavior in specific situations or contexts.
• It involves identifying target behaviors and observing the factors that influence them, using the ABC's of observation: Antecedent, Behavior, and Consequences.

Psychological Testing

• Psychological tests determine cognitive, emotional, or behavioral responses associated with specific disorders.
• They also assess longstanding personality features, such as a tendency to be suspicious.

Projective Testing

• Projective tests involve clients responding to ambiguous stimuli, such as inkblots (Rorschach Inkblot Method) or interpersonal scenes (Thematic Apperception Test).
• These tests were among the first to emerge and are used to assess personality.

Personality Testing

• The Minnesota Multiphasic Personality Inventory (MMPI) is a comprehensive personality measure that detects random responding or intentionally misleading responses.
• The MMPI has become popular, with over 200 separate scales consisting of combinations of MMPI items.

Intelligence Testing

• Binet's test was intended for children, while David Wechsler's Wechsler-Bellevue test was designed for adults.
• Wechsler later created tests for school-age and preschool children, and revisions of his tests are commonly used today.

Neuropsychological Testing

• Neuropsychological testing measures abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning and abstraction.
• It helps clinicians make educated guesses about an individual's performance and possible existence of brain impairment.

Diagnosing Psychological Disorders

• Diagnosis and categorization of mental illness have been central to clinical psychology.
• Emil Kraepelin is considered a pioneer of diagnosis, coining early terms to categorize mental illness.
• The Diagnostic Statistical Manual of Mental Disorders (DSM) has been revised several times, with the latest edition being DSM-5 (2013).
• Proposed disorders include Internet Gaming Disorder, Attenuated Psychosis Syndrome, Persistent Complex Bereavement, and Non-suicidal Self Injury.