Scroll below or search in the bar for "Mental Status Exam: Behavioral Aspects" to see the first part of these posts. MSEs include an evaluation of both behavioral aspects and cognitive aspects. Today's post will include the second component of cognitive aspects. Come back on Friday for a question related to this topic!

Cognitive Aspects of an MSE

Whereas observation alone can be used to obtain information about behavioral variables, to collect data about cognitive functioning you must also actively question the client to elicit the material you need.

• Thought Content: Similar to flow of thought, thought content is reflected in the content of a client’s speech. Examples of abnormal thought content include delusions and morbid preoccupations. Depending on the nature of the abnormal thought content, diagnostic possibilities include a primary psychosis, depressive or bipolar disorder, mental disorder due to another medical condition, or substance/medication-induced mental disorder. Mood-congruent delusions, for example, are associated with a mood disorder, while mood-incongruent delusions are more typical of schizophrenia.
• Perception: Perception refers to the accuracy of a client’s five senses (sight, hearing, touch, smell, and taste) or her ability to correctly perceive external stimuli and her own internal processes. Examples of abnormal perceptions include illusions (misperceptions of actual stimuli) and hallucinations (perceptions in the absence of actual stimuli). Hallucinations can involve any of the five senses and may be associated with a primary psychosis, mental disorder due to another medical condition, or substance/medication-induced mental disorder. Auditory hallucinations are the most common type among people... (More)

Preparing for the exam is an ongoing, almost daily task. (note here that I said “almost daily” so that means if you are consistent then take days off as a reward to yourself and a break to your brain).

We all have other obligations that can make fitting in the time to study difficult. Below are some methods to help manage your time so that you can study as much as you need to, despite life getting in the way.

Find the Time to Study: To help manage your time effectively, we suggest that you begin by developing your study schedule by recording your obligations on a wall calendar. Doing so will give you a “snapshot” of your life so that you can develop a realistic study schedule.

• Begin by listing all of the work, family, and other non-exam related demands on your time.
• Prioritize these demands and decide which ones are “mandatory” and which ones can be eliminated, postponed, or delegated to someone else.
• Record all the mandatory demands on your wall calendar and include an estimate of how much time each demand will require.
• Determine the amount of time that is available for studying. Notice which days are free for studying and how many hours are available on those days for studying. Does the amount of time you have seem appropriate for the amount of material you will need to study? If your schedule does not allow adequate time for studying, see if there are additional non-exam related... (More)

Most MSEs include an evaluation of both behavioral aspects and cognitive aspects. Behavioral aspects are described below. Come back Friday for a question related to this topic, and come back next week for the cognitive aspects of MSEs.

A mental status exam (MSE) is used to evaluate a client’s current mental functioning. As a social worker, you may see clients who have an undiagnosed mental illness, neurological condition, or neurocognitive disorder (e.g., dementia). Understanding how to use a mental status exam enables you to recognize key symptoms and refer clients for needed psychiatric evaluations and evaluations of medical problems that affect psychological functioning (especially neurological evaluations). In conjunction with other data, information collected from an MSE may also be used to formulate an appropriate clinical diagnosis.

To conduct an MSE, you observe a client’s behavior in an informal, systematic way, noting the presence of cognitive, emotional, and behavioral problems. For example, you note the presence of unusual behavior or answers that suggest a mental disorder. You then use your observations to make preliminary decisions about which areas of the client’s functioning should be assessed in more detail and, sometimes, more formally. A common practice is to make mental status observations during the course of the interview and then change to direct questioning near the end of the interview to elicit additional information needed for the MSE.

Behavioral Aspects: Behavioral functions are evaluated through direct observation of the client’s speech and nonverbal behavior during an interview (i.e., you observe certain cues... (More)