Mini Mental State Examination Answers Assessment Answer

k 2013). In the context of the present case study, it is necessary to interpret how Annabelle’s thoughts are disturbed for delivering optimal quality care services to the patient. Assessment needs to be done in order to highlight the ability of the patient to synthesize external stimuli. How Annabelle’s thoughts are disturbed can be interpreted by analysing whether she is able to interpret incoming information, whether she perceives that other individuals have an understanding of her thoughts, whether she demonstrates neologisms and whether she has the viewpoint that her thoughts are to be held responsible for the negative events. In the case of Annabelle, it is likely that she is suffering from delusion. Other defining characteristics include delusion of persecution, inappropriate reactions to a communication made by others, state of confusion, signs of anger and fear, an exhibition of distractibility, violet gestures, and interrupted sleep. Interpretation of how the thoughts are disturbed may be achieved through analysing Annabelle whether she shows ambivalence through the behaviours and statements.

A perception in the context of mental state examination is the sensory experience, and the classifications of perceptual disturbances are illusions, hallucinations, and pseudo-hallucinations. An illusion is the false sensory perception when there is the presence of external stimuli. It can also be defined as the distortion brought about in the sensory experience. A hallucination is the sensory perception when there is no external stimulus present. The experience of the subject is real is this case, unlike an illusion. A pseudo-hallucination is when a subject has a fantasy, as experienced in subjective space. Other forms of abnormalities are derealisation, depersonalisation or distortion in the sense of time-frame (Kneisl and Trigoboff 2012). In the present case study, Annabelle is suffering from one of the forms of perceptual disturbances. Annabelle is found to be unaware of the circumstances she is going through and does not appropriately reciprocates to it. Perceptual disturbances are difficult to highlight as patients do not agree to the fact that they are suffering from some form of disturbances. There are some clinical implications of interpreting how the patient has disturbances in the senses. It is desirable to gather important information about the patient regarding the experiences she had. A comprehensive assessment instrument would be helpful in gaining new insights regrading the anxieties and fears she has been suffering from. The patient needs to be allowed to talk about the experiences she had in the past for relating her behaviour with what she has gone through. Considering the phenomenological diversity of perceptual disturbances would also help in revealing significant information regarding the changes noticed in the condition of the patient. The variations found in the phenomenology adequately reflect the changes in the emotional state of the patient (Mitchell 2013).

Mood can be defined as the individual’s internal state at any instance of time. It is a more prolonged state. Affect is defined as the external dynamic manifestation of the internal emotions of an individual. It has also been referred to as differentiated feelings. In the field of psychology, it is beneficial to conceptualise the existing relationship between mood and emotional affect. Affect is the immediate expressions due to an emotion whereas mood is the emotional experience that prevails for a longer period of time (Paniagua and Yamada 2013). The range of affect includes blunted, expansive, flat and restricted. The intensity of the affect can be normal, exaggerated, blunted, heightened or flat. A patient may be demonstrating the full range of affect at the time of assessment or a restricted affect (Huline-Dickens 2013). Annabelle’s mood can be described as being irritability. Irritability is described as the mood in which an individual is easily provoked to anger and is annoyed at slightest pretexts. Such mood is considered to be a feature of maniac episodes. The irritable mood is exhibited by Annabelle as she shows sudden outbursts of anger and irritation. The range of affect in the case of Annabelle is flat whereas the intensity of her affect is heightened. The flat range is marked by a significant decrease emotional expressiveness. Annabelle spoke in a monotonous voice and had less facial expression. She also appeared apathetic. This form of affect is a negative symptom of mental health disorder. The patient, in this case, lacked a normal range of behaviours and feelings. The intensity of the affect for Annabelle can be described as heightened since she is strikingly sentimental and melodramatic. She has the tendency to create tantrums over situations and act as per her desire. At home, started screaming all of a sudden and the stopped suddenly too. She had shouted and slumped to the floor and then sobbed at the healthcare setting.

Appearance is the physical aspects that include height, weight, age, manner of grooming and dressing. Colourful and bizarre clothing indicate mania, whereas unkempt and dirty clothes, suggest depression or schizophrenia (Taylor 2013). In the present case study, Annabelle has dirty clothes and is barefoot. She has multiple piercings in her lip, eyebrow, and nose. Her hair is coloured ink and blue and is matted and unkempt. Wight loss signifies physical illness, depressive disorder or chronic anxiety (Baker 2004). Annabelle is found to have lost weight as she does skips meals and does not eat for days. The reason for such poor nutrition can be depression. Poor personal hygiene is a result of self-neglect. Her arms are covered with sores whose reason is unknown. She may have undergone some form of pain that she has not disclosed. Abnormalities in behaviour include particular abnormal movements as related to the individual’s activity level. Stereotypes refer to the purposeless movements like head banging or hand movement (Forbes and Watt 2015). In the present case study, Annabelle is found to be pacing and wringing her hands, that is inappropriate. Hand wringing is a psychomotor activity. The increase in movement and arousal indicate mania. An inability to stay at a place, preferably sit at a place can be considered as a side effect that antipsychotic drug has. Lack of eye contact denotes depression, like Annabelle, who did not have eye contact at the time of assessment. The reaction of the client at the time of the mental state examination is also noteworthy. In the present case, the patient is found to be co-operative and smiles. Her general behaviour is safe from the perspective of a health care professional. However, she is disturbed and withdrawn subsequently.

References

Barker, P.J., 2004. Assessment in psychiatric and mental health nursing: in search of the whole person. Nelson Thornes.

Forbes, H. and Watt, E., 2015. Jarvis's Physical Examination and Health Assessment. Elsevier Health Sciences.

Huline-Dickens, S., 2013. The mental state examination. Advances in psychiatric treatment, 19(2), pp.97-98.

Kneisl, C.R. and Trigoboff, E., 2012. Contemporary psychiatric-mental health nursing. Pearson Higher Ed.

Mitchell, A.J., 2013. The Mini-Mental State Examination (MMSE): an update on its diagnostic validity for cognitive disorders. In Cognitive Screening Instruments (pp. 15-46). Springer London.

Paniagua, F.A. and Yamada, A.M. eds., 2013. Handbook of multicultural mental health: Assessment and treatment of diverse populations. Academic Press.

Taylor, M.A., 2013. The neuropsychiatric mental status examination. Elsevier.

Townsend, M.C., 2014. Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.

Videbeck, S., 2013. Psychiatric-mental health nursing. Lippincott Williams & Wilkins.