NR 548 EXAM 3 QUESTIONS AND ANSWERS
1. All Borderline Subjects Are Tough Troubled
Characters: Appearance Behavior (and attitude)
Speech
Attect (and
mood) Thought
process
Thought
content
Cognitive
examination
2. What does an MSE accomplish?: It helps make a diagnosis,
especially in cases in which historical
data are unreliable and allows you to create a vivid pt description for your
records
3. Appearance Qualities to Note: - Self-esteem: does the pt care
about appearance?
- Personal statement: does the appearance say something about the pt's
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, interests?
- Memorable aspects
4. Qualities of Speech: - Rate
- Volume
- Latency of response
- General quality
5. Speech Terms: - Normal, thoughtful, articulate, intelligent, rapid,
staccato, pressured, rambling, continuous, loud, soft, barely audible, slow,
halting
6. Stability of Affect: continuum from stable attect to labile attect.
Marked lability of attect is usually a marker of either mania or acute
psychosis, but it may also be seen in dementia and other neuropsychiatric
syndromes
7. Appropriateness of Affect: A patient who laughs uncontrollably
while talking about her mother's death is exhibiting inappropriate attect,
and this is useful to record. Inappropriate attect is often seen in psychosis or
mania. Don't overpathologize, however; many intact people smile a bit
when talking about sad things. This may reflect a defense mechanism such
as denial, rather than psychosis
8. Range of Affect: Mentally healthy humans exhibit a full range of
attect. At some moments they feel happy, at other moments annoyed, and
at others sad. Depressed patients are said to exhibit constricted attect, and
patients with schizophrenia are often said to exhibit flat attect. The problem,
of course, is that many healthy people exhibit
a narrow range of attect. This may be especially true during a psychiatric
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, interview, because patients may not feel emotionally safe exposing themselves
to a stranger. Thus, the diagnostic specificity of a limited range of attect is
suspect and should not be overinterpreted.
9. Intensity of Affect: Intensity is often hard to distinguish from range of
attect, and like range, the diagnostic
specificity is unknown. The usual jargon describes three grades: intense, flat,
and blunted. Flat and blunted are usually
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1. All Borderline Subjects Are Tough Troubled
Characters: Appearance Behavior (and attitude)
Speech
Attect (and
mood) Thought
process
Thought
content
Cognitive
examination
2. What does an MSE accomplish?: It helps make a diagnosis,
especially in cases in which historical
data are unreliable and allows you to create a vivid pt description for your
records
3. Appearance Qualities to Note: - Self-esteem: does the pt care
about appearance?
- Personal statement: does the appearance say something about the pt's
1/
16
, interests?
- Memorable aspects
4. Qualities of Speech: - Rate
- Volume
- Latency of response
- General quality
5. Speech Terms: - Normal, thoughtful, articulate, intelligent, rapid,
staccato, pressured, rambling, continuous, loud, soft, barely audible, slow,
halting
6. Stability of Affect: continuum from stable attect to labile attect.
Marked lability of attect is usually a marker of either mania or acute
psychosis, but it may also be seen in dementia and other neuropsychiatric
syndromes
7. Appropriateness of Affect: A patient who laughs uncontrollably
while talking about her mother's death is exhibiting inappropriate attect,
and this is useful to record. Inappropriate attect is often seen in psychosis or
mania. Don't overpathologize, however; many intact people smile a bit
when talking about sad things. This may reflect a defense mechanism such
as denial, rather than psychosis
8. Range of Affect: Mentally healthy humans exhibit a full range of
attect. At some moments they feel happy, at other moments annoyed, and
at others sad. Depressed patients are said to exhibit constricted attect, and
patients with schizophrenia are often said to exhibit flat attect. The problem,
of course, is that many healthy people exhibit
a narrow range of attect. This may be especially true during a psychiatric
2/
16
, interview, because patients may not feel emotionally safe exposing themselves
to a stranger. Thus, the diagnostic specificity of a limited range of attect is
suspect and should not be overinterpreted.
9. Intensity of Affect: Intensity is often hard to distinguish from range of
attect, and like range, the diagnostic
specificity is unknown. The usual jargon describes three grades: intense, flat,
and blunted. Flat and blunted are usually
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16
