PSY 446 Lecture Notes - Lecture 4: Mental Status Examination, Medical History, Sexual Orientation
2 May 2018
School
Department
Course
Professor
Pediatric Psychology
● Sample Case
○ Adolescant female
○ Caucasian
○ Has broken both arms
○ Elite gymnast
What is clincal assessment?
● Clinicians develop a summary of the client’s symptons and problems
● On going process
● Evaluation stage
○ Hoping to get medication, want to get better…
● Find and establish baseline to figure moniter what they need and what stae they are in
Goals of Assessment
● Establish collaborative r/s with client
● Establish diagnosis
○ Does she feel nervous does she have anxiety
● Treatment recommendations
○ What kind of treatment for specific illness
Video
Homelife and family relationships
Academics
Medical history
Relationships
Family history
Self esteem
Confindence
Refferal source is lawyer
Models of Classification
● International classifactiation of diseases and health related problems(IDC-10)
● Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
● PRECIPITATING STRESSOR- event that brings client into therapy
Psychological Assessment
● Clinical Interviews
● Behavioral Observation
● Pychological tests
● Integrating assessment data
The Clinical Interview
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● Goals
○ Identify problems
○ Understood client’s interpersonal style
○ Determine diagnosis and treatment
What are problems what are her symptoms and how long have she been feeling this.
How is she interacting from me, what does she want from me, will she engage,
Unstructured (or Semi- structured)- list of questions of all disorders
A: Can be used for clients who dont like to talk a lot
D: lengthy and ask questions that you didnt mean to ask
Structured choosing- where to go depending on client
A: more comfortable and space, wont leave out any intitianal questions, not a lot of room
of error for psychologist, less room for forgetting things (USED FOR RESEARCH SETTINGS)
D: dont know what to talk about
Behavioral Observations
● Mental status exam (MSE): structured way of osbserving and describing client’s state of
mind. Where is the client actually at. Like apearance, attitude, how is she engaing with
you. Is her thinking distorted or innapropriate depending of age. Perception annoyances,
is she seeing or hearing things that are actually not here. How sound is her judgement,
is she risky, intentional or accidental. Does she have insight in role in her situation.
Symptom Iventories
● Structured, quantifiable instruments
Know thoughts about suicide or death, plan on doing it before, her plans for the future, past
attempts, her intent, protective factors looks different form person to person.
Racial and Socioeconomical Health Disparities
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What do you do to achieve good health?
● Good environmental conditions
● Good caregivers to for attachments with
● Education
● Balance
● Sleep
What is health disparity?
● Differences in their health status of different groups of people
● Age
● Gender
● Race and ethinicity
● Origin/Geographical location, rural vs urban
● Sexual orientation
● Preventable
Schuster et al. reading:
❖ Sample of three urban areas
❖ Then broke 5th grraders down to racial categies
❖ Gave them #of diff health behaviorscc. Like measruing how safe like helmet when
wearing
❖ Some were, were you bullied by peers, witness violence
❖ Do kids in racial groups vary?
❖ Found health disparities in all groups
❖ Already from a young age kinds have these health disparities
❖ Artile did to look at is there any mediator that accounts for that. Or anything causes it?
Socioeconomic status > sttatus (education) and income, mediator= the childs school.
❖ Improvements make disparities go away whch then is a good time to intervene.
Bronfrenbrenner’s ecological systems theory?
Microsystem: teachers, sisters, brothers, parents, friends
Mesosystem: pediatrition, dentist
Ecosystem: indirect envoronment, doesnt interact with child but influences child, caregiver’s
place of work affects child.
Macrosystem: cultural values that child is apart of,
Chronosystem: related to time, 1. Timing something happens in development, death or parent
or aregiver when child is 3 versus 16 2. Historical time, wtas it like to be a kid in the 50’s vs
whas it like growing up in 2018. technology , politcal and economical impacts, religious levels or
culture.
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Document Summary
Clinicians develop a summary of the client"s symptons and problems. Hoping to get medication, want to get better . Find and establish baseline to figure moniter what they need and what stae they are in. Does she feel nervous does she have anxiety. What kind of treatment for specific illness. International classifactiation of diseases and health related problems(idc-10) Diagnostic and statistical manual of mental disorders (dsm-5) Precipitating stressor- event that brings client into therapy. What are problems what are her symptoms and how long have she been feeling this. How is she interacting from me, what does she want from me, will she engage, Unstructured (or semi- structured)- list of questions of all disorders. A: can be used for clients who dont like to talk a lot. D: lengthy and ask questions that you didnt mean to ask. Structured choosing- where to go depending on client.
