Mental Status Exam Training, part 2. Thought Process

[@timrichardson4018]

I'm a PA student starting my mental health rotation this coming week. These videos are very helpful! The practice video clips are particularly helpful!

[@Alien_at_Large]

I've been married for about 18 years to a man who got hit by a car when he was six years old. He suffered a left hemiparesis and was in an induced coma for 10 days. He had to re-learn how to do everything, including how to talk and walk. This video has helped me realize that his speech isn't normal. I don't know if this statement makes any sense to psychologists, but I wonder if his thinking is really tangential or if he just has trouble expressing his thoughts with speech. If I wanted to say something like "Jane blew up at work today because the shift lead came over and told her to stop talking on the job", I would just say that. But for my husband to say the same thing would take 15 minutes (no, that's not an exaggeration). He would start with "Jane got mad" and end with "the shift leader told her not to talk". But in between, I would not know why Jane got mad because I would be hearing the weather, the people he talked to at lunch break, the history of his employer's safety rules, and who the next HR guy is going to be. It hurts my head when he talks.

[@hollyjoy9523]

These videos help me tremendously. Thank you so much!

[@rambam23]

I think when talking about how bad one’s week has been, listing off a number of bad things that have happened is perfectly logical rather than tangential because they’re all contributing to the main point.

[@CXTracy]

Thank you so much for these videos! They provide so much insight into the Mental Status Exam and have really opened my eyes into the many Psyc states that us humans have!

[@oneseater9554]

Wow weighing the clear is tough when deciding how the topic or speech is stated then perceived

[@FithriyaaniRashidi]

2. Thought process Definition : how a person makes sense of the world and makes connection between content Form of thought:- Logical : clear, direct connections between content. one idea flows directly into another. Circumstantial: digressions to unnecessary details in and speech before communicating the central idea (talk, then derails/detour, then back to the issue) Tangential : oblique, digressive, irrelevant speech. the central idea is not communicated. (detour/digression from central idea which is not communicated/expressed). Loose Associations: little vague connection is made between concepts; continuous tangential rabbit holing. Can be a symptom of schizophrenia. (some connections made with the content, but moves the conversation further and further away from the central idea) Flight of ideas: multiple thoughts and ideas are generated spontaneously without obvious connection. Often occurs in manic states; associated with bipolar disorder. ( ideas does not make clear connection at all, vague connection/tenuous , spontaneous thought generated without connection) Guided practice : 1. Full/broad & congruent Dysphoric (dimensions of irritability) Loose associations 2. blunted/flat Dysphoric mood (irritation and frustration) Circumstantial thought process Attention : 3 elements : 1.Distractible - focus can shift quickly onto external environment. this awareness interrupts the present dialogue. associated symptom of aniety, ADHD. 2. Preoccupied - inattentive to the external environment, internally focused, seems to be thinking deeply. Can be associated with depression, psychosis (schizophrenia), schizoid personality. 3. Rumination - Preoccupation with a single idea or theme. Associated with anxiety, OCD; can lead to delusional thoughts. In autism, this is "perseveration". Speed of Thought: 1.Latent - a prolonged period of time between a thought and it's verbal expression. associated with depression and anxiety. (long pauses) 2.Racing Thoughts - multiple thoughts occurring in a seamless fashion. Often in list form. These thoughts have pressured quality. Associated with anxiety, manic states (bipolar). Guided practice of attention and speed of thought: 1. full/broad, congruent, dysphorical tangential rumination racing thoughts 2. full/broad, congruent, dysphoric, logical, unable to assess, racing thoughts

[@patrickdippel7336]

thank you!

[@soniaarruda1760]

Thank you very much for this training series. It is invaluable!

[@marymacbrookins]

Thank you for this series Dr. Field. Great work to all involved. Merry Christmas.

[@PeeedaPan]

thank you so much for this series of videos Dr. Field

[@dorazambrano947]

Very well developed and easy to deliver the content of this lectures to my brain. Thank you

[@ebonypenguin2899]

Thankyou for these videos. Much appreciated.

[@suns1457]

this is an amazing video! thanks!

[@JB-se1dz]

Awesome vid, thx Doc!

[@peacefuljourney4858]

Job well done! Thanks for all the information.

[@alexpenfold8637]

Brilliant resource, thank you

[@maryamfallahi875]

Very helpful. Thank you so much

[@lukepearson8918]

Hello, can you explain why the first guided practice is loose associations and not tangential, because it seems pretty linked to me.

[@moonstryder1740]

multiple tangentiual links?

[@omarsaleh1989ify]

great video thanks thomas

[@shaeedhall7180]

Great job i found it very helpful given my track.

[@LouiseDengate-wm6gq]

What is the reason for the gradually loss of logic? Is this because of overwhelm of the pre frontal cortex?

[@shaneevans7641]

who else is here because they are in the masters program of Social Work and has to watch these lol

[@emoobss]

Flight of Ideas is explain wrongly, there is noticeable connections between Ideas

[@user-lr5gu9ue6j]

I agree, the one which has no association whatsoever and is perhaps all over the gaff is (in the UK) referred as word salad. also (in general), is loose associations akin to knights move?

[@josephambrose8560]

Is there a link to the MSE questionnaire that you use?

[@zubersanadi6404]

Content is good but sound quality is very poor

[@virnan]

This girl is a good actor and it her acting is kind of funny.

[@kiaikim1292]

Latent thoughts may also be a sign of aphasia, common with TBI, PTSD, and other trauma-induced conditions.

[@Christ_Is_Life10-10]

Kiai Kim would a neurodevelopmental condition such as ADHD autism spectrum or learning disorder also fit?

[@kiaikim1292]

@@Christ_Is_Life10-10 I don't know enough about neurodevelopmental disorders, so can't say. However, having been diagnosed with ADHD as an adult, and then PTSD several years later, I would think the mechanisms behind latent thoughts would be different. I think of aphasia as occurring during moments of dissociation, but maybe it occurs otherwise.

[@emilyi9161]

This is really helpful 👏 👌

[@madhulathaadusumilli4812]

Hi sir will u help me solve this woman with forgetfulness, dosnt concentrate to wrk ,burning her hands during cooking , once went to a place and realize she don’t know y she is here , what in MMSE u will find about the affect of mood?

[@thisisfacey]

thanks this really helped with my essay

[@livbennett6388]

I won't say I necessarily agree with this as circumstantial thought

[@gabrielorsi3599]

Is that Anthony Jeselnik in the examples?

[@seanwildlife9398]

you are amazing

[@cantwaittodietoday9924]

Why dont psychiatrist examine themselves and their own colleagues? Sociopathy and narcissism is also being mentally unwell.

[@professordrabhijitsayamber2299]

Om shanti ke