Mental Status Examination - Essay Example

?Mental Status Examination Report Michael Smith birth: 12th August, 1989 Evaluation: 10 July, Appearance Mr. Michael Smithgave his consent for this mental status examination. Though he appeared his stated age of 23, he was often repetitive and somewhat fidgety. He was well groomed and did not display any bizarre attitude or mannerism. Mr. Smith had maintained eye contact all through the interview and seemed to relate well with the interviewer. He also appeared to be little restless and kept twisting his fingers. Mood/Affect Mr. Smith appeared to be a little depressed and disgruntled with the world at large. He was unwilling to participate in games as he was too tired. He often prevaricated in answering and would look down at his feet when giving wrong replies. He was quite focused but had to be prodded to give correct answers. His affect was generally slovenly and when discussing certain topic, he would get irritated. At one point, he also stood up in anger and had to be cajoled to resume the examination. Speech/language Mr. Smith’s speech was lucid and he was often sarcastic in his comments, especially when he was asked about polygraph test. He also stuttered and hesitated replying and would sometimes, speak slowly. His immaturity was occasionally exposed when he used words like ‘kinda’, ‘man’, ‘meds’, ‘kicked outta’ etc. Though mostly he was using grammatically correct English, but when agitated, his speech would slow down and language would be interspersed with slang. Thought process Michael Smith displayed adequate concentration but would regularly complain of being too tired to answer any question. Though, his thought process seemed to be goal oriented, he would try to avoid giving answers and often display irritation when asked about his whereabouts. He would also change his answers, showing interrupted chain of thought. He was also quite expansive when questioned about his life in school and talked animatedly about his family and being ADHD. He also repeatedly denied any knowledge about person called ‘Thomas’ who was supposedly his accomplice in the crime. Though he often seemingly changed his statements, he emphatically denied having any problems with his memory. It was also corroborated when interviewer confirmed his father’s year of death by asking about the name of the president in that year. Thought content Michael Smith displayed some memory lapse with regard to recent events, especially related to person called ‘Thomas’. His answers also seemed to be different from those given under polygraph test. He was well articulated in his replies even when they did not seem to match with earlier answers to same question. There was neither delusion nor any hallucinations reflected in his answers. He only seemed to forget recent events and his not remembering Thomas was crucial indicator of some serious psychological problem. He could be suffering from dementia as dementia patients tend to forget the recent memories including people, events and places. Thought Perception Michael Smith’s perception of recent events revealed selective memory loss. He pointedly refused to acknowledge ‘Thomas’ as his accomplice in crime and continually denied knowing anyone by that name except for his father, whose name was also Thomas. When confronted with the fact that he had accepted knowing about Thomas during polygraph test, he angrily denied it and accused polygraph test to be a lie. He was aware of polygraph examination and would obliquely tell interviewer to refer to it for answer. His recollections of past events were not backed by factual data. He was very coherent when he talked about his childhood, including his family and school. Although, he frequently displayed memory loss by saying he does not remember or is not sure, he was quite assertive in his statement that he was with his girlfriend previous night and that from there he had gone straight to his home. Though it was not so obvious, he was little disoriented and frequently got exasperated because he could not remember things. But his perceived cognitive ability to recall statements under polygraph test regarding his meeting with his girlfriend is important factor that gives ambiguity to the tentative diagnosis of dementia. Summary Michael Smith is 23 years male who had participated in the crime with another person known by the name of ‘Thomas’. He was well groomed with adequate concentration but displayed selective memory loss. The selective memory ensures that part of information is not included in the recall of an event. Thus one’s judgment of events is largely dependent on the memory that stores information about that event. His frequent loss of memory indicated that he was cognitively confused throughout his examination. Due to cognitive disorganization, the sequence of events could not be recalled accurately by the participant, revealing signs of dementia. This could be the reason that he was not able to remember Thomas and his role in the scene of crime or crime itself. Mr. Michael Smith’s non-verbal behavior was sometimes not normal and showed hyperactive disorder. He was also frequently getting irritated and revealed his impatience through his non-verbal behavior. Though most of the time he maintained eye contact with the interviewer, but his irritation and his restlessness with the topic, related to crime demonstrated that he might be subconsciously lying or could be having difficulty in remembering things. He had also accurately recalled the name of the American President of the year that his father had died. This showed that his dementia might be in early stage. Indeed, the various parameters of psychological behavior helped to conduct mental status examination of the subject (Hicks, nd). Recommendation Mr. Michael Smith’s examination has revealed psychological problems and therefore he needs to undergo comprehensive psychological and psychiatric evaluation. His previous health records should also be examined so that his true mental status could be determined and evaluated for correct diagnosis and treatment. As a child, Mr. Smith was diagnosed as ADHD. Hence, it is important that he be interviewed and assessed under safe environment where he could feel comfortable and not subjected to undue stress or anxiety. This would help him to express his thoughts freely. Moreover, his signs of early dementia need to be reaffirmed through interview strategy that incorporates cognitive theory of communication (Beck, 2011). This would greatly facilitate him to remember events of the crime. The cognitive interview strategy is also appropriate to dispel any doubts and remove ambiguity in the diagnosis. It is also recommended that Mr. Michael Smith undergo hypnosis as hypnotic suggestions have effective response therapeutic outcomes that can be authenticated (Hull, 1933). Under hypnotic therapy, subjects experience physiological response as a direct result of the cognitive suggestions and ideomotor. Hypnosis could be important way of finding out his involvement or non-involvement in the crime. Though Mr. Smith has shown early sign of dementia but his hyperactivity and impulsivity as demonstrated by his verbal and non-verbal behavior could very well lead to criminal activity. The hypnosis would be a good an effective way to ascertain his role in the crime and give insight into his psychological behavior. Reference Beck, Judith S. (2011). Cognitive Behavioural Therapy: Basics and Beyond (2nd ed.). New York: The Guilford Press. Hicks, J. (n.d.). Forensic report writing tips. Retrieved from http://www.forensicmind.com/assets/docs/Report+Writing+Tips+(psych).pdf Hull, C. L. (1933). Hypnosis and suggestibility: An experimental approach. New York: Appleton-Century Crofts. Read More