Questions Related to Various Stages of Mental Health

Question 1

Thought form and thought content and state how they are related to Mental State Exam and discuss how Annabelle’s thoughts are disturbed

Thought form refers to the tempo of thoughts wherein some people experience flights of ideas and thoughts usually move so rapidly that further makes the speech incoherent. The form of thought indicate the specific problems which also includes several types of thought disorder such as neologisms and derailment and that often changes the behaviour and attitude of a person. There are several elements included in the thought form wherein individual may be described as having retarded or inhibited thinking. This changes behaviour of a person and may also get affected due to pattern of interruptions and disorganization of thought processe.

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Thought content describes a patient’s delusions, obsessions, phobias and preoccupations. Under this concept, thoughts keeps on changing and multiple thoughts come at a time in the mind. It also changes the degree of belief that is associated with the thoughts. Suicidal, homicidal ideas and feeling of obsession also considered in the thought content (Koslowski and, 2016). Both the concepts are related to Mental State Exam which aids to find out comprehensive cross- sectional description of patient’s mental state. In the present case, Annabelle is experiencing flights of ideas wherein she gets frequent changes in her speech and as a result, this makes her speech incoherent.

Although the registered nurse, have carefully observed a distinguish chain of poetic associations in the patient’s speech. Thus, it can be said that she has few associations in her mind which makes her scream when she sees the ceiling. In every situation, a number of things come in her mind which ultimately changes her behaviour. In this situation, registered nurses could have performed Mental State Examination which could reveal cognitive impairment about patient.

Question 2

Define perception as it relates to a MSE and then discuss how we might interpret how Annabelle may have some disturbance in one or more of her senses

Perception is sensory experience and the three broad categories of perceptual disturbance are hallucinations, pseudohallucinations and illusions (Coyne, McDaniel and Stockdale, 2016). Hallucinations is defined as a sensory perception where external stimuli does not exist and it is experienced in external space. On the other hand, illusion is defined as a false sensory perception which exists in the presence of external stimulus and it could also be recognised as a distortion of a sensory experience. Other dimension is pseudohallucinations which is experienced in internal or subjective space. In this sensation, patient makes numerous fantasies which changes his or her viewing acts.

In the present case, Annabelle is having pseudohallucinations perception which led her to think too much regardless of the thoughts that come in her mind (Ettner, 2016). This can be justified through considering her condition especially when she screams “they are everywhere, they are under my skin and the whole planet is falling”. She then turns to be distressed and as a result she proceeds back to screaming. Even if nothing is there near to her; still she keeps on screaming as if something is there in front of her.

She always looks up to the celling and she stares like something is there; this amends her thought process. In terms of perception, it can be said that she has other sensory abnormalities as well which includes a distortion of the patient’s sense of time. Patient also loses the sense of self depersonalization and sense of reality. Therefore, according to her condition, auditory pseudohallucinations is suggestive of dissociative disorders which is associated with other dimensions. According to Annabelle’s perception, she is having several disturbances in all her senses.

Question 3

Define both ‘affect’ and ‘mood’. How would you describe Annabelle’s mood and the range and intensity of her affect

The difference between mood and affect in the MSE is subjected to some disagreements. It typically describes the external and dynamic manifestations of a person’s internal emotional state (Ito and Matsushima, 2016). However, mood is regarded as a person’s predominant internal state that changes the behavioural and attitude of the person. It is also called as differentiated specific feelings and prolonged state of disposition. Relating it to the case of Annabelle, it can be said the intensity of mood changes rapidly wherein patient become neutral, dysphoric and euphoric.

In such stages, Annabelle becomes unable to experience any sort of pleasure in current situations (Smith and, 2016). This has also lead to anhedonia; hence Annabelle is having the issue of mood swings. A person’s nonverbal behaviour such as anxiousness and flight of ideas affects the entire behaviour and attitude and that also leads to bring many changes in thinking and ability aspects. It can also be measured through using the parameters such as appropriateness, intensity, range and reactivity (Belsher and, 2016). Thus, according to the situation of Annabelle, affect may be described as appropriate or inappropriate to the current situation along with the thought content.

Annabelle has a bland affect which describes her dispersed experience and that also shows a congruent affect. This could also lead to Schizophrenia. Hence, in such situation the intensity of the affect may be described as normal, blunted affect and exaggerated. Since, it is associated with depression; therefore it brings various changes in the personality disorders. Annabelle is also having problems in speech which may be described as having restricted affect. Henceforth, it can be said that affect and mood both changes the intensity of thinking and behaving.

Question 4

Giving examples from the Case Study, how would you describe her behaviour and her appearance as set out in a MSE?

Health care practitioners and clinicians analyses the physical aspects such as appearance of the patient and afterwards, they ascertain the type of domain that exists in the patient (Ito and Matsushima, 2016). Since, Annabelle wears colourful clothes, so she might have mania; whereas on the other hand, unkempt and dirty clothes suggests that Annabelle has depression. Annabelle has also the sign of malnutrition as her mother stated that she does not eat properly. Under her observation, it also includes personal hygiene analysis (Dawes and, 2016). Weight loss is also a depression disorder which she has and because of that she is having physical illness as well.

When a patient has abnormalities in behaviour, he also experiences abnormalities in activities. Hence, it includes observation of specific abnormal movements along with the general movements of the patient’s level of activity and arousal. As per the behaviour, Annabelle is having neurological disorder as she has symptoms of choreiform, athetiod or choreoathetoid. Annabelle is also experiencing akathisia as this depicts her inability to sit (Sourander, Lempinen, Ristkari and Klomek, 2016). This also shows a side effect of antipsychotic medication. In the present case, the examiner has realized that Annabelle’s eyes repeatedly glances to different sides which states that she has pseudohallucinations. However, most of the clinicians say that lack of eye contact would be a result of depression or autism.


  • Adams, C. and, 2016. Mental health problems in people living with HIV: changes in the last two decades: the London experience 1990–2014.
  • Belsher, B. E. and, 2016. Mental Health Utilization Patterns During a Stepped, Collaborative Care Effectiveness Trial for PTSD and Depression in the Military Health System. Medical care.
  • Coyne, S. M., McDaniel, B. T. and Stockdale, L. A., 2016. “Do you dare to compare?” Associations between maternal social comparisons on social networking sites and parenting, mental health, and romantic relationship outcomes. Computers in Human Behavior.
  • Dawes, A. J. and, 2016. Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA. 315(2). pp.150-163.
  • Ettner, S., 2016, June. The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Impact on Financial Requirements and Quantitative Treatment Limits for Substance Abuse Treatment among “Carve-In” Plans. In 6th Biennial Conference of the American Society of Health Economists. Ashecon.
  • Ito, M. and Matsushima, E., 2016. Presentation of coping strategies associated with physical and mental health during health check-ups. Community mental health journal. pp.1-9.
  • Koslowski, N. and, 2016. Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis. The British Journal of Psychiatry, pp.bjp-bp.
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