False Beliefs, Mental Status

Word Salad: a series of words that seem completely unrelated. Word salad represents probably the highest level of thinking disorganization. Clients who exhibit word salad are incoherent. what of client thinking. What clients talk about can give interviewers valuable information about mental status.

Clients can talk about an unlimited array of subjects during an interview. However, several speci?c content areas should be noted and explored in a mental status exam.

These include delusions, obsessions, suicidal or homicidal thoughts or plans, speci?c phobias, and preoccupation with any emotion, particularly guilt . Although it is important in most mental status exams to ask a routine question regarding suicidal thoughts or impulses, we delay our discussion of suicide assessment until Chapter 9. The remainder of this section focuses on evaluating for delusions and obsessions.

Delusions are de?ned as false beliefs. They are deeply held and represent a break from reality; they are not based on facts or real events. For a particular belief to be a delusion, it must be unexplained by the client’s cultural, religious, and educational background. Examiners may ?nd it useful to record client reports of delusions verbatim. Examiners should not directly dispute clients’ delusional beliefs. Instead, a question that explores a client’s belief, such as the following, may be useful: “How do you know this [the delusion] is the case?” .

Clients may refer to many different types of delusions. Delusions of grandeur are false beliefs pertaining to a person’s own ability or status. Most frequently, clients with delusions of grandeur believe they have extraordinary mental powers, physical strength, wealth, or sexual potency. They are usually unaffected by discrepancies between their beliefs and objective reality. In some cases, grandiose clients begin to believe they are a speci?c historical or contemporary ?gure .