Mental Health Assessment Questionnaire

Linear Thought Process

Thoughts follow a straight, understandable sequence

Linear example

I woke up, ate breakfast, and came to my appointment

Logical thought process

thoughts make sense and are based on reasonable connections

Logical example

I’m tired because I didn’t sleep last night

Organized Thought Process

Thoughts are clear, structured, and easy to follow

Organized example

patient answers questions appropriately and stays understandable

Goal-directed thought process

patient’s thoughts stay focused on answering the question or accomplishing a task

Goal-directed example

I need to get my medication refilled, so I called the pharmacy

Circumstantial thought process

gives too much unnecessary detail, but eventually gets to the point

Circumstantial example

I need my medication. i went to the pharmacy, but it was raining, and i forgot my umbrella→ eventually says “i need a refill”

Tangential thought process example

goes off-topic and never gets back to the original point

Tangential example

why are you here today? i’ve been having headaches. My sister gets headaches too. She lives in chicago

Racing thoughts thought process

thoughts move very quickly, often difficult to keep up with

Racing thoughts example

patient rapidly jumps from one thought to another

Flight of ideas thought process

rapid shifting between topics where the ideas are loosely connected. common with mania

Flight of ideas example

“I love school. School has books. Books are expensive. Money is important. Important people are famous…”

Disorganized thought process

thoughts are confused, fragmented, or difficult to understand

Disorganized example

patient’s response doesn’t make a coherent or understandable sequence

Thought blocking thought process

patient suddenly stops talking and cannot continue their thought

Thought blocking example

I was going to tell you about my…long pause…I don’t remember

Preservative thought process

Patient repeats the same word, phrase, idea or response even when the topic changes

Preservative example

How are you sleeping? My dog died. Are you eating? My dog died.

Thought process

how the patient’s thoughts are organized and expressed

Thought content

what the patient is thinking about

No unusual content noted

Patient's thoughts do not contain concerning or abnormal beliefs/preoccupations.

Preoccupation

Patient is extremely focused on one particular thought, topic, person, or concern

Preoccupation example

Constantly talking about their upcoming court date even when asked about other topics

Obsessions

Unwanted, repeated, intrusive thoughts that cause anxiety or distress

Obsessions example

“I keep thinking that I contaminated everything with germs.”

Compulsions

Repetitive behaviors or mental acts that the person feels driven to perform to reduce anxiety

Compulsions example

washing hands 30 times because they are afraid of germs

Paranoia

An unreasonable or excessive suspicion that others are trying to harm, watch, control, or deceive the person

Paranoia example

My coworkers are secretly trying to poison me

Delusions

Fixed, false beliefs that remain despite evidence showing they aren't true

Delusions example

I am the president of the United States, despite evidence that they aren’t

Grandiosity

An inflated belief about one's importance, abilities, power, wealth, or identity

Grandiosity example

“I am the smartest person in the world, and I can solve every problem.”

Ideas of reference

Believing that ordinary events, objects, conversations, or media are specifically directed at or about them

Ideas of reference example

“That person on TV was talking directly to me.”

Somatic concerns

Excessive or unusual concern about the body, health, or physical symptoms

Somatic concerns example

“I know there is something seriously wrong with my organs,” despite normal medical evaluations

Guilt

Excessive feelings of blame, worthlessness, or believing they are responsible for things that aren't their fault

Hopelessness

Believing the future will not improve or that there is no reason to continue

What are important to assess in patients who may be experiencing depression or suicidal thoughts?

Guilt and hopelessness

Perception

how the patient experiences or interprets sensory information

What are the categories under perception?

auditory hallucinations, visual hallucinations, tactile hallucinations, olfactory hallucinations, illusions, responding to internal stimuli

Tactile hallucinations

feeling something touching or happening to the body when nothing is actually there

Illusions

a real sensory stimulus is present, but the person misinterprets it

Illusion example

a patient sees a coat hanging on a chair but thinks its a person

Responding to internal stimuli

The patient appears to be responding to something that isn't observable to others, often suggesting hallucinations

Examples of internal stimuli

talking to someone who isn’t there, looking around as if hearing voices