| Chapter
16:
(Based upon Logan, Learning to Observe Signs of Mental Impairment)© |
REALITY CONFUSION
__ Reports hallucinations
__ Hearing Voices__ Misperceives harmless image as being threatening__ "Seeing things" (people, objects, unformed images such as flashes of light)
__ Smelling things not there
__ Tactile (feelings of being touched by someone/something not there)
__ Gustatory (false perception of taste)
__ Irrational fears, i.e., leaving his cell, heights, spiders, snakes
__ Seems confused about people or surroundings
__ Consistent false beliefs. i.e.
__ Lawyers out to get him__ Guard/another person in love with him
__ Food being poisoned
__ Being controlled by outside forces
__ Others are talking about him
Nonsensical Speech
__ Speech which is incoherent at times
__ Use of new word formations (not slang)
__ Use of "non-words"
__ Use of non-sequiturs
__ Conclusions based on faulty promises
Half Answers
__ Brief, unelaborated answers to questions
__ Monosyllabic answers to questions
__ Language tends to be vague, repetitive, stereotyped
__ Answers are lengthy but actual information is little
__ Speech seems like "empty philosophizing"
Off Track
__ Changes subject in the middle of a sentence in response to another stimulus
__ Answers questions in an oblique or irrelevant way
__ Pattern of speech seems "disjointed"
__ Ideas slip gradually off-track from one oblique thought to another
__ Speech pattern which is circuitous, indirect or delayed in reaching its goal
Includes many tedious details
__ Seems "long-winded"
__ Requires that you interrupt in order to finish business
__ Starts on one subject, then wanders away and never returns
__ Persistent, inappropriate repetition of words, ideas or subjects once the discussion begins
Rapid Speech
__ Talks rapidly and is hard to interrupt
__ Sentences left unfinished because of eagerness to move on
__ Continues talking even when interrupted
__ Often speaks loudly and emphatically
__ Talks too much and interrupts others
Delayed or Interrupted Speech
__ Speech is very slow
__ Excessive wait before answering or responding
__ Difficulty finding right word to use
__ Stops in the middle of a thought and after some silence cannot remember what he was talking about
__ Says his "mind went blank"
Sound-Related Problems
__ Recognizable mispronunciations
__ Substitution of inappropriate word
__ Slurred speech
__ Speaks in a monotone even when discussing emotional material
__ Talks in excessively formal or stilted way
__ Language may appear "quaint or outdated"
Other Language Problems
__ Writing is very small
__ Writing is prolific
__ Has trouble reading
__ Spells poorly
MEMORY AND ATTENTION
__ Has trouble remembering childhood data
__ Has trouble recalling things that happened in past few months
__ Has trouble remembering things in last few days
__ Has trouble recalling events surrounding crime or trial
__ Has trouble remembering people's names
__ Reports "memories" which do not correspond to documentation
__ Seems to "fill in" details of faulty memory
__ Sometimes appears to be "lying" about events in his life or events surrounding crime
__ Has extraordinary ability to recall
__ Problems concentrating
__ Attention drawn to irrelevant or unimportant stimuli
__ Loses train of thought
__ Problems with attention and concentration on emotionally-charged issues
MEDICAL COMPLAINTS
__ Exaggerated concern over health
__ Self-wounds or wounds suspicious in origin
__ "Accidents"
__ Difficulty falling asleep
__ Difficulty staying asleep
__ Excessive sleeping
__ Change in eating habits
__ Loss or decrease in appetite
__ Blurred vision
__ Need to squint or move closer when reading
__ Hearing problems
__ Ringing in ears
__ Headaches
__ Dizziness
__ Nausea
__ Excessive tiredness
EMOTIONAL TONE
__ Worry, fear, over-concern for present or future
__ Mistrust, belief others harbor malicious or discriminatory intent
__ Sorrow, sadness, despondency. pessimism
__ Irritability, belligerence, disdain for others, defiance
__ Impotence
__ Extreme, heightened emotions
__ Flatness in emotional tone. near absence of emotional expression
__ Sudden changes in mood which are disproportionate to situation
__ Inappropriate laughter
PERSONAL INSIGHT AND PROBLEMS SOLVING
__ Low self-esteem
__ Exaggerated self-opinion
__ Overrates level of ability
__ Unrealistic goals; failure to take disabilities into account
__ Denial of mental problems
__ Difficulty planning ahead
__ Poorly organized
__ Difficulty thinking as quickly as needed
__ Difficulty changing a plan or activity when necessary
__ Difficulty in accurately predicting consequences
__ Easily frustrated
__ Impaired ability to learn from mistakes
PHYSICAL ACTIVITY
__ Restlessness
__ Fidgety
__ Kicks leg often/moves arms around a lot
__ Overly talkative
__ Unusually quick reactions
__ Hyper-alert to what is happening in visiting room; constantly looking around, checking behind himself
__ Slow movement, slow speech
__ Slow reaction in movements or while answering questions
__ Balance problems
__ Clumsiness, poor coordination
__ Tense posture and/or facial expression
INTERACTIONS WITH OTHERS
__ Unresponsive family
__ No regular visitors or letters from others
__ No participation in yard activities
__ Discontinuation of yard activities
__ Lack of social greetings to fellow inmates in visiting room
__ Awkward or inappropriate interactions with others in visiting room
__ Willingness to "go along with" or cooperate in almost any way
__ Deficiency in relating to others; lack of spontaneous interactions
__ Socially inappropriate comments and/or actions (including sexual or aggressive)
__ Trouble understanding that some of his behavior is inappropriate
OTHER OBSERVATIONS
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

©2001
Kentucky Dept. of Public
Advocacy
http://www.dpa.state.ky.us