Mental State Examination mood and affect

TableAlthough these authors suggest that “both of these conventions can be applied, ” there may be inconsistencies in practice because of possible incompatibility between the temporal and objective/subjective perspectives. Should an internal emotional tone always be thought of as sustained?

To assess prevailing definitions of mood and affect among trainees, a questionnaire was administered to psychiatric residents from eight programs in New York City.

Method

Section:

A questionnaire with 14 true/false questions was administered. Ninety-nine residents chose to participate.

Answers were totaled across programs. Questions 1 through 12 were designed to demonstrate how the individual resident defined mood or affect by presenting specific aspects of their definitions and asking whether these were true or false. Two additional questions dealt with the manner of documenting mood and affect in the mental status examination. Questions 1–4 addressed the temporal perspective of mood and affect; questions 5–12 related to the objective/external versus subjective/internal approach; questions 13–14 inquired about the use of quotation marks to record mood or affect.

Results

Residents demonstrated inconsistencies in their views of mood and affect along the temporal continuum. Although mood was defined as pervasive and sustained by 60.6% of trainees, it was also said to be moment-to-moment by 50.5%. Affect was seen as pervasive by only 26.3% and as momentary by 66.3%.

The 14 questions can be viewed as seven pairs, virtually inviting a “true” response to a question if the preceding response was “false” and vice versa. Thus, inconsistency is reflected in the difference between these opposite answers to successive questions in the pair (contradictory response rate, as seen in ). The degree to which residents strayed from consistency was much greater for temporally oriented questions (1 versus 2; 3 versus 4) than for the subjective/objective or internal/external descriptors.

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