Symptom Severity and Functional Impairment

SymptomSeverity and Functional Impairment

SymptomSeverity and Functional Impairment

Treatingindividuals who may be suspected to have some psychological problemsmay prove hard nut to crack for the physicists dealing withpsychological issues. For instance, for the psychologists to work outways they can come up with the efficient and effective methodology totreat the patients, they must perform some important tests. Thesemedical tests are aimed at assessing and examining the condition thatthe patient is mentally. The psychologists need to know the mentalstatus and functional power of the patient before they can carry outtherapy.

Thispaper is aimed at providing information on the two tests of severityof symptoms and also two tests carried out on functional impairment(Chwastiak,Ehde, Gibbons, Sullivan, Bowen, &amp Kraft, 2014)..The paper displays the tests comparatively as they are analyzedsimultaneously. The severity symptoms tests comprise of theStructured Interview of the Symptoms Reported and the Mini MentalState Examination. The tests for functional impairment include BurnsBrief Inventory of Communication and Cognition and the OhioFunctional Assessment Battery. These tests are compared and analyzedby the psychologists so that they can determine the precise methodswhich they can employ on their clients. The psychologists are keen onlearning the different symptoms that the patients exhibit so thatthey can refer them to the right therapy in the clinic.

VirtualClient: Emma Kinch


Age– 78

Race– Black

Gender– Female

Ethnicity– Bajan

VeteranStatus – None

ImmigrantStatus – Bajan citizen

Language– English

SensoryImpairment – Blind

MotorImpairment – None

MedicalConditions – Hypothyroidism

PresentingProblem – Sad



AffectiveSymptoms – Depressed


BehavioralSymptoms – Aggression

CognitiveSymptoms – Memory impairment

Familyand Support Systems – Isolated

Recentdeath of husband

ResultsIntelligence Testing – Weakness in Gr

Resultsof NEO PI-R – High, neuroticism


TwoInstruments Most Appropriate To Measure Functional Impairment

Psychologyassessment instruments

Forour Virtual Client, instruments were avoided on the off chance thatthey were designed for a particular body areas or health conditionssuch as cancer.


Afar reaching methodology was taken to distinguish diligent tormentappraisal instruments. The pursuit distinguished 1) any distributedpoll, study, instrument or rating scale grew essentially to surveysteady (noncancer) torment in grown-ups, and instruments which hadbeen produced for different purposes, and hence tried on this patientgathering and 2) pertinent companion explored distributed foundationwriting for each recognized instrument.

Distinguishingbetween neuropathic and nonneuropathic pain

Interviewadministration and Self-report

TheDouleur Neuropathique 4 Questions (DN4)

Thisis a 10-item instrument with high between rater unwavering quality,high Kappa on retest, solid face legitimacy and moderate relationshipwith wellbeing professionals` finding. A meeting contributes threethings, utilizing Yes/No reactions, the rest of a 0–100 scale. Thisinstrument is fitting for phone organization.

Structuredinterview of the reported symptoms

TheStructured interview of the reported symptoms was launched in 1992 inthe United States of America. The structured interview of thereported symptoms test is described as benchmark to assess whether anindividual is feigning illness in order to escape someresponsibilities. People who fake illness may be really challengingbefore it will not be easily noted that they are normal (Harvey,Howanitz, Parrella, White, Davidson, Mohs, &amp Davis, 2014)..These malingering individuals do not have a clear indication of thedisorder they have that makes the clinician to know what exactlytheir problem is. Therefore, the structured interview of reportedsymptoms helps in identifying if an individual is having a cognitiveimpairment or he or she is malingering.

Structuredinterview of reported symptoms is effective in detecting malingeringin three categories mood disorders, schizophrenia, andpost-traumatic stress disorder in people. The test has constantlymaintained its ability to distinguish between different aspects inrelation to the clinical samples available.

MiniMental State Examination

Thismethod of testing symptom severity is described by scholars as anoutline of personally administered mental state measure. This test isan estimable measure of perception status in adult human beings. MiniMental State Examination focuses on screening patients andinvestigating if these exists any impairments in their volitionalprocesses. In case the impairments are detected, the test unveilsextend that the patients exhibits the impairment at any instant. Thecourse of perception changes is adhered to by the Mini Mental StateExamination when employed in the treatment of patients havingpsychological problems. The testing method also allows the clinicianattending the patient to have a window of opportunity to document theresponse of the patient towards the treatment method used. The mainpurpose of Mini Mental State Examination is to give psychologists ago ahead in performing the assessment of the patients’ state of themind (Minzenberg,Poole, Benton, &amp Vinogradov, 2014).

Theadvantages enjoyed upon employing the Mini Mental State Examinationis that it does not require specialized training or equipment for theexercise. In addition to the earlier mentioned, this tests itreliable and valid for assessment and diagnosis of Alzheimer’sdisease. Finally, it is useful for assessment of cognition in a smalloffice space due to its little administration span.

Thedisadvantages associated with Mini Mental State Examination are lackof perception to vague cognitive perception and the inability todifferentiate between normal patients and those with Alzheimer’sdisease. The test is also criticized for the difficulties experiencedin trying to copy and apply it in other aspects (Lawson,Yarnall, Duncan, Khoo, Breen, Barker, &amp Burn, 2014).

Thefunctional impairment tests

Theburns Brief Inventory of Communication and Cognition

Thisis an impairment test which determines what communicative orcognitive skills are destroyed or interfered with in the patients whosuffer from neurological injury. The instrument of testing focuses onthree inventories so that the skills which are interfered with can beevaluated. The inventories which the instrument looks at conciselyare the left hemisphere, the right hemisphere and the complexneuropathology. Each particular inventory is divided into domains andthen divided further into task sets that the psychologist employs togive feedback.

Thetesting method involving the burns Brief Inventory of Communicationand cognition indicates high degree of internal reliability. The testis reliable but not valid to most groups according to the researchconducted by the statisticians.

Thesymptoms severity tests are both valid and reliable to the users ingetting what they want from the tests carried out. The mental statusexamination helps in learning the patient’s problems at a cheapercost than the other methods. For instance, it can be carried out in asmall space of the clinician working environment (Afari,&amp Buchwald, 2014).The functional impairment tests are also very reliable if they arecarried out but cannot be very in the aspects they need to beexercised. The method proves hectic in practice when applied in theparticular aspects due to the requirements which need to be met inorder to serve clients.

Ihave selected the mini mental state examination and the Burns BriefInventory of Communication and cognition as the best practices whichcan be applied by the psychologists. These two methods lead to makinginformed judgments by the psychologists when advising or treating thepatients (Skorga,&amp Young, 2015).Mini mental state examination helps the clinician to know theparticular cognitive impairment affecting the client and offer theright treatment. Furthermore, the functional impairment test helps indetermining the particular cognitive skills which have been damagedafter a neurological injury. When the clinician gets to know theexact part affected then he or she will work on that partspecifically without wasting time. The two methods are very effectiveand efficient in solving cognitive impairment problems when employedby physicians.

Thelimitations associated with the two testing methods I have choseninclude the following the mini mental state examination does notrecognize the tender cognitive impairment. It only detects theserious mental problems (Castro‐Costa,Dewey, Uchôa, Firmo, Lima‐Costa,&amp Stewart, 2014)..This test does also not distinguish between normal clients and thosewho suffer from the Alzheimer’s disease. On the other hand, theBurns Brief Inventory of Communication and cognition it’s tootheoretical than practical. It is very easy to work with the burnsbrief inventory of communication and cognition in some cases but hardto apply in other situations.


Thesymptom severity and functional impairment test are very important asthey make the treatment of the patients with cognitive impairmenteasier. The psychologists are capable of learning the patients’mental states acting appropriately.


Chwastiak,L., Ehde, D. M., Gibbons, L. E., Sullivan, M., Bowen, J. D., &ampKraft, G. H. (2014). Depressive symptoms and severity of illness inmultiple sclerosis: epidemiologic study of a large community sample.AmericanJournal of Psychiatry.

Harvey,P. D., Howanitz, E., Parrella, M., White, L., Davidson, M., Mohs, R.C., … &amp Davis, K. L. (2014). Symptoms, cognitive functioning,and adaptive skills in geriatric patients with lifelongschizophrenia: a comparison across treatment sites. AmericanJournal of Psychiatry.

Minzenberg,M. J., Poole, J. H., Benton, C., &amp Vinogradov, S. (2014).Association of anticholinergic load with impairment of complexattention and memory in schizophrenia. AmericanJournal of Psychiatry.

Afari,N., &amp Buchwald, D. (2014). Chronic fatigue syndrome: a review.AmericanJournal of Psychiatry.

Skorga,P., &amp Young, C. F. (2015). Mini-Mental State Examination for theDetection of Alzheimer Disease and Other Dementias in People WithMild Cognitive Impairment. ClinicalNurse Specialist,29(5),265-267.

Castro‐Costa,É., Dewey, M. E., Uchôa, E., Firmo, J. O., Lima‐Costa,M. F., &amp Stewart, R. (2014). Construct validity of the minimental state examination across time in a sample with low‐educationlevels: 10‐yearfollow‐upof the Bambuí Cohort Study of Ageing. Internationaljournal of geriatric psychiatry,29(12),1294-1303.

Lawson,R. A., Yarnall, A. J., Duncan, G. W., Khoo, T. K., Breen, D. P.,Barker, R. A., … &amp Burn, D. J. (2014). Severity of mildcognitive impairment in early Parkinson`s disease contributes topoorer quality of life. Parkinsonism&amp related disorders,20(10),1071-1075.