Nursing: Mental Health

Running head: NURSING
Nursing: Mental Health
Name of the Student
Name of the University
Author Note

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Question 1
Two components of the mental state examination (MSE) that is related explicitly with
the case study include:
1. Appearance and general behaviour: The main variables of appearance and general
behaviour include the physical appearance of the person (apparent vs. stated age),
grooming (immaculate/unkempt), dress (subdued/riotous), eye contact (furtive/direct)
and posture (kyphotic/erect). According to MSE, the grooming of the person with
depressive disorder shows unkempt appearance (Mirza et al. 2016). The unkempt
appearance of Munny was not significant as he was dressed well. However, his
clothes were loose fit. Loosely fitted clothes is attributable due to his significant
weight loss In case of psychosis, the affected individuals fails to maintain proper eye
contact. The lack of proper eye contact is evident in case of Munny. When Munny
visited the centre, the nurse who greeted him noticed that he is refusing to make eye
contact. He is slumped in his own chair and was staring at the floor and this indicates
mannerism or stereotype posturing. Munny is also refusing the answer the questions
raised to him in full sentences, and is only nodding his head. His wife also
complained that Munny mainly orates in monosyllables and shows limited interest in
talking with others.
2. Affect and Mood: Emotions are judged based on the mood of the person and the
affect. The mood of Munny seems to be low as he was sitting with his eye sight
looking at floor. He is refusing to make eye contact and to indulge in effective
communication. He was mainly responding by nodding his head. Kaup et al. (2016)
are of the opinion that disinterest in communication, and refusal to make eye contact
indicates that an individual is suffering from severe depression or self-esteem. Overall

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mood and affect showed dysphoric attitude that is having significant indication of
depression, guilt and anxiety (Asghar-Ali & Boyle, 2018).
According to Diagnostic and Statistical Manual or Mental disorder V (DSM V),
relevant criteria for detection of depression include significant depressed mood for majority
of the day like a constant feeling of sadness, hopelessness and emptiness (American
Psychiatric Association, 2015). The appearance of Munny provides resemblance of
hopelessness, sadness and emptiness. Like though he was well-dressed with loose fitting
clothes. He was refusing to make eye contact, staring over the floor and was answering with a
nod or in monosyllabic words. His feeling of hopelessness further got highlighted when he
provided consent that he has thoughts about whether his life is worth living. Second criteria
for detection of major depressive episode in DSM V include significant weight loss,
markedly diminished interest in the pleasure or other daily living activities and loss of
appetite (American Psychiatric Association, 2015). Wife of Munny reported that he has lost
interest in food, showing the signs of decreased appetite with significant loss in weight. He
was also reduced his interest daily living activities like initially he love he spend time with
his children but at presented Munny showing less interest in communicative and rarely notice
children and take part in other daily living activities. He mainly keeps himself locked in his
room.
Question 2
The stress-vulnerability model was elucidated by Zubin et al. in the year 1977. This
model is extremely useful for identification and treating of the mental health complications.
According to this model, with the increase in the level of stress in life, the vulnerability of
developing stress and anxiety increases. A significant vulnerability threshold must be crossed
in order to experience high level of stress and anxiety.