Introduction
The fourth edition of the Diagnostic and Statistical Manual of Mental Disorder, text revision (DSM-IV-TR) is a collection of mental disorders. It includes the definitions, classifications, and organization of the disorders. Also, the manual contains a list of criteria that is used to make a diagnosis. The DSM-IV-TR is widely used by professionals in mental health in the United States and the Western world. The process of making a diagnosis consists of examination and analysis of the patient resulting in labeling and identification of a mental disorder. The DSM-IV-TR is an assistant of any mental health professional in analyzing the symptoms and signs of illness reported by an individual being examined. In this study, the DSM-IV-TR is used for the analysis of the main character of a movie called A Beautiful Mind. The movie is about a famous mathematician, a Nobel Price winner, John Forbes Nash Jr. The mathematician is suffering from Schizophrenia, which is depicted throughout the movie. In the movie, the audience can see how Schizophrenia manifests and can identify the symptoms of the disorder. The DSM-IV-TR can be used for an efficient and successful diagnosis of Schizophrenia of the main character in the movie.
Main body
One of the schizophrenia criteria in the DSM-IV-TR is delusions. Delusions, in DSM-IV-TR, are described as “erroneous beliefs that usually involve a misinterpretation of perceptions or experiences” (American Psychiatric Association, 2000). Based on their content, the most common types are persecutory and referential delusions. Persecutory delusions are when an individual is convicted that he or she is being followed or spied on. At the same time, referential delusions are when the person thinks that various signs such as comments, passages in texts, lyrics of sons are specially referred to him (American Psychiatric Association, 2000). Also, there is a grandiose type of delusion, which is when a person is assured that he or she has some great insight or discovery. In A Beautiful Mind, the main character is having a delusion of grandeur during the early development of the disorder. It can be seen in the scene when John makes a connection between light, lemons, and a tie of his classmate, and then claims that his tie is awful. Also, it can be seen by the character’s delusion that he is working for the Department of Defense on a top-secret mission on decoding Soviet messages.
Another symptom of Schizophrenia, which can be seen in the movie, is a hallucination. Hallucinations in DSM-IV-TR are described as “distorted perceptions, commonly, voices that the person understands are different from their own thoughts” (Flanagan et al. 2012). However, according to Flanagan et al. (2012), some patients described their hallucination as contradicting the description in DSM-IV-TR, stating that they could not distinguish the difference between the hallucination and their own thoughts (p. 378). In the movie, hallucination is one of the symptoms, which can be seen by several imaginary people in the main character’s life. For instance, throughout the movie, the main character talks to his roommate and even discusses his works with him. However, it turns out that his roommate is not real, and it was just a hallucination. Also, William Parcher, who John thinks is a government’s secret agent, is also a hallucination. Hallucinations of John were so convincing that even his wife believed that Charles, the roommate, is real and exist. This characteristic of the main characters’ symptoms of Schizophrenia contradicts the description of hallucination since John was unaware that Charles was a plot of his imagination.
Moreover, a lack of emotional expression and decrease of its intensity, or also known as affective flattening, is another symptom of Schizophrenia described in DSM-IV-TR. In DSM-IV-TR, affective flattening can be identified by “the person’s face appearing immobile and unresponsive, with poor eye contact and reduced body language” (American Psychiatric Association, 2000). These symptoms can be seen in the main character of the movie throughout the plot development. One of the examples from the movie is when John says that he “doesn’t like people much.” The phrase was said with very little emotion, and the message of the phrase tells that he is emotionally depressed. Another scene that depicts affective flattening is the state of John when he is preparing to bathe his baby. He sits with no emotions, and his face clearly shows that he is not happy. John does not even pay attention to a crying baby on his hands.
Avolition is another symptom of Schizophrenia described by DSM-IV-TR. Avolition can be characterized as “an inability to initiate and persist in goal-directed activities” (American Psychiatric Association, 2000). A person with avolition might sit for a long time with no activity, showing no interest in involvement in work or other social activities. One of the reasons for lack of motivation to reach the goal is a shame about their illness (Flanagan et al. 2012). In the movie, the main character also experiences avolition. It can be seen through his conversation with Charles, where he tells John that he has been sitting here for two days, and John replies that while others are publishing their work, he cannot even find a topic for his doctorate. It clearly shows that the main character is having difficulties with his doctorate, which is goal-directed activity. Thus, it can be concluded that the main character is in a state of avolition.
One of the various subtypes of Schizophrenia is a Paranoid Type. According to DSM-IV-TR, the Paranoid Type of Schizophrenia is “the presence of prominent delusions or auditory hallucinations in the context of a relative preservation of cognitive functioning and affect” (American Psychiatric Association, 2000). In the movie, it can be clearly seen that the main character is able to cognitively function and even unaware of his disorder for a long time. In addition, the main character shows increased suspiciousness, which can be seen when he thinks that Russian agents are following him. These are obvious symptoms of Paranoid Type of Schizophrenia.
Conclusion
To sum up, the DSM-IV-TR is a well recognized manual for the diagnosis of various mental disorders. In this study, the DSM-IV-TR was used to evaluate the symptoms of the main character of the movie called A Beautiful Mind. The manual was efficient in assisting in the identification and characterization of the symptoms. Several symptoms, including delusions, hallucinations, affective flattening, avolition, suspiciousness, were successfully identified and characterized by the DSM-IV-TR manual. Most of the symptoms of the main character were in accordance with their description in the manual. However, some symptoms were contradicting the description in the manual. Nevertheless, the DSM-IV-TR manual can be considered an effective tool for diagnosing mental disorders.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC.
Flanagan, E. H., Solomon, L. A., Johnson, A., Ridgway, P., Strauss, J. S., & Davidson, L. (2012). Considering DSM-5: The Personal Experience of Schizophrenia in Relation to the DSM-IV-TR Criteria. Psychiatry: Interpersonal & Biological Processes, 75(4), 375–386.