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Understanding the DSM5

through Film
Catherine Pearlman, PhD, LCSW
College of New Rochelle
November 16, 2013
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Overview
 Introduction

 Use of film in Psychosocial Pathology

 This session we will discuss:
 Benefits of using film while learning DSM
 Issues with film as a learning tool
 Some DSM descriptions
 4 diagnoses seen through film
+ Why the DSM needs film?

Brings life and color to diagnosis

 Demonstrates
presentation of diagnosis
beyond diagnostic criteria

Allows for an emotional reaction

 Helps remember Dx and symptoms
 Creates empathy and thoughtfulness in
working with person with Dx
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Why the DSM needs film continued
Window into how diagnosis affects life
and others
Education and entertainment
Generate debate and analysis of
portrayal
Engagement
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Caveats
Films and TV shows are a business
Filmsoften show mental illness, not
necessarily mental health
Stereotypical, not necessarily
scientific or clinical
Can confuse two diagnoses
(schizophrenia and dissociative
Identity Disorder)
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Caveats
 Can add to Stigma
 Canincrease suicidal ideation, cutting,
anorexia
 Patients
more often seen as violent (If it
bleeds…)
 Therapeutic workers in films are often
unethical, unprofessional, or ineffective
 Prince of Tides
 Antoine Fisher
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An Introduction to Symptomology
 Ideas of Reference: false belief that others
are talking or referring to oneself, People
on television or radio
 Delusions- Fixed false beliefs based on
incorrect inference about external
background
 Obsessions: persistent thought that cannot
be eliminated, associate with anxiety
 http://aitlvideo.uc.edu/aitl/MSE/MSEkm.swf
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How to View the Films

 Look with a critical lens, don’t just watch the

story
 Look for symptomology
 Observe environment
 Observe social interactions
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Tic Disorders – DSM 5
Tourette’s
 Both multiple motor and one or more vocal
tics
 Tics
come and go but persistent more than
1 year
 Onset before 18 years
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Tic Disorders
Diagnostic Features
 Simpleor Complex
Motor tics
 Vocal tics
 Echopraxia
(Repeating
someone else’s
movements)
 Coprolalia – socially
unacceptable words,
gestures, slurs
 Co-occurring with
OCD 16:00 – 17:40
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Anorexia Nervosa - DSM 5
 Restriction of intake

 Low body weight for age, sex, developmental

trajectory

 Intense fear of gaining weight

 Persistent behavior that interferes with gaining

weight

 Disturbance in body image

 Lack
of recognition of seriousness of low body
weight

 Types: Restricting, binging/purging

+ THIN
Inpatient eating disorder treatment
 Emaciated

 Body Temperature

 Lowpulse, blood
pressure
 Obsession

 Difficulty eating, no joy

 Lack of seriousness
 Perceived body image
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Schizophrenia – DSM 5
2 or more of following:

 Diminished Emotional Expression

 Grossly
Disorganized or Catatonic
Behavior

 Hallucination

 Delusions

 Disorganized Speech
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Schizophrenia – Associated Features
 A constellation of symptoms but every case can look a little
different

 Inappropriate affect

 Dysphoric mood – anger, depression, disturbed sleep,

anxiety, phobias

 Slower processing, memory loss, lower language function,

difficulty inferring

 Reductions in attention

 Lack of insight or knowledge of diagnosis

 *onset often after teen years after typical childhood

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A Beautiful Mind
 Visual Hallucination
 Roommate and neice
 Ed Harris, Secret Agent

 Delusions
 He is a secret agent
 A device implanted in his
arm

 Negative Symptoms

 Dysphoric symptoms
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Hoarding – DSM 5
 Persistent
difficulty discarding possessions,
regardless of value

 Distress over discarding

 Perceived need for items

 Accumulation of possessions causing clutter,

 Compromised intended use of rooms –bathroom,

kitchen, sleeping on couch

 Clinicallysignificant distress or impairment of

social, occupational functioning
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Hoarding – DSM 5 continued
Types

 With Excessive acquisition

Severity

 Good or fair insight –recognizes behaviors are

problem

 Poor insight – Most behaviors not a problem

 Absent insight or delusional beliefs – “Hoarding

not a problem” despite evidence
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Hoarders on A&E
 Loss of function of the
room
 Saved paper, books, old
clothing, magazines,
bags
 Social impairment
 Animal hoarding – but
not providing for health
and safety
 Unsanitary conditions
 Indecisiveness
 Distractibility
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Review

 Film is a great way to put life into the DSM

 Use a critical eye to evaluate pros and cons
of use of film
 Use Film as a teaching tool
 Film/documentaries are excellent in
helping helping professionals understand
the realities of living with a diagnosis
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Questions?

Thank you for coming.