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分析:为一位电影偶像确定诊断的尝试。

Analysing : an attempt to establish diagnosis for a film icon.

作者信息

Skryabin Valentin Yurievich

机构信息

Moscow Research and Practical Centre for Narcology, Russia.

出版信息

BJPsych Bull. 2021 Dec;45(6):329-332. doi: 10.1192/bjb.2020.146.

Abstract

Todd Phillips's film Joker, a 2019 psychological thriller, has stirred up strong reactions to the portrayal of the lead character's mental disorder, which is never specified. I used DSM-5 criteria to study whether Joker/Arthur Fleck showed signs of a real mental disorder. The psychopathology Arthur exhibits is unclear, preventing diagnosis of psychotic disorder or schizophrenia; the unusual combination of symptoms suggests a complex mix of features of certain personality traits, namely psychopathy and narcissism (he meets DSM-5 criteria for narcissistic personality disorder). He also shows the symptoms of pseudobulbar affect due to traumatic brain injury. This apparent co-occurrence of both mental disorder and a neurological condition may be confusing for audiences trying to understand mental illness.

摘要

托德·菲利普斯2019年的心理惊悚片《小丑》引发了人们对主角精神障碍刻画的强烈反应,而主角的精神障碍从未明确说明。我运用《精神疾病诊断与统计手册》第五版(DSM - 5)的标准来研究《小丑》/亚瑟·弗莱克是否表现出真实精神障碍的迹象。亚瑟所展现出的精神病理学表现并不明确,无法诊断为精神分裂症或精神障碍;这些症状的异常组合表明其具有某些人格特质的复杂混合特征,即心理变态和自恋(他符合DSM - 5中自恋型人格障碍的标准)。他还因创伤性脑损伤表现出假性延髓情绪的症状。这种精神障碍和神经疾病的明显同时出现可能会让试图理解精神疾病的观众感到困惑。

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本文引用的文献

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Film, psychotherapy, and the taming of rage at the mother.电影、心理治疗与对母亲的愤怒的驯服
J Clin Psychol. 2020 Aug;76(8):1514-1519. doi: 10.1002/jclp.23003. Epub 2020 Jun 25.
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"The Joker" does the Oscars right, but gets it wrong!
Asian J Psychiatr. 2020 Jun;51:102039. doi: 10.1016/j.ajp.2020.102039. Epub 2020 Mar 30.
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Recognizing and treating pseudobulbar affect.认识并治疗假性延髓情绪。
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9
Diagnosing pseudobulbar affect in traumatic brain injury.诊断创伤性脑损伤中的假性延髓性麻痹。
Neuropsychiatr Dis Treat. 2014 Oct 7;10:1903-10. doi: 10.2147/NDT.S63304. eCollection 2014.
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Acad Psychiatry. 2010 Mar-Apr;34(2):145-9. doi: 10.1176/appi.ap.34.2.145.

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