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A Dsm-Iv Diagnosis as Applied to the Portrayed Character John Nash in the Film

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A DSM-IV Diagnosis as applied to the portrayed character John Nash in the film

"A Beautiful Mind"

In the movie, "A Beautiful Mind", John Nash displays classic positive symptoms of a schizophrenic. This movie does a fair job in portraying the personality and daily suffering of someone who is affected by the disease, although the film does not give a completely historically accurate account. In the film, John Nash would fall into the category of a paranoid schizophrenic, portraying all the symptoms that are typical for this illness. Nash suffers delusions of persecution, believing that there is a government conspiracy against him. He believes that because he is supposedly a secret agent working for the government breaking Soviet codes, and that the KGB was out to get him. In addition to these delusions, Nash experiences hallucinations which are shown from the moment that he starts college at Princeton University. He hallucinates that he has a roommate, when in reality it is uncovered later in the film that he was in a single occupancy room his entire stay at Princeton. Additionally, he frequently has conversations and takes advice from this imaginary roommate. He also imagines a little girl that is introduced to him by his alleged roommate. While going about his daily life, he is constantly surrounded by these inventions. These are classic positive symptoms of the paranoid schizophrenic, which are heavily supported by DSM-IV. Psychological predictions also agree with the behavior John Nash exhibited in the movie. This movie accurately teaches the public the positive affects of a schizophrenic. The movie does not portray schizophrenia as a split of Nash's personalities, rather a split from reality. He imagines other people and hallucinates vividly throughout the movie. Even at the conclusion of the movie, John Nash learns to accept and cope with his psychological disorder. He learns to ignore his hallucinations and is very careful about whom he interacts with. At the conclusion of the movie, he is not cured of schizophrenia, but he is still recognized for his brilliance with the Nobel Prize.

DSM IV is rigorous in the definition of schizophrenia:

Diagnostic criteria for Schizophrenia: DSM IV-TR; A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

(1) Delusions (2) hallucinations (3) disorganized speech (e.g., frequent derailment or incoherence) (4) grossly disorganized or catatonic behavior (5) negative symptoms, i.e., affective flattening, alogia, or avolition. Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

Clearly, criterion A as portrayed by the movie alone is sufficient for a diagnosis. However it is note worthy that Ron Howard's portrayal was not historically accurate, to wit: Nash's hallucinations were exclusively auditory, and not both visual and auditory as shown in the film. It is true that his handlers, both from faculty and administration, had to introduce him to assistants and strangers. But, Nash did not actually experience visual hallucenations. However, the auditory hallucenations alone are sufficent to satisfy DSM IV criteria A. Also Needless to say, criteria B was certainly satisfied as well. For these reasons, A diagnosis of Positive Symptom Schizophrenia is the most if not the only, appropriate diagnosis given the severity of Nash's mental illness.

At the time of Nash's diagnosis, only the older treatment models for schizophrenia were available. Those models viewed patients with schizophrenia as hopeless cases who needed to stabilized with hospitalization. While being hospitalized the patients are maintained with medications, such as Thorazine. These medications had heavy tranquilizing effects and made management of patients easier. But the drugs being induced only suppressed the disease; the drugs could neither arrest nor reverse the positive symptoms. As a result Nash resisted his medications, and the positive symptoms returned. What is fascinating is that Nash himself applied a form of Self-Cognitive-Behavioral Psychotherapy, and that this actually did work. The basic premise of cognitive therapy is that beliefs, expectations, and assessments of self and the world affect how we perceive ourselves and others,



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