Additionally, this study's newly identified cinematic stereotype of “schizophrenia as possessed” reinforces stigmatizing messages about people with schizophrenia—making those with schizophrenia seem even more aberrant and dehumanized—through the suggestion or depiction of interactions with supernatural entities. The specific types of treatments shown or alluded to by the movie were noted on the coding sheet. A character who displayed exceptional skills or talents during active or residual phases of schizophrenia was coded as a genius. If a cause was specified—such as genetics or schizophrenogenic parent—it was noted on the coding sheet. These movies provided a realistic and sympathetic representation of the numerous challenges encountered by people with schizophrenia, such as societal stigma (The Soloist), disruption of family and other relationships (Canvas, Oil on Water, and Some Voices), and day-to-day struggles to cope with symptoms (Angel Baby; Clean, Shaven; and Revolution #9). (Attitudes towards mental illness) Developing a learning resource for use within a clinical call centre: a systematic literature review on attitudes towards mental illness. 9, American Psychiatric Association Publishing, DSM-5® Handbook of Differential Diagnosis, DSM-5® Handbook on the Cultural Formulation Interview, The Journal of Neuropsychiatry and Clinical Neurosciences, Psychiatric Research and Clinical Practice, Psychiatric Services From Pages to Practice, News media portrayal of mental illness: implications for public policy, Crossing the line—learning psychiatry at the movies, Homicidal maniacs and narcissistic parasites: stigmatization of mentally ill persons in the movies, Fall and rise of the movie ‘psycho killer.’, The clinical use of films in psychotherapy, Schizophrenia: illness, stigma, and misconceptions. Rates of schizophrenia are higher among African Americans than Caucasians (30) and only slightly higher among males than females (31). 1, Early Intervention in Psychiatry, Vol. As noted by Byrne (6) and Wedding and Niemiec (7), the psychiatric patient turned homicidal maniac is an ever-present feature of contemporary “slasher” or “psycho killer” films. Negative symptoms, which contribute significantly to the disability associated with schizophrenia are hard to treat with currently available medication. Forty-two characters from 41 movies were identified, a majority of whom were male and Caucasian. Causation of schizophrenia, if directly stated or implied, was coded as primarily environmental, primarily biological, or a combination of the two. 3, 17 May 2016 | The Journal of Behavioral Health Services & Research, Vol. They included the Internet Movie Database, Turner Classic Movies, Yahoo! No other disorder arouses as much anxiety in the general public, the media, and doctors. This study appears to be the first to provide an empirically based content analysis of the portrayal of schizophrenia in contemporary movies. : Predicting violence in schizophrenia: a prospective study. We and our partners will store and/or access information on your device through the use of cookies and similar technologies, to display personalised ads and content, for ad and content measurement, audience insights and product development. The cinematic character with schizophrenia typically is Caucasian and male, characteristics that are counter to actual incidence data. Considerable evidence indicates a substantial biological basis for schizophrenia (16) and use of antipsychotic medications—not electroconvulsive therapy or catharsis—as first-line treatment of schizophrenia symptoms. Sources for locating movies were Internet and print movie databases that allowed a search by topic or keyword. If a character's symptoms could be attributed to a general medical condition or to the direct effects of a substance (13), the movie was excluded. Future efforts extending this line of research would contribute to the discourse on the optimal uses of entertainment media to correct misinformation about schizophrenia and to promote an informed understanding of those with schizophrenia and other mental illnesses. Nonsuicidal self-harm by people with schizophrenia has been observed (15), but its prevalence is unknown (16). Of the 42 characters in this movie analysis, 35 displayed some form of violent behavior toward others, and 13 engaged in homicidal behaviors. Negative symptoms were less frequently depicted. Although the word ‘schizophrenia’ is often associated with violence in the media, this is the exception rather than the rule. Late walking 4. Nevertheless, clearly there is a need to provide accurate information about mental illness to counter the negative messages found in mass media. A majority of characters were male (N=33, 79%) and Caucasian (N=40, 95%). Of course some people … In media reporting and in public opinion schizophrenia probably has more negative associations that any other public health issue in the UK today. More contemporary movies have continued to conflate violent behavior with mental illness. The truth is: It does not mean someone has a 'split personality'. We love seeing mentally unstable characters in movies chase “normal” characters around with a chainsaw. The pervasiveness and nature of misinformation are difficult to ascertain because of the lack of empirically based studies of movies portraying schizophrenia. One limitation of this study concerned the inclusion of only commercial movies made for theatrical release. Some movie characters with schizophrenia were depicted as having unusual experiences with otherworldly ph… Schizophrenia is categorised by so called ‘positive symptoms’ such as hearing voices (hallucinations) and ‘negative symptoms’ (disordered thinking, poor motivation, poor social function). Notable among the stereotypes supported was the association of schizophrenia and unpredictable behavior and violence. A majority of the characters engaged in unpredictable behavior (N=30, 71%) and displayed some form of self-harm, ranging from self-mutilation to suicide (N=29, 69%). Causation of schizophrenia was infrequently noted, although about one-fourth of movies implied that a traumatic life event was significant in causation. American Behavioral Scientist 46:1594–1600, 2003 Crossref, Google Scholar, 3 Wedding D , Boyd M , Niemiec RM : Movies and Mental Illness: Using Films to Understand Psychopathology, 3rd ed rev. It is anticipated that results will help clarify the prevalence and nature of stereotypes and misinformation foundin this widely patronized entertainment medium. New York, Facts on File, 2007 Google Scholar, 17 Rosen A , Walter G , Politis T , et al. Health and Wellbeing. Only two characters, both African-American males, represented minority groups. 4, 24 April 2020 | JAMA Network Open, Vol. Delusions were featured most frequently, followed by auditory and visual hallucinations. Schizophrenia Research 94:23–28, 2007 Crossref, Medline, Google Scholar, 15 Skegg K : Self-harm. They review and reflect on some of the ways mental health has been portrayed in the media, including TV episodes and newspaper articles.The way mental illness is portrayed and reported in the media is incredibly powerful in educating and influencing the public. Please read the entire Privacy Policy and Terms of Use. I am sure no deliberate offence is intended and there have been far worse examples in the media when discussing people with mental health problems but such language does … Social Psychiatry and Psychiatric Epidemiology 47:487–503, 2012 Crossref, Medline, Google Scholar, 11 Walsh E , Gilvarry C , Samele C , et al. 44, No. Studies of this question have been criticized for having a number of methodological limitations (24). : Community attitudes to mental illness. Lancet 366:1471–1483, 2005 Crossref, Medline, Google Scholar, 16 Noll R : The Encyclopedia of Schizophrenia and Other Psychotic Disorders, 3rd ed. In particular, when characters with schizophrenia are presented as “homicidal maniacs” in “slasher” or “psycho killer” movies. Media analysts (8,9) have criticized movies for associating schizophrenia with unpredictable and often violent behaviors. 6, Journal of Obsessive-Compulsive and Related Disorders, Vol. Enter your email address below and we will send you the reset instructions, If the address matches an existing account you will receive an email with instructions to reset your password, Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. To date, these studies still do not exist, and, despite the considerable criticism of movie portrayals of severe mental illness, there have been no published empirical analyses of movie portrayals of schizophrenia to verify these criticisms. Media messages associating violence with severe mental illness may also contribute to stigmatization and the consequences of social rejection, social distancing, and discrimination that are often experienced by those with a severe mental illness (33,34,43). Critics of entertainment media have indicated that cinematic depictions of schizophrenia are stereotypic and characterized by misinformation about symptoms, causes, and treatment. [A table listing the movies and characters is available online as a data supplement to this article.] Schizophrenia does not mean someone has a split personality or multiple personalities. Two researchers independently rated each character with a checklist that assessed demographic characteristics, symptoms and stereotypes, causation, and treatment. : Race and risk of schizophrenia in a US birth cohort: another example of health disparity? A majority of characters displayed violent behavior toward themselves or others, and nearly one-third of violent characters engaged in homicidal behavior. Journal of Psychiatric and Mental Health Nursing 15:684–693, 2008 Crossref, Medline, Google Scholar, 36 Wolff G , Pathare S , Craig T , et al. Inaccurate and negative portrayals have potential significance for how viewers interpret media messages about schizophrenia and how these interpretations inform attitudes and beliefs among both the general public and among those with schizophrenia. There are some common myths or mistaken beliefs about schizophrenia which come from the media. Journal of Health and Social Behavior 41:208–223, 2000 Crossref, Google Scholar, 35 Putman S : Mental illness: diagnostic title or derogatory term? 1 Stuart H : Violence and mental illness: an overview. A few studies have found visual media to be effective in correcting misinformation about schizophrenia (40,45) and effective in increasing empathy toward persons with schizophrenia (43). Movies available for rent or purchase were viewed if the database's description referred to a character or a plot characterized by any of these terms. An important question concerns the interaction of media-informed knowledge and attitudes about schizophrenia and other severe mental illnesses and stigma and discrimination toward those with a mental illness. English-language commercial movies that featured at least one character with schizophrenia and that were released for theatrical showing between 1990 and 2010 were viewed in their entirety. 2, Tidsskrift for Den norske legeforening, Vol. There is more media misinformation about schizophrenia than about any other type of mental health problem. World Psychiatry 4:181–185, 2005 Medline, Google Scholar, 28 Wilson C , Nairn R , Coverdale J , et al. The myth of schizophrenia and violence, that people with schizophrenia are inherently violent, persists. First, almost half of movie characters were judged to be of low socioeconomic status, consistent with epidemiological data demonstrating the inverse relationship between socioeconomic status and schizophrenia (29). The myth that love can cure schizophrenia was found in nearly one-fourth (N=10, 24%) of the movies. The Causes of Schizophrenia 6. Entertainment media are often cited as an important source of information about mental illness. (Psychiatric Services 63:655–659, 2012; doi: 10.1176/appi.ps.201100371). : From shunned to shining: doctors, madness and psychiatry in Australian and New Zealand cinema. According to a review of over 400 movies featuring psychotherapy, only one movie showed effective use of drug therapy (19). Over two decades ago, Hyler and coauthors (5) noted the absence of well-controlled studies of movie portrayals of patients with a mental illness and recommended using psychiatric taxonomic criteria to analyze the content of movies. Although all of the movies contained misinformation about schizophrenia, in a few movies the misinformation was judged to be inconsequential and did not detract from an overall accurate and compelling portrayal of schizophrenia. Stigma in Schizophrenia. Stories in the news and on TV shows are often sensationalised and misleading. In this study, the finding that contemporary movies provide misinformation and negative representations of schizophrenia paralleled the negative depictions of mental illness by other media, such as television and newspapers (24). Neurotransmitters are chemicals that carry messages between brain cells. Over two decades ago, Hyler and coauthors (5) identified the “homicidal maniac” as one of Hollywood's more pejorative stereotypes about people with mental illness. 4, Journal of the American Psychiatric Nurses Association, Journal of Community & Applied Social Psychology, Early Intervention in Psychiatry, Vol. Effective treatments are available, yet patients and their families often find it hard to access good care. Cambridge, Mass, Hogrefe, 2010 Google Scholar, 4 Akram A , O'Brien A , O'Neill A , et al. Rates of suicide completion were estimated to be ten to 16 times higher among people with schizophrenia than among the general population (13,14). According to movie critics, movies have falsely promoted the premise that traumatic life events, such as dysfunctional parenting, cause schizophrenia (18) and that schizophrenia can be cured by the special empathetic understanding of a loving helper (7,19,20). Entertainment media are often cited as contributing to the formation and reinforcement of misinformation and negative attitudes about mental illness (37,38). World Psychiatry 2:121–124, 2003 Medline, Google Scholar, 2 Wahl OF : News media portrayal of mental illness: implications for public policy. Most characters displayed positive symptoms of schizophrenia. Eight characters (19%) showed flat affect, and two (5%) showed alogia and avolition. Dangerous or violent behavior was defined as intent to harm oneself or others. The media, however, especially the movies, portray schizophrenia in a different light than the actual disorder. In addition, a majority of characters engaged in self-harm, and 24% committed suicide, a misleading characterization given that suicide rates among individuals with schizophrenia are estimated to range from 10% to 16%. Crime. However, given the popularity of DVD subscription services and streaming video, these movies may actually be reaching a wide audience. Over half of the movies that alluded to or depicted treatment referred to the use of medications, a finding that may reflect a greater awareness by filmmakers of current psychiatric treatment for schizophrenia. Several inaccurate characterizations of schizophrenia in movies were found. I have noted for several years that the mass media, including the BBC commonly refer to people presumed to be diagnosed with schizophrenia by such terms as 'a schizophrenic man' or ‘a paranoid schizophrenic’.. I thought that when I became an adult, I would have to start watching it, as if it was a compulsory grown-up thing. A second challenge concerned the decision to include movies with characters identified as having schizophrenia even though their actions did not meet criteria for schizophrenia. The author acknowledges Rita Olfers, M.A., and Alexia Wilson, B.A., for their support in viewing and coding movies. You can change your choices at any time by visiting Your Privacy Controls. Examples of environmental causes are traumatic events or dysfunctional family interactions. American Journal of Public Health 89:1328–1333, 1999 Crossref, Medline, Google Scholar, 34 Martin J , Pescosolido B , Tuch SA : Of fear and loathing: the role of “disturbing behavior,” labels, and causal attributions in shaping public attitudes toward people with mental illness. Settings for treatment were coded as inpatient, outpatient, combination of inpatient and outpatient, or other. 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Of notable concern is the finding that the “homicidal maniac” stereotype associated with schizophrenia is prevalent in contemporary movies. These movies were included in the analysis because by linking unusual behaviors with the label of schizophrenia, they most likely would lead viewers without disconfirming information to believe such behaviors were indicative of schizophrenia. Medical Journal of Australia 167:640–644, 1997 Crossref, Medline, Google Scholar, 18 Hyler SE : DSM-III at the cinema: madness in movies. Woman admits killing 88-year-old church warden in village shop. The Feelings an Individual with Schizophrenia May Experience 7. : Mental illness depiction in children's films. The purpose of this study was to provide a content analysis of the portrayal of schizophrenia in contemporary movies to ascertain the prevalence of stereotypes and misinformation about schizophrenia. Psychiatric Services 52:953–958, 2001 Link, Google Scholar, 45 Penn DL , Chamberlin C , Mueser KT : The effects of a documentary film about schizophrenia on psychiatric stigma. 36, No. With Prejudice Toward Individuals With Mental Illness, End-of-Life in Disney and Pixar Films: An opportunity for Engaging in Difficult Conversation, Perceptions of schizophrenia in the Australian community: 2005–2017, Connectivity and dysconnectivity: A brief history of functional connectivity research in schizophrenia and future directions, Listening to the Voices People Hear: Auditory Hallucinations Beyond a Diagnostic Framework, The Impact of Films on Viewer Attitudes towards People with Schizophrenia, Community Health Workers: a Resource to Support Antipsychotic Medication Adherence. These media, however, have been widely criticized for their negatively stereotypic and inaccurate depictions of mental illness (1,2). Information about your device and internet connection, including your IP address, Browsing and search activity while using Verizon Media websites and apps. Indeed, a literature review (24) of 34 empirical studies of media portrayals of mental illness published between 1990 and 2003 found only three studies that discussed movies and none of them analyzed depictions of schizophrenia (19,25,26). Find out more about how we use your information in our Privacy Policy and Cookie Policy. So ruling out these developmental disorders is one of the first steps in diagnosis. Positive symptoms (bizarre delusions, hallucinations, disorganized speech, and disorganized behavior) and negative symptoms (alogia, avolition, and flat affect) consistent with DSM-IV-TR diagnostic criteria for schizophrenia were coded (13). HuffPost is part of Verizon Media. Movies may also perpetuate the misconception that schizophrenia is linked to genius or extraordinary creative ability (17). 31, No. Race and risk of schizophrenia in a US birth cohort: another example of health disparity? 5, International Journal of Mental Health, Vol. Some movie characters with schizophrenia were depicted as having unusual experiences with otherworldly phenomena, an unexpected finding. Sensational stories in the media tend to present people with schizophrenia as dangerous, even though most people diagnosed with schizophrenia don't commit violent crimes. It does not make someone dangerous or violent. Although movie characters with schizophrenia were almost exclusively Caucasian, and a majority were male, in the United States, African Americans have significantly higher rates of schizophrenia compared with other racial groups (29) and males have only a slightly higher incidence rate of schizophrenia than females (30). Estimate of socioeconomic status was based on the character's predominant place of residence (27) and was categorized as low (included living on the street), middle, high, or undetermined (for example, living in an inpatient setting or halfway house). 3, Australian & New Zealand Journal of Psychiatry, Vol. Probably the most disparaging stigmatizations of mental illness in media lie in the film portrayals of antagonists with mental illness. Movies, in particular, have been faulted for misrepresenting mental illness and perpetuating stereotypes (3). A diagnosis of schizophrenia does not mean 'split personality', or indicate that someone will be calm one minute and then be 'out of control' the next. This is why the media continues to feed us these misconstrued stories. Psychiatric News 42:6, 2007 Link, Google Scholar, 9 Dinan TG : Schizophrenia: illness, stigma, and misconceptions. By spreading and promoting myths about schizophrenia and violence, these industries have caused great damage to the struggle to reduce shame associated with mental illness. For the purpose of interrater reliability, all movies were also independently coded by a graduate student trained in the use of the coding scheme. Five characters (12%) were depicted as possessing visionary insights or paranormal abilities that ostensibly allowed interaction with otherworldly and often malevolent forces. Yet the association of genius with schizophrenia is considered largely to be a myth, given that the diminished cognitive abilities of many people with schizophrenia preclude the ability to sustain the focused attention necessary for creative achievement (16). Critics of entertainment media have indicated that cinematic depictions of schizophrenia are stereotypic and characterized by misinformation about symptoms, causes, and treatment. International Review of Psychiatry 21:267–268, 2009 Crossref, Medline, Google Scholar, 5 Hyler SE , Gabbard GO , Schneider I : Homicidal maniacs and narcissistic parasites: stigmatization of mentally ill persons in the movies. Other abnormal motor behaviors — for example, rocking or arm flapping Some of these signs and symptoms are also common in children with pervasive developmental disorders, such as autism spectrum disorder. This myth may come from the fact that the name ‘schizophrenia’ derives from two Greek words meaning ‘split’ and ‘mind’. There's more misinformation in the media about schizophrenia than about any other type of mental health problem. Ten (24%) characters committed suicide. For instance, Dr. Patricia Owen, a psychology professor at St. Mary’s University in Texas, focuses on the media’s impact on abnormal psychology, which is a field that focuses on mental disorders. Although one review of epidemiological studies (10) found that people with schizophrenia were more violent than the general population, much of this violence appeared to be attributable to a small subgroup of people with comorbid substance abuse and a history of violence (1,11). Psychotherapy: Theory, Research, Practice, Training 36:180–189, 1999 Crossref, Google Scholar, 26 Wahl O , Wood A , Zaveri P , et al. 155, 20 December 2019 | Community Mental Health Journal, Vol. People with schizophrenia have reported feeling hurt and offended by media messages (41) and have anticipated discrimination resulting from the portrayal of mental illness by the media (42). To those who struggle with severe mental illness, the pejorative stereotypes found in movies about schizophrenia have detrimental consequences. 80, No. 6, 2 April 2016 | Current Psychology, Vol. British Journal of Psychiatry 177:4–7, 2000 Crossref, Medline, Google Scholar, 33 Link BG , Phelan JC , Bresnahan M , et al. These cinematic depictions, however, are not supported by research. 3, Australian & New Zealand Journal of Psychiatry, Vol. 2, 17 August 2017 | OMEGA - Journal of Death and Dying, Vol. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook. The surprisingly rich contours of schizophrenia epidemiology, Stigmatization of people with mental illnesses, Public conceptions of mental illness: labels, causes, dangerousness, and social distance, Of fear and loathing: the role of “disturbing behavior,” labels, and causal attributions in shaping public attitudes toward people with mental illness, Mental illness: diagnostic title or derogatory term? It does not make someone dangerous or violent. Movies have been criticized for paying negligible attention to psychopharmacological treatments for mental illness (19), while featuring other treatments, such as electroconvulsive therapy (21) and catharsis (19), as commonplace. Hospital and Community Psychiatry 42:1044–1048, 1991 Abstract, Google Scholar, 6 Byrne P : Fall and rise of the movie ‘psycho killer.’ Psychiatric Bulletin 22:174–176, 1998 Crossref, Google Scholar, 7 Wedding D , Niemiec RM : The clinical use of films in psychotherapy. Hospital admission is often not needed and many people with schizophrenia live a stable life, work, and have relationships. : Experience of stigma among outpatients with schizophrenia. Schizophrenia Bulletin 29:383–391, 2003 Crossref, Medline, Google Scholar. Some people will have one or two episodes and go on make a … Media Coverage and How It Can Cause Fear and Misunderstanding in Regard to Schizophrenia 5. That the general public holds misinformed beliefs and negative attitudes about serious mental illness has been well documented (32–34). Comprehensive Psychiatry 29:195–206, 1988 Crossref, Medline, Google Scholar, 19 Gabbard K , Gabbard GO : Psychiatry and the Cinema. Although a special empathetic understanding may help in symptom management, the notion of cure through a loving relationship is fiction. The contemporary movies reviewed by this study both supported and refuted stereotypes and misconceptions about schizophrenia. JCLP/In Session: Psychotherapy in Practice 59:207–215, 2003 Google Scholar, 8 Gabbard G : Schizophrenia on filmmaker's canvas. Schizophrenia is a serious mental disorder in which people interpret reality abnormally. 49, No. 56, No. The consistently negative media portrayals of people living with schizophrenia certainly bring that theory into question. Language delays 2. Irish Journal of Psychological Medicine 1:3–4, 1999 Crossref, Google Scholar, 10 Van Dorn R , Volavka J , Johnson N : Mental disorder and violence: is there a relationship beyond substance use? (Attitudes towards mental illness) Developing a learning resource for use within a clinical call centre: a systematic literature review on attitudes towards mental illness, Dangerousness, unpredictability, and the fear of people with schizophrenia, Relationship of the media to attitudes toward people with mental illness, Dispelling myths about schizophrenia using film. December 2019 | American Journal of Behavioral health Services & Research, Vol mistaken beliefs about schizophrenia schizophrenia in media! Include developmental problems, such as: 1 are hard to access good care someone has a split personality multiple. As inpatient, outpatient, combination of inpatient and outpatient, or suffer a... A traumatic life event was significant in causation M.A., and nearly one-third of violent engaged! May 2016 | Current Psychology, Vol auditory and visual hallucinations as commonplace despite the that... 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Services & Research, Vol depicted as having unusual experiences with otherworldly phenomena, an finding..., the schizophrenia in media media and the cinema well documented ( 32–34 ) causes are traumatic events dysfunctional... With severe mental illness has been observed ( 15 ), biological ( for example, ). Sensationalised and misleading there a relationship beyond substance use, drink alcohol heavily or use narcotics, comically. Alluded to by the movie were noted on the coding sheet coded on each.... People with schizophrenia are hard to access good care to video paranormal may represent a newly identified stereotype in movies—! Yet patients and their families battle daily 95 % ) showed alogia and avolition by scholars... The movies and characters is available online as a treatment modality ( 22.! 26 June 2019 | Community mental health, Vol, 24 April 2020 JAMA., Journal of Death and Dying, Vol for locating movies were fairly accurate in some of. 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