Question

The Solist (2009) Charecter: Nathaniel Ayers

   Nathaniels Dignosis: Schizophrenia

Each character (Nathaniel Ayers) is exhibiting a specific psychological disorder.  After watching the film, write the diagnosis for the character (Schizophrenia). You will then need to list the symptoms (behaviors) that the character is showing in support of your diagnosis.  You will need to refer to the DSM to ensure you have all the symptoms needed to diagnose (schizophrenia) your character.

*For example, if you have diagnosed your character as Obsessive Compulsive Disorder, you will need to list criteria as outlined by the DSM such as the obsessive thoughts and compulsive actions to support the diagnosis.  Additionally, incorporate other issues portrayed in the film that the book talked about as it is relevant.  For example, in some of the movies listed, they talk about the events which may have “caused” the disorder such as abuse and trauma, childhood experiences, etc.

Use the diagnosis of schizophrenia in order to show symptoms that would be exhibted throguh schizophrenia and apply them to Nathaniels in the movie. Refer to the DSM

Answer 1

• Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling
• The psychotic features of the disorder typically emerge between the mid-teens and mid-thirties, with the peak age of onset of the first psychotic episode in the early to mid-twenties for males and late twenties for females.
• The DSM 5 outlines the following criterion to make a diagnosis of schizophrenia:
• Two or more of the following for at least a one-month (or longer) period of time, symptoms are typically divided into positive and negative symptoms because of their impact on diagnosis and treatment. Positive symptoms are those that appear to reflect an excess or distortion of normal functions.
• Negative symptoms are those that appear to reflect a diminution or loss of normal functions. These often persist in the lives of people with schizophrenia during periods of low (or absent) positive symptoms. Negative symptoms are difficult to evaluate because they are not as grossly abnormal as positives ones and may be caused by a variety of other factors as well (e.g., as an adaptation to a persecutory delusion).
• Delusions-the patient displays false beliefs, which can take many forms, such as delusions of persecution, or delusions of grandeur. They may feel others are attempting to control them remotely. Or, they may think they have extraordinary powers and abilities.
• Hallucinations-hearing voices is much more common than seeing, feeling, tasting, or smelling things which are not there, however, people with schizophrenia may experience a wide range of hallucinations.
• Disorganized speech-(e.g., frequent derailment or incoherence) - these are also called "word salads". Ongoing disjointed or rambling monologues - in which a person seems to talking to himself/herself or imagined people or voices.
• Grossly disorganized or catatonic behavior- (An abnormal condition variously characterized by stupor/innactivity, mania, and either rigidity or extreme flexibility of the limbs).
• Negative symptoms, such as diminished emotional expression-these symptoms are the lack of important abilities. Some of these include:
• Alogia, or poverty of speech, is the lessening of speech fluency and productivity, thought to reflect slowing or blocked thoughts, and often manifested as short, empty replies to questions.
• Affective flattening is the reduction in the range and intensity of emotional expression, including facial expression, voice tone, eye contact (person seems to stare, doesn't maintain eye contact in a normal process), and is not able to interpret body language nor use appropriate body language.
• The symptoms must impair one’s life and get in the way of her ability to work (or go to/participate in school), have positive relationships (or any relationships at all), and practice self-care. The problems in these areas must be new, a decline in previous status.
• Duration of the symptoms is also important for a schizophrenia diagnosis. Someone must have been experiencing steady symptoms for at least one month. Symptoms must be present some of the time for six consecutive months.
• Personality traits guide schizophrenic subtype and, indeed the highly intelligent Nathaniel is a paranoid schizophrenic who constructs elaborate narratives pieced together by misperceptions of meaning.
• He is strange and inward from birth, choosing to live in the basement and always within close proximity to his musical instruments.
• Nathaniel's hallucinations remain exclusively auditory (the most common form) and manifest in a sincere voice with a simple message that others can hear his thoughts (thought broadcasting).
• Ayers experiences auditory hallucinations, disorganized speech, a blunted affect and negative symptoms such as social withdrawal and anhedonia.
• People who experience anhedonia have lost interest in activities they used to enjoy and have a decreased ability to feel pleasure.Blunted affect is a markedly diminished emotional expression.
• Flashbacks to Ayers' childhood reveal that he developed schizophrenia at an adolescent age. He first experienced auditory hallucinations while playing the cello at a music rehearsal at Juilliard as a student. He heard male, female, and youthful voices telling him different things such as “I'll protect you from the pain”, “they can hear your thoughts”, and “run away, Nathaniel.”
• The voices are transient and become more prominent the more he plays the cello. His love and talent for music therefore became both a gift and a curse. Ayers reluctantly runs away from his family, friends, and life as a result of not understanding his condition, not knowing where to turn to for help, and not wanting to harm his family.
• All of these are clearly present for greater than six months. He also exhibits homelessness and has poor hygiene.