CASE STUDY OF PAT

SOLITANO 2
Case Study of Pat Solitano in
Silver Linings Playbook
Introduction
Pat Solitano is the main
character from the movie Silver
Linings Playbook. He is a
middle aged white man who
spent 8 court ordered months in
a psychiatric institution after a
violent attack which lead to him
being diagnosed with bipolar
disorder. First, this paper will
contain information on bipolar I
disorder. Next, the paper will
break down the experiences and
actions of the character that lead
to the diagnosis and contributed
to the hypothesized disorder
using the biopsychosocial
model. Lastly, the conclusion
will be summarized.
Hypothesized Diagnosis
Bipolar I disorder is
characterized by manic episodes
that alternate with major
depressive
episodes (Durand & Barlow,
2016). The fifth edition of the
Diagnostic and Statistical
Manual of
Mental Disorders (DSM-5)
describes a manic episode using
several criteria (American
Psychiatric Association, 2014).
Specifically, individuals
experience an abnormal
increase in
energy or activity. They also
experience unusually elevated,
uninhibited, or irritable mood.
To be
considered a manic episode,
both of these must occur for
most of the day, almost every
day, for 1
week. The only exception to
this is if the period of mood
disturbance requires
hospitalization for
any amount of time.
Additionally, Individuals will
have at least three of the
following symptoms
during a manic episode:
amplified sense of self-esteem,
decreased need for sleep,
increased
talkativeness, racing thoughts,
become easily distracted,
increase in either goal-oriented
or non-
goal-oriented activity, and
increase in dangerous activities.
The DSM-5 outlines many
different criteria for a major
depressive episode such
depressed mood and decline in
interest or pleasure, but
mentions that while major
depressive
CASE STUDY OF PAT
SOLITANO 2
Case Study of Pat Solitano in
Silver Linings Playbook
Introduction
Pat Solitano is the main
character from the movie Silver
Linings Playbook. He is a
middle aged white man who
spent 8 court ordered months in
a psychiatric institution after a
violent attack which lead to him
being diagnosed with bipolar
disorder. First, this paper will
contain information on bipolar I
disorder. Next, the paper will
break down the experiences and
actions of the character that lead
to the diagnosis and contributed
to the hypothesized disorder
using the biopsychosocial
model. Lastly, the conclusion
will be summarized.
Hypothesized Diagnosis
Bipolar I disorder is
characterized by manic episodes
that alternate with major
depressive
episodes (Durand & Barlow,
2016). The fifth edition of the
Diagnostic and Statistical
Manual of
Mental Disorders (DSM-5)
describes a manic episode using
several criteria (American
Psychiatric Association, 2014).
Specifically, individuals
experience an abnormal
increase in
energy or activity. They also
experience unusually elevated,
uninhibited, or irritable mood.
To be
considered a manic episode,
both of these must occur for
most of the day, almost every
day, for 1
week. The only exception to
this is if the period of mood
disturbance requires
hospitalization for
any amount of time.
Additionally, Individuals will
have at least three of the
following symptoms
during a manic episode:
amplified sense of self-esteem,
decreased need for sleep,
increased
talkativeness, racing thoughts,
become easily distracted,
increase in either goal-oriented
or non-
goal-oriented activity, and
increase in dangerous activities.
The DSM-5 outlines many
different criteria for a major
depressive episode such
depressed mood and decline in
interest or pleasure, but
mentions that while major
depressive
CASE STUDY OF PAT SOLITANO
Case Study of Pat Solitano in Silver Linings Playbook

Introduction

Pat Solitano is the main character from the movie Silver Linings Playbook. He is a

middle aged white man who spent 8 court ordered months in a psychiatric institution after a

violent attack which lead to him being diagnosed with bipolar disorder. First, this paper will

contain information on bipolar I disorder. Next, the paper will break down the experiences and

actions of the character that lead to the diagnosis and contributed to the hypothesized disorder

using the biopsychosocial model. Lastly, the conclusion will be summarized.

Hypothesized Diagnosis

Bipolar I disorder is characterized by manic episodes that alternate with major depressive

episodes (Durand & Barlow, 2016). The fifth edition of the Diagnostic and Statistical Manual of

Mental Disorders (DSM-5) describes a manic episode using several criteria (American

Psychiatric Association, 2014). Specifically, individuals experience an abnormal increase in

energy or activity. They also experience unusually elevated, uninhibited, or irritable mood. To be

considered a manic episode, both of these must occur for most of the day, almost every day, for 1

week. The only exception to this is if the period of mood disturbance requires hospitalization for

any amount of time. Additionally, Individuals will have at least three of the following symptoms

during a manic episode: amplified sense of self-esteem, decreased need for sleep, increased

talkativeness, racing thoughts, become easily distracted, increase in either goal-oriented or non-

goal-oriented activity, and increase in dangerous activities.

The DSM-5 outlines many different criteria for a major depressive episode such

depressed mood and decline in interest or pleasure, but mentions that while major depressive

pisodes occur frequently in

bipolar I disorder, they are not
required to make a diagnosis
(American Psychiatric
Association, 2014).
Biopsychosocial Factors and
Interactions of Factors
Biological Factors
First, we explore biological
factors that might have
contributed to Pat Solitano’s
development of bipolar I
disorder. While twin studies
have found evidence that mood
disorders
such as bipolar disorders are
hereditable, this may not be the
case with Pat Solitano (Durand
&
Barlow, 2016). One could argue
that Pat has a genetic
predisposition to his condition
because his
father shows signs of
undiagnosed obsessive-
compulsive disorder, but there
is not enough
research examining the genetic
relationship between bipolar
disorder and OCD. Therefore, I
believe Pat’s relationship with
his father to be a social factor
contributing to his condition,
which
will be examined later in this
paper.
However, it should be noted
that both OCD and bipolar
disorder share some of the same
biological factors with anxiety
in general, such as an overactive
neurobiological response to
stress (Durand & Barlow,
2016). Consequently, if Pat’s
father carries a gene putting him
at
greater risk for anxiety, he
could have passed that gene to
Pat. Following this theory, Pat
and his
father’s overactive
neurobiological responses to
stress predispose them to having
disorders but
they have different disorders
because of the different
psychological and social factors
they
experienced in their lives.
Psychological Factors
Next, we examine in which
ways Pat Solitano met the
psychological criteria for
bipolar I
disorder. Throughout the movie
Pat wakes his parents up in the
middle of the night for reasons
that most wouldn’t think
worthy, such as his contempt
for Ernest Hemingway. It is
during these
pisodes occur frequently in bipolar I disorder, they are not required to make a diagnosis

(American Psychiatric Association, 2014).

Biopsychosocial Factors and Interactions of Factors

Biological Factors

First, we explore biological factors that might have contributed to Pat Solitano’s
development of bipolar I disorder. While twin studies have found evidence that mood disorders

such as bipolar disorders are hereditable, this may not be the case with Pat Solitano (Durand &

Barlow, 2016). One could argue that Pat has a genetic predisposition to his condition because his

father shows signs of undiagnosed obsessive-compulsive disorder, but there is not enough

research examining the genetic relationship between bipolar disorder and OCD. Therefore, I

believe Pat’s relationship with his father to be a social factor contributing to his condition, which

will be examined later in this paper.

However, it should be noted that both OCD and bipolar disorder share some of the same

biological factors with anxiety in general, such as an overactive neurobiological response to

stress (Durand & Barlow, 2016). Consequently, if Pat’s father carries a gene putting him at

greater risk for anxiety, he could have passed that gene to Pat. Following this theory, Pat and his

father’s overactive neurobiological responses to stress predispose them to having disorders but

they have different disorders because of the different psychological and social factors they

experienced in their lives.

Psychological Factors

Next, we examine in which ways Pat Solitano met the psychological criteria for bipolar I

disorder. Throughout the movie Pat wakes his parents up in the middle of the night for reasons

that most wouldn’t think worthy, such as his contempt for Ernest Hemingway. It is during these

scenes that he was experiencing

manic episodes. The first
indication of this is that it
occurred at
3 A.M. meaning he wasn’t
sleeping. Along with his lack of
a need for sleep, his thought
were
racing, he was hyperactive and
he was extremely talkative, all
of which are listed as symptoms
for a manic episode in the
DSM-5 (American Psychiatric
Association, 2014).
During another point in the
movie, Pat mentions to his
therapist that he called the
police
on his wife because he believed
she was conspiring against him.
This constitutes as a delusion
because it is something he
believes to be real even though
it isn’t (Durand & Barlow,
2016). A
frequent delusion Pat suffers
from during times of extreme
stress and panic is he can hear
his
wedding song even though it’s
not playing. This song is even
more significant to Pat because
it is
the song that was playing when
he walked in on his wife
cheating on him. Pat’s delusion
of
hearing this song is frequently
followed by an angry outburst,
often times physical. The DSM-
5
states that when individuals
with bipolar I disorder are
delusional, they may become
physically
and verbally hostile towards
others (American Psychiatric
Association, 2014).
Pat also exhibits a cognitive
style frequently seen in
individuals with bipolar
disorder. In
these styles, individuals
ambitiously strive for goals and
perfectionism and are overly
critical of
themselves (Durand & Barlow,
2016). Pat can be seen striving
for perfection when he talks
about
changing for his wife Nikki. He
believes that reading the books
from her syllabus and running
every day will make him a fit
and perfect husband. He thinks
that these actions will convince
her
return to him despite her having
no interest in doing so. Pat is
also overly critical of himself
and
this is discovered when he
argues with Tiffany. In response
to his judgement of her actions,
Tiffany tells Pat that she loves
the bad parts of herself and asks
if he can say the same about
himself. Later when he is
recanting the argument to his
therapist, he admits that he
doesn’t love
the bad parts of himself.
scenes that he was experiencing manic episodes. The first indication of this is that it occurred at

3 A.M. meaning he wasn’t sleeping. Along with his lack of a need for sleep, his thought were

racing, he was hyperactive and he was extremely talkative, all of which are listed as symptoms

for a manic episode in the DSM-5 (American Psychiatric Association, 2014).

During another point in the movie, Pat mentions to his therapist that he called the police

on his wife because he believed she was conspiring against him. This constitutes as a delusion

because it is something he believes to be real even though it isn’t (Durand & Barlow, 2016). A

frequent delusion Pat suffers from during times of extreme stress and panic is he can hear his

wedding song even though it’s not playing. This song is even more significant to Pat because it is

the song that was playing when he walked in on his wife cheating on him. Pat’s delusion of

hearing this song is frequently followed by an angry outburst, often times physical. The DSM-5

states that when individuals with bipolar I disorder are delusional, they may become physically

and verbally hostile towards others (American Psychiatric Association, 2014).

Pat also exhibits a cognitive style frequently seen in individuals with bipolar disorder. In

these styles, individuals ambitiously strive for goals and perfectionism and are overly critical of

themselves (Durand & Barlow, 2016). Pat can be seen striving for perfection when he talks about

changing for his wife Nikki. He believes that reading the books from her syllabus and running

every day will make him a fit and perfect husband. He thinks that these actions will convince her

return to him despite her having no interest in doing so. Pat is also overly critical of himself and

this is discovered when he argues with Tiffany. In response to his judgement of her actions,
Tiffany tells Pat that she loves the bad parts of herself and asks if he can say the same about

himself. Later when he is recanting the argument to his therapist, he admits that he doesn’t love

the bad parts of himself.

Social Factors

Environmental factors. In this section, we discuss the environmental factors that

contributed to Pat’s hypothetical disorder. In the 7 th edition of Essentials of Abnormal

Psychology, the case of Jane is given to serve as an example of bipolar disorder (Durand &

Barlow, 2016). Jane’s son, Mike, has obsessive compulsive disorder which the authors believe is

related to his relationship with his mother. As previously stated, Pat’s father also has OCD. It is

possible to surmise that Pat’s bipolar disorder is related to his relationship with his father.

Initially, his father’s obsessions seem to be centered around football. He holds the TV remotes a

certain way and rubs a special handkerchief when he watches the games because he believes that

will make his team will win. However, as the film continues it becomes clear that Pat’s father’s

obsessions are actually focused on Pat. His father believes that Pat is a lucky charm and blames

Pat when their team doesn’t win the game. His father’s disorder is clearly stressful to Pat and

impacts his life. From this it can be inferred that the environment Pat was raised in affected him

negatively and, similarly to Mike’s environment, contributed in the development of his disorder.

Traumatic events. In this section, we discuss the stress related factors that contributed to

Pat’s hypothetical disorder. One traumatic event in particular haunts Pat throughout the movie,

his wife cheating on him. The 7th edition of the Essentials of Abnormal Psychology explains how

traumatic and stressful events such as that have been found to be related to the onset of bipolar

disorder (Durand & Barlow, 2016). For instance, negative stressful events trigger depression and

positive stressful events trigger mania. At first glance, this information doesn’t align with the

hypothesized diagnosis because Pat’s wife cheating on him was a negative event even though it

seems to have triggered a manic episode. However, Pat’s reaction to seeing his wife cheat on him

was not Pat’s first sign of

bipolar disorder. He told his
therapist that one week before
his wife
cheated on him he had the
delusion that his wife was
conspiring against him. Thus,
another
positive stressful event, such as
getting a promotion, could have
caused the onset of a manic
episode. Following the criteria
in the DSM-5 that a manic
episode lasts longer than one
week, Pat
would have been in a manic
episode during the time he
walked in on his wife with
another man
which lead to his violent
outburst, arrest, and
hospitalization.
Interaction of Factors
Although it would be much
simpler if only one factor
caused psychological disorders,
that is not the case. Pat Solitano
is a perfect example of how
biological, psychological, and
social
factors work together to
contribute to bipolar disorder.
The social factor of unjust guilt
instilled
on him by his father when their
team lost contributed to the
psychological factors of
feelings of
inadequacy and a negative
cognitive style. This negative
cognitive style, in combination
with the
biological factor of an
overactive behavioral approach
system mentioned in the 7
th
edition of
Essentials of Abnormal
Psychology, lead Pat to be
especially vulnerable to bipolar
disorder
(Durand & Barlow, 2016). So
much so, that when he
experienced stressful life
events, he was
unable to cope and became
manic. All three factors
contributed to the onset and
continuation of
Pat’s disorder. Hence, all three
factors must be examined to
diagnose Pat properly.
Conclusion
In conclusion, Pat Solitano
more than likely has bipolar I
disorder. This conclusion was
reached by using the
biopsychosocial model. This
model explains how the
integration of Pat’s
genetic predisposition,
psychological symptoms, and
stressful life lead to his
disorder.
was not Pat’s first sign of bipolar disorder. He told his therapist that one week before his wife

cheated on him he had the delusion that his wife was conspiring against him. Thus, another

positive stressful event, such as getting a promotion, could have caused the onset of a manic

episode. Following the criteria in the DSM-5 that a manic episode lasts longer than one week, Pat

would have been in a manic episode during the time he walked in on his wife with another man

which lead to his violent outburst, arrest, and hospitalization.

Interaction of Factors
Although it would be much simpler if only one factor caused psychological disorders,

that is not the case. Pat Solitano is a perfect example of how biological, psychological, and social

factors work together to contribute to bipolar disorder. The social factor of unjust guilt instilled

on him by his father when their team lost contributed to the psychological factors of feelings of

inadequacy and a negative cognitive style. This negative cognitive style, in combination with the

biological factor of an overactive behavioral approach system mentioned in the 7th edition of

Essentials of Abnormal Psychology, lead Pat to be especially vulnerable to bipolar disorder

(Durand & Barlow, 2016). So much so, that when he experienced stressful life events, he was

unable to cope and became manic. All three factors contributed to the onset and continuation of

Pat’s disorder. Hence, all three factors must be examined to diagnose Pat properly.

Conclusion

In conclusion, Pat Solitano more than likely has bipolar I disorder. This conclusion was

reached by using the biopsychosocial model. This model explains how the integration of Pat’s

genetic predisposition, psychological symptoms, and stressful life lead to his disorder.

Biological

Pat has overactive neurobiological responses to stress as a genetic predisposition to his condition
because his father shows signs of undiagnosed obsessive-compulsive disorder. The environment he was
raised in with his father’s disorder were stressful and had a negative an impact to his life. Which lead to
Pat’s negative cognitive style. When he experienced stressful life events, he was unable to cope which
triggered his mania. This explains how the integration of Pat’s genetic predisposition, psychological
symptoms, and stressful life lead to his disorder.

A biological factor is Pat’s overactive neurobiological responses to stress because his father shows signs
of undiagnosed obsessive-compulsive disorder which can be a genetic predisposition to his condition.
The environment he was raised in with his father’s disorder was stressful and had a negative impact on
his life. This social factor leads to a psychological factor in Pat’s negative cognitive style. He was unable
to cope with the stressful life events he experienced which triggered his mania. Pat’s genetic
predisposition, psychological symptoms, and stressful life contributed to his disorder.

A biological factor is Pat’s overactive neurobiological responses to stress because his father shows signs
of undiagnosed obsessive-compulsive disorder which can be a genetic predisposition to his condition.
The environment he was raised in with his father’s disorder was stressful and had a negative impact on
his life. This social factor leads to a psychological factor of Pat’s negative cognitive style. When he
experienced stressful life events, he was unable to cope which triggered his mania. This explains how
the integration of Pat’s genetic predisposition, psychological symptoms, and stressful life lead to his
disorder.

both OCD and bipolar disorder share some of the same biological factors with anxiety in general, such as
an overactive neurobiological response to

stress (Durand & Barlow, 2016). Consequently, if Pat’s father carries a gene putting him at

greater risk for anxiety, he could have passed that gene to Pat.

Pat and his father’s overactive neurobiological responses to stress predispose them to having disorders
but they have different disorders because of the different psychological and social factors they
experienced in their lives.

Social and Psychological

His father’s disorder is clearly stressful to Pat and

impacts his life. From this it can be inferred that the environment Pat was raised in affected him

negatively

The social factor of unjust guilt instilled on him by his father when their team lost contributed to the
psychological factors of feelings of inadequacy and a negative cognitive style.

He experienced stressful life events, he was unable to cope and became manic.

All three factors contributed to the onset and continuation of Pat’s disorder.

This model explains how the integration of Pat’s

genetic predisposition, psychological symptoms, and stressful life lead to his disorder.