GOVERNMENT COLLEGE UNIVERSITY, LAHORE

DEPARTMENT OF PSYCHOLOGY

SEEMAB FATIMA
1437-BH-PSY-19
ABNORMAL PSYCHOLOGY
MOVIE REVIEW
SUBMITTED TO
MAM AMNA ASIF

(SILVER LINING, JOKER)

May 8, 2022
 SILVER LINING
SUMMARY
Movies begins with the Pat (main character) being discharged off the mental hospital. He saw his
wife intimidating with the history teacher and went made on him. He was beaten to death by Pat.
He was caught up by the police and sent to the hospital by the court because was diagnosed with
the bipolar disorder. He spent 8 months there and then discharges but he was not recovered yet.
He pretended that he was well and taking medicines on time but actually he wasn’t, that why he
hadn’t recovered yet. His friend Danny was also discharges from hospital with. He talked a lot in
the way.
After coming back he started living with his parents in their house and they informed him that
his wife Nikki has left him and sold the department. He was very upset at this. He also lost his
job as a substitute teacher, he tried to get it back. But his first priority as to reunite with Nikki.
He had problems with sleep. All night he keeps awaking. While reading a book in a fine mood he
immediately got angry at something in the story and threw book out that broke the window’s
mirror. He went in his parent’s room at 4 am and starting talking continuously about the novel.
He usually gets hyper on little things. One morning he woke up his parents at 3 am because he
couldn’t find his weeding video. He gone mad and made a lot of noise that neighbors called the
police. Such incidence usually happened with Pat.
One day he was invited by his friend on the dinner, he was about to leave from the door because
he felt that he isn’t looking good for a dinner. But his fried brought him inside. There he met
Tiffany Maxwell, who was young widow. She was a recovering sex addict. He was a crazy girl.
Pat and Tiffany developed an odd friendship and pat found that she can be the source of his
contact with Nikki. Pat asked her to covey his letter to Nikki and she wanted him to be his dance
partner in the coming competition in return. He reluctantly agreed. He got a reply letter from
Nikki which he later found that it was written by Tiffany herself.
Everything was going well and then he went to the game show where his father bet the Eagles
would win. But there was a great mess and Pat beaten up men there. His father lost a lot of
money in bet. Then Tiffany came to his house and asked his father to bet on them that they will
score 5 in dance competition. They went to the competition. Nikki was also there. They scores 5
and his father won the bet. Pat went to Nikki, talk to him and then he left her and ran after
Tiffany who had left the place. He admitted that he love her and found that she had written that
letter. They then became a couple and lived happily.
CHARACTERS WHO ARE SUFFERING FROM MENTAL PROBLEMS
PAT SOLITANO
He was diagnosed with Bipolar 1 Disorder.
SYMPTOMS
 Elevated mood
He exhibited persistent elevated mood. When he met the teacher, he was highly excited. He
wanted to get his job back. He talked unstoppably and loudly. Similarly, another night he was
in an elevated mood. He completed book in few hours, and continuously changing his
positions and spent the whole night moving around, and reading book.)
 Irritability
He showed irritable mood various times. He threw book out of the widow that went out by
breaking the mirror. And he went to awake his parents at 4 am in morning and started talking
excessively and then started shouting.
At another need he was searching for his wedding video, he again made his parents to wake
up at 3 am that he couldn’t find that. He became violent. Searches for it in a mad manner.
Throwing everything on the floor, when his mother tried to stop him he pushed him and her
head hit on the floor, he fought up with his father and made a lot of noise, that police came
up to check.
Another example of this behavior is when he went to his therapist, his wedding song was
playing. That song triggered him and he had gone mad, threw things away and shout to shut
the song.
He also fought ruthlessly at the game show and ruined everything. These all are the examples
of hid irritable mood.
 Mood swings
He also had mood swings. While he was studying book in a calm mood, he suddenly get
hyper and elevated and then while taking about death in novel he gone depressed. He also
mentioned to his psychiatrist that he has mood swings and weird thinking that is brought on
by stress.
 Delusion
He also mentioned that he had delusions. He felt that he told the police when he saw history
teacher in his with his wife. But actually he didn’t told anybody, and started beating the
history teacher.
 Insomnia
He usually didn’t sleep at night and spent night in reading book, or searching for something
or just waking up and also don’t feel sleepy.
 Worthlessness
 We also get an evidence of his feeling of worthlessness or low self-esteem, when he went to
dinner and came back from the door by feeling that he may is not looking fine for the dinner.
He isn’t dressed up in the right manner. He wasn’t also confident about doing dance.
DSM 5 CRITERIA
For a diagnosis of bipolar 1 disorder it is necessary to meet the following criteria for a manic
episode. The manic episode may have been preceded by and may be followed by hypomanic or
major depressive episode.
Manic episode
Criteria A is fulfilled, according to which an individual exhibits persistent elevated and irritable
mood and increased goal directed energy. We have seen various incidents of elevated and
irritable moods as mentioned above. He also had increased goal directed energy. His goal was to
get his wife back, and he tried very hard to get her back.
For diagnosis three or more of the following symptoms of Criteria B are required to meet. In
case of Pat, he exhibit these symptoms including:
 Inflated self-esteem (we get this evidence when he headed back from door of his friend as
he felt he is not looking good for dinner, he was also not confident for dance
competition).
 Decreased need for sleep (he had this symptoms as he usually spent nights by reading
book or doing some other activity and didn’t sleep much).
 More talkative than usual (it happened a lot with him. One night he talked unstoppably
when telling their parents about novel, and also talked a lot when he met teacher. He
usually talked more than normal).
 Increase in goal-directed activity (his goal was get reunion with his wife and he showed
increased energy and activity towards this goal).
As more than three symptoms of this Criteria are met so diagnosis can be made.
Criteria C is also met because this disturbance caused marked impairment in his social, personal
and occupational life as he lost his job and his wife due to disorder. And he was also hospitalized
to prevent harm to others. Because before hospitalization he beat the history teacher to death. He
usually got aggressive as he hit his mother and did fight with his father.
Criteria D is also met because his symptoms was not because of any other medical condition or
substance use.
Major depressive episode
He showed some symptoms of criteria A of depressive episode as he lost significant weight (A3),
he showed insomnia as he felt reduced need for sleep (A4), and he exhibit criteria A7, which
includes feelings of worthlessness, delusions sometimes and guilty about being sick as he said
that “I hate my illness and I want to control it”.
For the diagnosis at least five symptoms should be met and these symptoms should case
significant impairment in normal functioning. But in case of Pat these were not very severe
enough to cause impairment.
He didn’t show the enough symptoms of major depressive episode required for diagnosis.
Because he mostly showed elevated moods. Major depressive episode are common among the
patients of Bipolar 1 disorder but it is not required for the diagnosis of this disorder. In case of
Pat of silver lining the criteria was bipolar 1 is met but without the major depressive episode.
TIFFANY MAXWELL
Tiffany was a female lead character in the movie. He also showed various problems with his
personality. He shows hyper sexuality and mood swings. He sometimes seemed depressed also.
She exhibited some symptoms of Borderline personality disorder. Let’s have a look whether she
met the criteria for this disorder or not.
Borderline personality disorder
DSM 5 Criteria
Criteria A shows that a person should have pervasive pattern of interpersonal relations, self-
image and have marked impulsivity. For the diagnosis, at least five symptoms of this criteria
should be met.
Tiffany exhibited following symptoms.
 A pattern of intense and unstable interpersonal relations. There was intensity and
instability in her relations. While at dinner she immediately start fighting with her sister
and left from there. She then Chased Pat and wanted to be friend with him. Despite of
unwillingness of Pat, she insisted to be with him and showed intensity of relationship
with him. His relations was unstable. At one time she showed intensity and the other
moment she slept the Pat and left.
 She exhibited impulsivity in the area of sex that was potentially damaging. She was
hypersexual and had sex with every men of his office.
 Affective instability due to marked reactivity of moods. She showed irritably. She had
severe mood swings. When she went to restaurant, she was calm and suddenly she
became irritable and fell the contents of table.
 Chronic feelings of emptiness. She also usually exhibited emptiness feelings. He
mentioned to the Pat “when I wake up I feel empty! And I have nothing!”
 Inappropriate intense anger and difficult controlling anger. Tiffany found to be very
aggressive throughout the movie. She got angry in restaurant and couldn’t control it and
even she started shouting that Pat is harassing her. Then later she herself saved him from
police. She also slap Pat when she got angry.
As she has met five of these symptoms from criteria A for significant time period so she can be
diagnosed with the borderline personality disorder.
POSSIBLE CAUSES
PAT
There are the various causes of bipolar disorder. In the case of pat, the combination of various
factors lead him to develop bipolar disorder. These factors are given below.
Genetics:
Genetics played an important role in making him aggressive and bipolar. His father was also an
aggressive person and had mood swings. His father had OCD which also increase prevalence for
mood disorders. So he also inherent such temperaments. When these factors were triggered by
environment, he developed the disorder.
Role of neurotransmitter:
Many neurotransmitters are linked to the bipolar disorder. Specifically, dopamine, serotonin and
dopamine are involved. Imbalances in these chemicals causes manic and depressive episodes.
These were triggered by other environmental factors and caused mania in Pat. He was also
prescribed to take medicine to regulate the balance of neurotransmitters.
Psychological and social factors:
His life experiences also trigger this. First of all family environment where his father has
problems with moods and temperaments. Moreover there were problems in his married life. He
got intense stress when he saw his wife having sex with another man in his house. He had beaten
that man to death. This stress also proved to be a triggering factor. Moreover health and sleep
also play role. He has insomnia and feel reduced need for sleep.
All these factors collectively can play role in the development and maintenance of disorder.
TIFFANY
In the movie, there was not much focus on the life of tiffany so we cannot get the evidence of
any prominent causes of her problematic personality. But she mention one factor. She loved her
husband who was killed. And after the murder of her husband she developed the borderline
personality. So the stress of his husband’s death and loneliness afterwards played a role in
development of personality disorder.
4Ps MODEL FOR PAT’S BIPOLAR DISORDER
4Ps FACTOR BIOLOGICAL PSYCHOLOGICAL SOCIAL
MODEL

Predisposing Genetics Aggressive behaviors Social factors may

His father had OCD. due to genetics. involve his family
Problems so environment in which
inheritance serves as father exhibit mood
a predisposing factor. problems. Moreover
there were problems
 in n his marriage. His
wife cheated on him.

Precipitating Imbalance of Stress due to betrayal

Neurotransmitters. of his wife and loss of
his job.

Perpetuating His careless behavior Stress due to absence

towards intake of of his wife. Joblessness
medicine.
He didn’t take any Not wanting to get rid Relationship
medicines, when he of this part of his problems
was given in personality.
supervision he He said that he didn’t
pretended that he had like his disorder but
taken medicine and sometime she enjoyed
then he threw it that energy and said I
away. like the way I am.

He wanted to treat
himself by love rather
than medicines.
Protective Regular intake of Psychotherapy that he Social supports from
medicine. used to take. family and friends.

Cognitive behavior Developing love

therapy relationship with
tiffany.

4Ps MODEL FOR TIFFANY’S BORDERLINE PERSONALITY DISORDER

4Ps FACTOR BIOLOGICAL PSYCHOLOGICAL SOCIAL
MODEL

Predisposing substance use Unknown Unknown

Precipitating Stress of his husbands

Alcohol intake murder Loneliness
Joblessness
Anxiety due to
loneliness and
joblessness
Perpetuating
Hyper sexuality and Lack of close
emptiness. interpersonal
She felt empty. She relations.
was very upset
because she had to do Continuing excessive
the sex with sexual relationships.
everybody in office to
maintain her job.

Lack of any therapy.

She said that she
liked her crazy
personality and she
didn’t wanted to get
rid of it.

Protective Feelings of happiness

by having friendship Loving relationship.
with Pat and having
loving relationship Social support.
with him.

Successful dance
competition.
 JOKER
SUMMARY
The move is about a young mam Arthur Fleck, who is a mentally ill lonely man who aims to
become a world’s famous stand-up comedian. In the beginning of film, Arthur is doing the job of
a hired comedian. He has to hold a sign and dance. Some young boys snatch his sign and run
away. He runs after them and they break the sign over his head and beat him wildly.
He went to a therapist for his medication and ongoing health issues. While going back to the
home. A child in bus starts looking at him and he started making silly faces, then he suddenly
started laughing hysterically. The mother of that child questions him and he hands her a card on
which it is written that he has a medical condition that makes him laugh the way he does.
When he returns back to the workplace, his coworker givens him a gun to protect himself. He is
then confronted by his boss who scolds him for losing the sign board and asks him the he will
deduct the money from his pay.
He goas back to home, where he is watching TV show of Murry Franklin with his mother. He
imagines himself being on the Murry’s show and getting his attention. In his fantasy, he
imagines that he is amuses the audience on the show, Murry calls him on the stage and they
greeted each other.
One day he meets a young single mother, named Sophie. The next day he follows her. He invites
her to attend his comedy show. Arthur goas to the stage for performance, he becomes nervous
and starts laughing so that that he can barely speak and then he starts narrating jokes. Sophie
laughs on jokes.
Arthur goes to the children hospital to entertain then as a clown. While performing his gun falls
down. He is fired from his job for taking gun to the hospital. While he is returning back, he sees
that some boys harassing the girl in the bus. Suddenly his laughter begins, the boys think that he
is laughing on them and start beating him. He tries to explain them that he has a medical
condition of laughing but the boys keep on bating. He puts his gun out and shoots all three
wealthy boys mercilessly. The news spread like fire. Thomas Wayne condemn it and call the
lower class as “clowns”.
Arthur reads her mother’s letter to Thomas Wayne and get to know that he is his son. He goes to
see him when he is informed that his mother is a crazy women. Then in an events he confronts
Thomas and says that I know I am your son. He refuses and says that Penny was her
housekeeping staff and there is no change of him being his son. He further tells that he is not the
real son of penny, he adopted him. Arthur doesn’t believe him and goes into laughing condition.
Thomas is unaware of his medical condition and slaps him by saying that it isn’t funny. Arthur
returns home and tortures himself by slamming his head and putting himself in refrigerator.
The other day he receives call from Murry’s show to come as a guest. He rehearses for the how.
He repeatedly rehearse his entry and his postures and thinks that he will act to commit suicide in
front of live audience, believing that it will seem funny.
Then in order to get the proof of his mother’s mental illness, he goes to the mental asylum, where
he ran with his mother’s file. In which he read that he has a delusional and psychosis and
narcissistic personality. He further gets to know that penny adopted him. And her boyfriend
abused Arthur then he was child and Penny allowed her adopted child abuse. He was an
abandoned child. After beaten by Penny and her boyfriend he had a head injury, which caused
his laughing conditions. He return to the hospital where penny is admitted and he kills her.
On return he goes to the Sophie’s home and starts talking him, on which she asks him to leave
and says that she doesn’t know him. That reveals that all his moments with Sophie was the part
of his hallucinations. In reality nothing like that happens.
When Arthur is getting ready for the show Randall comes to his apartment for the condolence of
his mother’s death. He picks knife and stabs him twice in the face and then smash his head
against the wall.
At night he goes to the Murry’s show. He enters by making funny postures. He narrates a jock
from a dark humor. Then he mentions that he killed those three boys. He says that people like
Thomas only speak for wealthy boys and no one cares for a clown like him. Murry gets angry
and scolds him. Then he shoots Murry straight on his head. Audience runs away, then he shoot
him again. Police arrests him. Clowns come out for protest. One clown kills Thomas and his wife
in front of their little son Bruce. The crowd puts the police’s car on fire. Arthur get injured and
goas unconscious. When he awakes he finds himself surrounded by the mob of cheering
mobsters in the clown masks. He starts dancing in front of them and spread his blood running
from nose around his lips and grins. He elevated like a god.
In the end, he is in the asylum in front of a therapist. He visualizes little Bruce whose parents are
killed in front of him. He thinks that he has turned the Bruce into himself them he laughs. We
wants to tell the therapist a joke but he resisted. He kills and gets out of the room and his
footprints leaves the blood on the white floor.
MENTAL DISORDERS EXHIBITED BY ARTHUR:
Arthur has exhibited a complex personality with the variety of symptoms reflecting multiple
mental disorders. He has shown the multiple symptoms of the disorders including pseudobulbar
affect, which is a neurological condition, narcissistic personality disorder, antisocial
personality disorder, delusional disorder, and brief psychotic disorder. He may not fulfil the
complete criteria of these disorders but he exhibits some of the symptoms of all of these
disorders.
PSEUDOBULBAR AFFECT
It is medical condition that consists of uncontrollable outbursts of laughter or crying
inappropriate to the patient’s external circumstances and incongruent with the patient’s internal
emotional state.
It is caused by traumatic brain injury. Arthur was abused by his Penny and her abusive
boyfriend in the childhood that lead him to develop a traumatic brain injury due to which he
developed this neurological disorder.
 Arthur showed the symptoms of this disorder because he repeatedly had the sudden
outburst of laughing and crying throughout the movie.
There are multiple incidents where we have seen the display of this disorder. Some of these
incidents include:
o His travel in bus when he tries to amuse child, he displayed into the sudden outburst
of laughter.
o He exhibit this during his session with therapist.
o While sitting in train when he saw three boys harassing a women.
o In his workplace when after his coworker gave him the gun.
o During his confrontation with Thomas Wayne.
o During his performance, when he was about to begin his speech.
o When he get to know about his mother’s reality.
o In the last scene when sitting the asylum.
Similarly in various places he experienced the sudden outburst of crying, when he was doing
makeup for clown, when he was writing his dairy, when he was getting ready for Murry’s show
and usually while smoking.
 The condition can be embarrassing and disruptive to the daily life. His spells of
laughter was embarrassing for him as he got embarrassed due to his laughter when he
was about to start his performance on the show. People laughed on him. They made fun
of him. It was also disruptive for this condition of his caused a lot of trouble for him. He
was beaten by other many times because they perceive his laughter as intentional. It
created a lot of problems for him.
 This crying and laughing is incongruent with patient’s mood and emotions. Whenever
he laughed or cried he didn’t actually feel like that. Various times he hated his laughter.
He wasn’t internally when he broke into episodes of laughter.
 These spells usually occur in response to some triggering factor. We have seen that
various times when he is anxious or sad, these outbursts of laughter occurs. As we have
seen its display when he gets upset by seeing boys teasing the girl, when he confronts
Thomas and he told that he is adopted child, when he known about the reality of his
mothers and when he gets fired from the job. All these are the triggering events of
these laughter outbursts.
NARCISSISTIC PERSONALITY DISORDER
It is a personality disorder characterized by an exaggerated sense of self-importance, a need for
admiration, and a lack of empathy for other people. The character of Arthur seemed to be a
narcissistic as he always believed that he was the best comedian, and always fantasized that he
has been admired by audience and his acts of vicious killings exhibit that he lacks empathy for
others.
Symptoms according to DSM 5 Criteria
 He exhibits the pervasive patterns of grandiosity (as he believed that is the great
comedian. He also mentioned “I am an undiscovered comedic genius”). He exhibits the
need for admiration (as he always wanted to be the center of attention, he imagines that
he is in the Murry’s show and captures the spotlight, host calls him on stage and praise,
he always wanted to be on shows and immediately agreed when called on the Murry’s
show and he has lack of empathy by the others (as he mercilessly killed three young
boys, and killed his mother on the hospital bed, he wildly killed Randall and Murry).
For the diagnosis five of the following symptoms of this criteria should be met. He exhibited
these symptoms as:
o He had grandiose sense of self-importance because he considered him the best and
wanted to be admired. (A1)

o He was preoccupied with the fantasies of unlimited success, power and ideal love. He
fantasize the he is in the spotlight, receiving attention. He was also preoccupies with the
fantasies of love of Sophie. He never met her actually, but he imagined kissing her,
talking to her, spending time with her and she being giving importance to him. (A2)

o He required the need for excessive admiration as mentioned and explained above.
(A4)

o Lacks empathy for others. His lack of empathy is evident from the number of murders
he performed as mentioned above in the criteria. (A7)

o He was envious of others and other are envious of him. He wanted to take the place of
other comedians on the TV. He believed that people are jealous of him therefore they
devalue him and have been rude to him. He believed that all people are awful who don’t
like his kind of people and they have no right to live.
So he fulfilled the criteria for narcissistic personality disorder as we get various evidence of these
symptoms from the movie.
ANTISOCIAL PERSONALITY DISORDER
Arthur also meets some symptoms of antisocial personality disorder.
DSM 5 CRITERIA
According to the symptoms mentioned in DSM, Arthur exhibits the following symptoms.
  Criteria A indicated that there is a pervasive patterns of disregard for and violation of
rights of others. We will see through the following symptoms that how he shows
disregard for the rights of others.

o Failure to conform to social norms with respect to lawful behavior as

indicated by repeatedly performing acts that are grounds for arrest.
This symptom was present in Arthur as he repeatedly performed the acts that were
illegal and set the grounds for arrest. These acts include killing his mothers, three
boys, his coworker, and Murry, and bringing gun to the children hospital.
o Irritability and aggressiveness as indicated by physical fights ad assaults.
He also shows this symptoms as he usually get involve in physical fights. In the
beginning he had a fight with the boys who ran after stealing his sign board, with
the the person who told him that his mother is crazy and with boys in the train, who
harassed the girl.
o Reckless disregard for safety of self and others.
He wasn’t concerned about safety of his and others. He usually tortured himself by
smashing his head against wall, punching to the metal, and hitting his head in the
mirror. He also hit and beat others.
o Lack of remorse.
He had no guilt for his wrong doings. He wildly killed 6 individuals including his
mother but he had no feeling of remorse, infect he felt happy after doing this and
genuinely laughed at it.
 Criteria B is fulfilled as it says that the individual must be of at least 18 years and he was
above 18 years old.
 Criteria D is fulfilled because his antisocial behavior was not exclusively during the
course of schizophrenia and Bipolar because he exhibit none of these disorders. \
As more the three symptoms of Criteria A are present and other criteria is also present so we can
also make the diagnosis of antisocial personality disorder.
BRIEF PSYCHOTIC DISORDER
He also displayed some of the symptoms of brief psychotic disorder.
DSM Criteria
A. Presence of one or more of the following symptoms including delusion, hallucination
and disorganized speech.
  Delusions
Arthur has delusions that Sophie loves him and she appreciated his work (delusions
of love). In his head he went to her home and kissed him. He also have the delusions
that he is a great comedian and people should admire him and in the last scene he felt
himself like the greatest one the way he was standing elevated (delusion of
grandiose).
 Hallucinations
He had hallucinations as saw Sophie in elevator and in the show where he is
performing. He had hallucinations that she was there with him when his mother was
in hospital. But in reality she was never with him.
B. Duration of the disturbance is at least one day but less then few months, with
eventual full return to the premorbid functioning.
He showed this disturbance for some days and then he realized that it was not reality when
actually went to Sophie’s home and she denied to recognize him. Then he came back to
reality.
C. Criteria C is also met because this disturbance is not better explained by major
depressive and bipolar disorder with psychotic features and also not by schizophrenia and
catatonia. Because Arthur didn’t exhibit any of these psychotic disorders so the only
condition that can explain his delusions and hallucinations for a brief period of time is
just brief psychotic disorder.
POSSIBLE CAUSES
For pseudobulbar affect:
For this medical condition the cause is very obvious and it is the traumatic brain injury and
this is a neurological disorder. Arthur had a traumatic brain injury in the childhood and after that
he developed this medical condition.
Because of the child abuse various body parts were injures, he was also tortured and his brain
was injured.
For narcissistic personality disorder:
 Genetics
There is no evidence for having any effect of genetics because he was an abandoned child and no
information about his biological parents is known.
 Environmental factors
Environment can play a role in the development of this disorder.
Home environment: he was an adopted child. He lived with the penny who adopted him. She
had narcissistic personality so he was brought up by the narcissistic mother. So her personality
could have contributed in his development of narcissistic personality disorder because children
imitate their caregivers, observe them and borrow some aspects of their personality.
Lack of father figure: he was brought up my single parent. He missed the affection of father.
Abandoned child: he was not brought up by his real parents. They abandoned him and he was
adopted by Penny. Penny also didn’t took a good care of him. She along with her abusive
boyfriend abused him. This abandonment can lead to the excessive desire for the admiration.
Child abuse: he was abused in the childhood. He was badly beaten up by his mother who let her
adopted child to be abused. He was injured and has brain injury too. She used to tie him with
radiator. So his childhood was very traumatic. This can lead to the development of lack of
empathy in him.
Low socioeconomic status: he also lived a poor life. He was not a privileged child. His needs
and desires were not fulfilled.
Moreover because of his laughing condition he was always embarrassed by the others. Many
people got aggressive on him because they perceive that he is making fun of them. Many beat
him and make fun of him. So he lived a life in which he wasn’t liked by anybody, people hated
him and had always been rude to him. He lived a very unwanted life.
All these factors made him love his own self as others don’t love him, he developed desire
for admiration and everyone’s rudeness and abandonment reduced empathy from himself
for other.
For antisocial personality disorder
 Family history
As it has already mentioned that inherited family history is not known because Arthur was an
adopted child. So there is no evidence of his biological parents having any mental disorder.
The lady who adopted him, had personality and delusional disorders. So the family in which he
brought up had the problems of personality disorders. It has nothing to do with the genetics but
the mother figure’s personality plays the role in shaping the child personality.
 Childhood trauma
Childhood trauma plays a very important role development of antisocial personality disorder. the
children who had experienced abuse, or mistreatment in the childhood, they grown up as less
empathetic and have less regard for others as the world hasn’t been very kind to them.
Arthur also experienced abuse in childhood, mistreatment from Penny and was tortured. This
trauma played a very important role in his development of antisocial personality.
 Social and environmental factors
He grown up in the low socioeconomic status that also contributed in his less regard for other’s
right. Such people are abandoned by the society and their desires and needs are unfulfilled.
Moreover he was also an abandoned child, his actual parents abandoned him in early childhood.
So the treatment that was given to him wasn’t kind and empathetic, turning his personality into
violent and non-empathetic.
Furthermore, due to his laughing condition, people always made fun of him, and abuse him.
Many people used to beat him for laughing which wasn’t under his control. He also spent his life
by being embarrassed of his laughing outburst. People had always been rude to him. They used
to beat him, embrace him and make fun of him for something that was not in his control. He has
lived a life in helplessness. People never understood that he had a neurological disorder.
A lot of mistreatment turned his personality into aggressive and violent, leading to the
development of antisocial personality disorder.
Causes for brief psychotic disorder
There are multiple causes for brief psychotic disorder including stress, trauma or presence of any
personality disorder.
Stress and trauma
This brief psychotic episode occurs mostly under some stress or in respond to any trauma. His
life was no less than a trauma. He had lived a traumatic childhood. He experienced child abuse.
And at the time when this episode occurred, he had recently experienced the stress of losing the
job, badly beaten up the group of boys and people making fun of him. So he started having
delusions that some Sophie loved him and he experienced hallucination for her presence. So
stress and trauma is the major cause.
Presence of any other personality disorder
Researches has revealed that the people experiencing some kind of personality disorders are at
the high risk of developing brief psychotic disorder. Because they are struggling to manage the
symptoms of these disorders and the psychotic episodes take place as effective coping skills. As
he was suffering from narcissistic and antisocial personality disorders. So in order to the
compensation, the brief psychotic episodes occurred.
4P MODEL
4Ps FACTOR BIOLOGICAL PSYCHOLOGICAL SOCIAL
MODEL

Predisposing Traumatic brain Child abuse Low socioeconomic

injury in the Childhood trauma status
childhood and abandonment.
Raised up by single
Pseudobulbar affect, Rudeness of people parent who was also
which is a towards him. not his biological
 neurological disorder. mother. She adopted
It also contributed in Because of his him.
his development of laughing condition
personality disorders. many people make Abusive home
fun of him. environment in his
childhood.
Embarrassment and
feeling of low self- He was brought up
esteem due to this by the mother who
medical condition. was delusional and
narcissistic.

Precipitating
His neurological Stress of losing his Joblessness
disorder of job.
uncontrolled Lack of loving
laughing. Felling of shame and relationship.
embracement when
Substance abuse he couldn’t control Lack of acceptance
laughing while by the society.
performing.
Illness of his mother.
Criticism by the
Thomas Wayne on
his poor comedy.

Lack of admiration
and praise.

Perpetuating
Continuing His laughing Cruelty imposed by
neurological disorder. condition didn’t allow society.
him to recover his
shame. People keep Unacceptance of his
Substance use on making his fun clown identity by his
due to this medical community.
Excessive intake of condition. This
medication. continuing disorder Poor interpersonal
didn’t allow him to be relationships.
accepted by society.
Continuously keep on Painful revelations by
beaten by the people society.
due to uncontrollable
laughing.
Lack of social
 Stress and trauma of support.
knowing that he is
adopted child. And Therapist reduced to
the lady who adopted help him further.
him was delusional
and narcissistic. He His criminal acts of
couldn’t relax and killing others also
bear when he got to gave him joy that
know that his mother served as a
along with her reinforcing factor for
abusive boyfriend him.
tortured him in the
childhood.

Along with all the

other factors
including stress due
to his poor financial
status, illness of
mother, disapproval
by society and
criticism on work, the
knowing about his
adoption and
childhood abuse was
intolerable.

These painful
revealing and
dealings of society
didn’t allow him to
recover from his
personality disorders.

Discontinued therapy.
Protective
Abandonment of Proper and regular Social support.
substance use. therapy.
Improved financial
Treatment of Love and acceptance status.
traumatic brain by society.
injury. Acceptance and
admirations by
Proper medication. society.

Making him believe

 that he is a good
comedian.

Good job
opportunities and his
performances in his
favorite shows.

PENNY FLECK
Penny fleck is another character in the movie who exhibits the mental disorder. She exhibits
delusional and narcissistic personality disorder. And from the movie we get an evidence of his
behavior that reflects delusions and narcissistic personality.
Delusional disorder
She had some symptoms of delusional disorder.
 There was the presence of delusions. She said that Thomas Wayne was his husband and
they had a son Arthur. She had also written a letter for Thomas in which mentioned “I
and your son need you”. Whereas in reality she worked as a housekeeper for Thomas and
he never married to her. And Arthur was also her adopted son, but she believed that he
was her real son.
 The symptoms was not because of schizophrenia.
 The disturbance was not attributable to the physiological effect of substance abuse
and anther medical condition.
Narcissistic disorder
As it was mentioned in movie that she also had narcissistic disorder. One symptoms was obvious
through his treatment that was lack of empathy. As along with her boyfriend, she allowed his
adopted son to be abused. She used to torture the little child. She used to tie him with radiator.
This indicated her lack of empathy for others.