OPUS Spring 2017
Letter from the Editor
Staff Articles
- Managing Mental Health in the Primary Care Sector
- An Interview with Dr. Joshua Aronson
- An Interview with Dr. Elise Cappella
- Childhood Emotional Abuse and Borderline Personality Disorder
- Split: A Review and Its Unexpected Merit
- The Influence of Leadership Style on Individuals’ Satisfaction on Small Teams
- The Impact of Postpartum Depression on the Mother-Child Relationship
- Don’t Worry, But Don’t Just Be Happy
- Teachers’ Use of Positive and Negative Feedback: Implications for Student Behavior
Krista Morgan
Producer Jonas Rivera and director Pete Docter’s (2015) animated movie Inside Out depicts our working minds through five personified emotions (i.e., Joy, Sadness, Fear, Disgust, and Anger) and addresses the large misconception that happiness is the key to having a fulfilled life. Inside Out follows the challenging transition and difficult adjustment the main character, Riley, an 11-year-old girl, experiences as she moves from her hometown in Minnesota to San Francisco, California. The film’s conclusion reveals the moral of the movie: sadness is an important and necessary emotion for us to experience, and that failure to acknowledge this can lead to problems in mental health, such as adjustment disorder (AD). Though adjustment disorder is not often mentioned or represented in popular culture, Rivera and Docter (2015) accurately portrayed the disorder in Riley throughout the film as her symptoms match the clinical criteria, and various cinematographic methods visually capture her struggles.
Until the release of the most recent Diagnostic and Statistic Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) and the International Classification of Diseases (10th ed.; ICD-10; World Health Organization, 1992), the criteria for adjustment disorder had been somewhat vague and, consequently, difficult to differentiate from other psychiatric disorders, such as conduct disorder (CD) and major depressive disorder (MDD; Casey & Doherty, 2012). Presently, adjustment disorder is characterized by emotional or behavioral symptoms that are instigated by an identifiable external stressor; the stressor must incur symptoms within three months of onset and last no longer than six months. These symptoms include marked distress that is disproportional to the severity of the stressor; inflicts significant social, occupational, or other impairment; and is not indicative of any other mental disorder or normal bereavement (American Psychiatric Association, 2013). Rivera and Docter’s (2015) film can be critically examined for adjustment disorder by using the current set of diagnostic criteria as a psychological lens through which to view the movie.
Upon first arriving in San Francisco, Riley and her family try to remain optimistic about their new home and community (Rivera & Docter, 2015). Despite these efforts, Riley becomes distressed from the move and
experiences extreme difficulty adjusting to her new home. Riley experiences impairment in school (i.e., inability to make friends) and hockey (i.e., inability to enjoy playing in a new environment), unnecessary agitation and acting out at home, and inability to control her emotions in various environments (i.e., lashing out at hockey tryouts, crying at school, resenting her friends from Minnesota). This is further reinforced as Riley transitions from wearing bright, seasonally appropriate clothing to hiding behind layers of black and grey clothes (Rivera & Docter, 2015)—a change that can be indicative of depressed mood (Karp, 1994).
Riley’s symptoms, which begin within the first three months of the move and last no more than an additional six months after, are indicative of a problem greater than typical child or adolescent mood swings or defiant behaviors, as the level of Riley’s distress is disproportionate to the severity of the distressing event (American Psychiatric Association, 2013). Riley seems to meet the criteria for someone suffering from adjustment disorder, according to the DSM-5 (American Psychiatric Association, 2013) and the ICD-10 (World Health Organization, 1992). While both AD and MDD specify depressed mood as a central component for diagnosis, we can differentiate Riley’s condition from MDD because her condition was triggered by the psychosocial stressor of moving to San Francisco (Doherty, Jabbar, Kelly, & Casey, 2014). All of these symptoms are contrary to Riley’s normal behavior and support the argument that she suffers from adjustment disorder in the film.
Renowned developmental psychologist Erik Erikson defines the adolescent period, ranging from ages 11 to 18, as the time when adolescents search for their identity in cultural, personal, communal, and individual contexts (Erikson, 1970). In an attempt to maintain her identity, Riley makes an effort to find a role to fill in her community by trying out for her local ice hockey team, but ends up storming off the ice out of frustration and anger (Rivera & Docter, 2015). Since hockey had always been important to Riley, this failed attempt to fit into her new social atmosphere caused Riley to feel that she had lost an important part of her identity and to take her rage out on her parents. This stage in psychosocial development made Riley more susceptible to developing adjustment disorder.
Young people may often behave delinquently or rebelliously as they attempt to create a firm sense of identity by experimenting with different roles, and, consequently, finding new emotional outlets (Murdoch Childrens Research Initiative, 2015). Parents are often the ones who are most affected by their child’s search for self, as the young adult fights back against rules and rigidity set by the parents (Murdoch Childrens Research Initiative, 2015). Though this tension between child and parents is normal, Riley, at the age of 11, is just beginning to enter this stage of development and is not behaving developmentally appropriately in the film. This is evident in how she is suddenly defiant against her parents, despite their efforts to do what they can to make San Francisco as enjoyable for Riley as possible (Rivera & Docter, 2015). Here, we can delineate AD from CD because in CD there is the assumption of underlying psychopathology that leads the child to behave defiantly, while in AD, a psychosocial stressor underlies the child’s deviant behavior (Cramer & Kelly, 2004).
Inside Out focuses on the impact mental health can have on children’s emotional development when it comes to social contexts disrupting the innocent joys of childhood abruptly (Rivera & Docter, 2015). Society places pressure on individuals to always be positive and happy, placing an unrealistic ideal that consequently stigmatizes sadness and mental health disorders rather than appreciates the potential value they bring. Rivera and Docter (2015) represent this juxtaposition through the tension between Joy and Sadness, each struggling to find a balance in Riley’s mind. As adolescents mature, they begin to experience deeper versions of such negative emotions that can be very difficult to acknowledge (Murdoch Childrens Research Initiative, 2015). Rivera and Docter (2015) and Erikson (1970) demonstrate that while it is not easy to feel deep versions of these emotions, it is critical for adolescent social emotional development to experience and learn to balance.