10 commonly used psychological assessments

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Sometimes, meeting with a client in therapy isn’t enough for a therapist to know what is going on. You are seeing someone out of her regular context, moved into a intrusive (though supportive) environment. You aren’t the same self in therapy as you are the rest of the time, so it can be good to get a closer look at traits and symptoms. If your therapist needs more insight into your situation, he might request that you take one or a series of assessments. Following are some of the most widely used ones.

1. Clinical interviews

Clinical interviews are a series of set questions that focus on any symptoms you may have, helping the clinician better assess if you have a diagnosable disorder. During the interview, you will be asked open-ended questions. The interviews generally last between 30 minutes and two hours. Sometimes, the clinician that is administering the test will assess 

attitudes, appearances and behaviors in order to 

supplement the verbal answers given.

2. Screening inventories 

A screening inventory is an assessment that is looking at client symptoms and distress. They can be used both to diagnose mental illnesses and to look at therapy progress and outcomes, depending on the test and context you are taking it in. For instance, the Outcome Questionnaire-45 (OQ-45) can be used before each session to check in on where the client is at. The Beck Depression Inventory (BDI) might be used to get a better handle on a client’s depression symptoms. The Symptom Checklist-90-R (SCL-90-R) might be used to look at a number of symptom clusters while conducting a psychological study. There are a wide variety of tests to suit many purposes.

3. Rorschach test

The Rorschach test (also known as the inkblot test) is perhaps the most famous psychological test of all time. It is a projective assessment wherein the subject is shown a series of symmetrical images created by ink on paper. The subject says what she sees in the images and the test administrator will write down everything, no matter how trivial it may seem. These statements are later interpreted in regards to personality, emotional functioning and to detect thought disorders. 

4. Thematic Apperception Test (TAT)

The TAT is another projective assessment. In this one, the subject is shown ambiguous images of people. The client will tell the proctor stories about the individuals the pictures, which can be interpreted in a multitude of ways. This test is considered a glimpse into the subconscious and the way people see the world. It has been used to study a variety of items, such as motives, concerns, personality and emotional stability. 

5. Rotter Incomplete Sentence Blank (RISB)

A third commonly used projective test is the RISB. In this assessment, the subject is given a list of 40 sentence stems, or incomplete sentences. These are deliberately vague and encompass such phrases as, “I need…,” “Other people…” and “My greatest fear…”. The subject simply completes the sentences however he wants. There is not much in terms of standardized scoring, but themes will emerge, such as a preoccupation with ones appearance or social anxiety. These can help the therapist better tailor treatment to areas of concern. 

                                                                                                                   6. Wechsler Adult Intelligence Scale (WAIS)

   

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The WAIS, currently in its fourth edition, is an intelligence test. It measures raw intelligence and gives you an IQ score. The average IQ is 100. It focuses on a variety of areas, including working memory, processing speed, arithmetic and vocabulary. It has questions ranging from picture completion to finding similarities between words. This test measures your aptitude, not how well you are actually doing in the areas tested.

7. Woodcock-Johnson Tests of Cognitive Abilities

The Woodcock-Johnson, in contrast to the WAIS, is made to measure cognitive performance. It shows how well you actually do in the areas of math, reading and writing. You may score higher or lower than your actual IQ would indicate; for this reason, it can be useful in identifying learning disorders. 

8. Minnesota Multiphasic Personality Inventory (MMPI)

The MMPI is the most commonly used psychological test. It is used to assess personality and psychopathology. Depending on the version of the test you take, you answer either 338 or 567 true or false questions about yourself. This is used to gauge your level of pathology in areas such as depression, hysteria and paranoia. Based on the areas you have the highest scores in, a portrait of your personality and psychological issues can be made. There is also an adolescent version of this assessment, the MMPI-A, which is 478 items long.

9. Millon Clinical Multiaxial Inventory (MCMI)

Used strictly to assess psychopathology, the MCMI does not tell you about personality in the same way the MMPI does. It has a clear focus on psychological symptoms, as it identifies personality disorders and clinical syndromes. It is, however, much shorter than the MMPI, only having 175 true or false questions that can generally be answered in 25-30 minutes. The adolescent version of this assessment is called the Millon Adolescent Clinical Inventory (MACI) and is 160 items long.

10. Child Behavior Checklist (CBCL)

This test is designed to be used with minors, starting as young as 18 months of age. A parent or caregiver takes the test and reports social, behavioral and emotional observations of the subject. There are also versions of the test that can be filled out by teachers or the youth themselves. The assessment asks how true certain statements are, such as “talks or walks in sleep” or “acts too young for his/her age.” Because parents and teachers have higher access to the youth than the therapist does, it can be helpful to get input from someone used to seeing the child in other settings. 

Have you taken any psychological assessments? Did you learn anything interesting about yourself? Talk about it in the comments. 

Diagnosis spotlight: anorexia nervosa

   

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When most people hear the word “anorexia,” they think of really skinny people. There is, however, a lot more to this disorder than ones weight. Anorexia nervosa is a disorder of both the body and the mind. It can have adverse effects in many areas of one’s life and should always be taken seriously.

First of all, it’s important to acknowledge that anorexia can happen to anyone, regardless of gender, age or race. A college boy could develop anorexia in response to athletic pressures, or transitioning out of independent living could instigate it for a senior citizen. The stressors that can lead to eating disorders are in all our lives and while young females are more at risk, it is important to acknowledge that that isn’t the whole population.

A hallmark trait of anorexia is the restriction of food intake. Someone with anorexia might create unhealthy diet plans, not giving the body the calories and nutrients it needs. Certain foods are avoided completely, leading to a very restricted diet of what has been called “safe foods.” 

For anorexia to be diagnosed, as opposed to another eating disorder, this restriction should lead to a low body weight. The DSM-V diagnostic criteria used by mental health professionals defines this as “less than minimally normal” for adults and “less than that minimally expected” for children and adolescents. 

Another criteria for anorexia is an intense fear of gaining weight or interfering with weight gain despite being at a low weight. This is often related to the final criteria. One of the following needs to be present: disturbance in how you perceive your body (thinking you’re fat when you’re not, for instance), your self-esteem being excessively influenced by the way you see your body or a failure to acknowledge the seriousness of the low body weight. 

Furthermore, there are two types of anorexia: binge-eating/purging type and restricting type. The former involves episodes of binge eating and/or purging behavior. Purging refers to expelling food from your body, like self-induced vomiting or misuse of laxatives or diuretics. The restricting type does not binge and/or purge, but loses weight through dieting, fasting and/or excessive exercise.

Anorexia also often accompanies other psychiatric illnesses. Depression, bipolar disorder, obsessive-compulsive disorder, personality disorders and self-injury are some of the more common comorbid conditions. This can make the anorexia even worse, as there is more internal turmoil. Getting treatment for other mental health – and physical – disorders can help in the recovery from anorexia.

If you or someone you love is experiencing these symptoms, it’s imperative that you seek out help from a qualified professional. Anorexia nervosa is the most deadly mental health disorder. It will wreak havoc on your body until it literally eats itself. You cannot survive without nutrition. But it’s not just your body. Suicide causes one in five anorexia deaths. It is so important to get help.

Find someone who specializes in eating disorders. They have their own specific challenges and your best shot at recovery is with someone experienced. There might also be local support groups you could join in addition to therapy. If the anorexia is severe or treatment-resistant, consider finding a treatment center. If serious physical symptoms develop, call 911 or get to an emergency room. Look out for fainting, seizures, irregular pulse and other symptoms that could be considered serious. Recovery from anorexia is essential, so don’t hesitate to get whatever help you need.

To learn more about supporting loved ones with eating disorders, read this.

What has been your experience with anorexia? What helped you or a loved one get better? Share your thoughts in the comments.

Are you in (too much) control?

The issue of control is highly related to mental health. Having control makes us feel safe in the world. A lack of it leads to fear and a sense of helplessness. Mental illness can sometimes be traced back to a need to feel more in control, whether it’s in a rational way or not. Here are just a few examples:

   
• Someone with obsessive-compulsive disorder might engage in unusual behaviors because she is under the belief that this will lead to certain outcomes. 
• An eating disorder can be a response to a lack of control of one’s environment, making the body a battleground instead.
• Sometimes, certain personality disorders include attempts to control other people through manipulation or harmful actions, which may or may not be a conscious decision.
• Self-injury can be a way of decreasing distress or other symptoms through taking charge of the pain.
• Depression can worsen when a                                                                                                                                               person believes he has no control  
                                                                                                                                    over his future. 

The question is, how do you learn to control your control? There are no easy answers to that. Trying to do so can create a cycle that can spiral out of control, so to speak, and make things worse. 

So instead of trying to use one controlling action to stop another, look at the original issue. Let’s imagine, for instance, that the root of your control issues is that someone you love has a dangerous physical illness. It’s scary, but you can’t change it. You can’t even really help with the treatment because you’re not her medical team. Lacking control might cause you to attempt to regain it in another area. You might become obsessed about your own health in an attempt to avoid getting ill as well. This can lead into dangerous territory with problems like a severely restricted diet, excessive exercise or taking a large amount of supplements without a doctor’s supervision. 

But the truth is, you can’t control your body completely. You can’t guarantee you will never get sick. Sometimes, it’s unavoidable. So step back and look at what you actually can control. You can decrease your risk of illness by living a healthy lifestyle. This should, however, be done with moderation and a regimen set up with the help of a health care professional.

You might also want to look even further back and think of your loved one. While you can’t provide a cure, you can find other ways of being of assistance. Ask him if he needs someone to drive him to medical appointments. Offer to clean her house. Keep him company while he is bedridden. This is a much healthier and more productive way of managing the emotions her illness have brought up for you. It’s important to recognize that this is actually helping him, whereas you going down a dangerous path with a health obsession does not. 

Sometimes, the best answer is to give the issue some space. Work with your therapist to find ways to manage the anxieties that uncertainty and lacking control bring up. You don’t have to act upon them. Some people find mindfulness and meditation helpful in this regard. Others might think through the situation logically and find some peace that way. Whatever you need to do, decrease the importance of having control. Accept what you cannot change and focus on the things you can do. Again, your therapist can be very helpful in this process.

You don’t have to let your need for control end up controlling you. It’s easier said than done, but gradually working at it one issue at a time will lead to progress. As time passes, it will become easier. You will master the skills you need to respond appropriately to uncertainty. This will lead to a reduction in symptoms and, more importantly, help you become a happier and healthier person.

Have you learned to let go of the need for control? What helped you? Share what worked in the comments.

The isolation of mental illness

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Mental illness can be a very lonely experience. It can feel like what applies to the rest of the world gets turned on its head when it comes to you. When others ask questions like, “Why didn’t you come to the party?” or “Why haven’t you finished your assignment?” it can be hard to come up with answers that are both understandable and that protect your dignity. It’s hard to find words to describe what permeates your life and makes you feel separate from everyone else.

I wish I could say that people are generally understanding and that if you just say it how it is, you’ll get an empathetic response and an offer of help. The truth is, people are generally uncomfortable talking about mental illness. This societal silence perpetuates the feelings of isolation that mental illness can create.

Still, mental illness affects everyone, whether through experience or indirectly through others in their lives. With one in four Americans struggling with mental illness in any given year, everyone knows someone. It is, however, for the most part an “invisible illness” and people learn to hide their symptoms so no one knows anything is wrong. But it’s still there. 

The next time you sit in a meeting, classroom or other group situation, start counting off one in four people. Now take that group and expand. Remember, the one in four figure is for any given year. Some people have recovered from a past mental illness and others will experience it in the future. Seeing how common it is in this way can be an eye-opener. It’s a lot more prevalent than it seems when you’re lying in bed at 3:00 p.m. and wondering what’s wrong with you since “everyone else” can move on with their days. 

   

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But knowing you are not alone and feeling isolated are not mutually exclusive. While you might theoretically know that others are struggling, too, it’s not like people show up to work saying, “I didn’t come in yesterday because I had a really bad panic attack,” like they say, “I didn’t show up because I had the flu.” Mental illness is surrounded by so much stigma and perceived shame that it’s hard to talk about.

If you want to change the conversation and help others understand how mental illness impacts everyone, that’s great. Just take care of yourself while you do so. As a starting point, here is an article on how to tell others you have a mental illness. If you’d rather avoid the topic, that’s okay, too. It’s your right to decide how much you want to talk about your condition, if you want to talk about it at all.

One thing that can help you feel less alone is through entertainment. Finding stories of others we can relate to can be cathartic and empowering. There are lots of mental health memoirs that focus on specific conditions, so you can surely find one for yours. For instance, there’s Prozac Nation for depression and Girl, Interrupted about borderline personality disorder. There are so many more if you just search for them. There are also fictional stories of mental illness, as well as more technical books. (I’ve compiled a list of books that help you learn more about your condition.) Movies that address mental health topics abound, too, like these Oscar-winning best picture films.

There are also online communities that can offer support. For instance, HealthyPlace has a variety of forums addressing different conditions. Another cool site is PatientsLikeMe, where in addition to having access to forums, you can track your symptoms. Everyone’s data is used to come up with helpful information. It covers a lot of medical conditions, but there’s a section for mental health concerns. Be aware, though, that these groups are for support only. They are not a replacement for a doctor or a therapist. Simple symptom management tips and sympathetic stories are great, but you should not use forums to resolve more serious issues.

Remember that mental health issues are just as much a part of the human experience as anything else. It can feel isolating, but you are by no means alone. You can choose to seek out others who share your experience, or you can just comfort yourself with the knowledge that what you are experiencing is, in its own way, normal. How you approach your condition is entirely up to you, but always know that you aren’t broken, you aren’t weird, you aren’t crazy and you aren’t alone.

What do you do when your mental illness makes you feel alone? Share feedback in the comments.

Diagnosis spotlight: narcissistic personality disorder

Everyone knows someone who might be described as arrogant, self-absorbed or vain. When these traits are taken to an extreme, they can become pathological. In narcissistic personality disorder (NPD), self-centeredness overtakes a person and can hurt ones functioning, success and relationships with others. 

 

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In someone with NPD, there is a certain grandiosity and a need for admiration. This is further complicated by a lack of empathy. With NPD, it is expected that one is treated as special and valuable while other people might not even be on the radar. This can manifest in several ways.

According to the DSM-5 (the manual used to diagnose mental illness), people with NPD have an exaggerated sense of self-importance. This might manifest through overstating accomplishments or expecting recognition of superiority without the achievements to match. There can also be fantasies of unlimited success, power, brilliance, beauty, or ideal love. He might see himself as special or unique and therefore only able to be understood by or willing to associate with other people deemed special. There can also be an excessive need for admiration.

NPD might lead someone to take advantage of others. This can be done due to an unwillingness to recognize the feelings or needs of others. Someone with NPD might also be very envious or believe that others are envious of her. There is commonly displays of arrogant behaviors or attitudes.

No one knows exactly how NPD develops. It might be a combination of biology, temperament and early social interactions. It is believed that it can develop as a result of parenting that focuses too much on the child’s specialness. This might be done to increase the parents' own self-esteem. On the other hand, it is possible for it to develop as a response to a childhood of neglect and abuse.

When properly managed, people with NPD actually have some highly adaptive traits. They might have high self-confidence, allowing them to try new things. Their self-esteem can encourage positive risk-taking. NPD can make someone very charming, which can be socially advantageous when used responsibly. There is a lot of leadership potential that can be tapped into in a healthy way.

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Left unregulated, however, NPD can take over lives and lead to a lot of social problems. Friends and family might get worn down by the self-centeredness and lack of empathy, making it difficult to build and retain meaningful relationships. Professional relationships can also be disrupted due to shows of entitlement and an unwillingness to collaborate. At its most destructive end, people with NPD can become abusive. They are able to make their victims feel like they are at fault. 

People with NPD rarely seek treatment. They fail to see how they are being destructive to themselves and those around them. It is not uncommon for NPD to go untreated while those in his life end up seeking help for themselves. When treatment is sought, it is usually only at the insistence of loved ones.

NPD can be hard to treat. Treatment generally means psychotherapy, as there is no medication for NPD. The course of therapy might focus on changing beliefs and behaviors that are destructive. They might be taught to be more empathetic and learn how to use their talents and resources to help others. This might not change feelings such as entitlement, but in practical terms, it leads to a more functional life.

Specific symptoms, such as anger and impulsivity, can be worked on as well. In general, one might look for the areas in which NPD is causing the most problems and focus on those. For instance, if a business owner cannot retain employees because of the way he treats them, therapy might focus on respect and valuing the contributions of others. Group and couples therapy can also be beneficial, as it allows those with NPD to explore relationships and how they relate to others. 

Treatment can be difficult for those with NPD. It challenges their world views and asks for a lot in terms of change. It is usually a long-term process. This might be especially bothersome if the person with NPD does not believe she has a problem. Loved ones can be helpful by responding positively to the person with NPD seeking treatment and can offer praise and support as changes are gradually made. It can be a rough path, but the improvements in relationships are worth the effort.

Books about mental illness and recovery

Books are an invaluable source of information. When it comes to mental health, they can be a great resource in helping you understand what you are going through. Following is a list of some of the top-selling books on various mental illnesses. I have not read all of them and I do not endorse any of them. I am simply going by what the most popular titles in the field are. I recommend reading reviews before purchasing a book, as that will give you a better idea of the content. The list is not comprehensive in any way. I hope you find something useful!

Anxiety

The Anxiety and Phobia Workbook by Edmund J. Bourne, Ph.D.

The 10 Best-Ever Anxiety Management Techniques by Margaret Wehrenberg, Psy.D.

The Mindful Way through Anxiety by Susan M. Orsillo, Ph.D. and Lizabeth Roemer, Ph.D.

Attention deficit hyperactivity disorder (ADHD)

Parenting Children with ADHD by Vincent J. Monastra, Ph.D.

Your Life Can Be Better by Douglas A. Puryear, M.D.

Driven to Distraction by Edward M. Hallowell, M.D. and John J. Ratey, M.D.

Autism spectrum disorders

Autism: A Practical Guide for Parents by Alan Yau

Autism by Dr. Robert Melillo

The Complete Guide to Asperger’s Syndrome by Tony Attwood, M.A., Ph.D.

Bipolar disorder

The Bipolar Disorder Survival Guide by David J. Miklowitz, Ph.D.

The Bipolar Workbook by Monica Ramirez Basco, Ph.D.

Living with Someone Who’s Living with Bipolar Disorder by Chelsea Lowe and Bruce M. Cohen, M.D., Ph.D.

Depression

The Depression Cure by Stephen S. Ilardi, Ph.D. 

The Mindful Way through Depression by Mark Williams, Ph.D., John Teasdale, Ph.D., Zinder Segal, Ph.D. and Jon Kabat-Zinn, Ph.D.

Feeling Good by David D. Burns, M.D.

Dissociative disorders

Coping with Trauma-Related Dissociation by Suzette Boon, Ph.D., Kathy Steele, M.N., C.S. and Onno van der Hart, Ph.D.

The Dissociative Identity Disorder Sourcebook by Deborah Bray Haddock, M.Ed., M.A., L.P. 

Rebuilding Shattered Lives by James A. Chu, M.D.

Eating disorders

8 Keys to Recovery from an Eating Disorder by Carolyn Costin, M.A., M.Ed., MFT and Gwen Schubert Grabb, MFT

Life Without Ed by Jenni Schaefer

Healing Your Hungry Heart by Joanna Poppink, MFT

Insomnia

Say Good Night to Insomnia by Gregg D. Jacobs, Ph.D.

The Effortless Sleep Method by Sasha Stephens

The Insomnia Workbook by Stephanie A. Silberman, Ph.D., DABSM

Obsessive-compulsive disorder 

The OCD Workbook by Bruce M. Hyman, Ph.D. and Cherry Pedrick, RN

The Mindfulness Workbook for OCD by Jon Hershfield, MFT and Tom Corboy, MFT

Obsessive-Compulsive Disorders by Fred Penzel, Ph.D.

Panic disorders

When Panic Attacks by David D. Burns, M.D.

Panic Attacks Workbook by David Carbonell, Ph.D.

From Panic to Power by Lucinda Bassett

Personality disorders

Understanding Personality Disorders by Duane L. Dobbert, Ph.D.

The Cognitive Behavioral Therapy Workbook for Personality Disorders by Jeffrey Wood, Psy.D.

Difficult Personalities by Helen McGrath, Ph.D. and Hazel Edwards, M.Ed.

Posttraumatic stress disorder

The PTSD Workbook by Mary Beth Williams, Ph.D., LCSW, CTS and Soili Poijula, Ph.D.

The Post-Traumatic Stress Disorder Sourcebook by Glenn R. Schiraldi, Ph.D.

When Someone You Love Suffers from Posttraumatic Stress by Claudia Zayfert, Ph.D. and Jason C. DeViva, Ph.D.

Schizophrenia

Surviving Schizophrenia by E. Fuller Torrey, M.D.

Schizophrenia: A Blueprint for Recovery by Milt Greek

The Complete Family Guide to Schizophrenia  by Kim T. Mueser, Ph.D. and Susan Gingerich, MSW

Substance abuse

The Mindfulness Workbook for Addiction by Rebecca E. Williams, Ph.D. and Julie S. Kraft, M.A.

Clean by David Sheff

Beyond Addiction by Jeffrey Foote, Ph.D., Carrie Wilkens, Ph.D. and Nicole Kosanke, Ph.D. with Stephanie Higgs

For loved ones

The Family Guide To Mental Health Care by Lloyd I. Sederer, M.D.

When Someone You Love Has a Mental Illness by Rebecca Woolis, M.F.C.C.

You Need Help! by Mark S. Komrad, M.D.

Memoirs

Broken Glass: A Family’s Journey Through Mental Illness by Robert V. Hine

Just Like Someone Without Mental Illness Only More So by Mark Vonnegut, M.D.

Crazy: A Father’s Search Through America’s Mental Health Madness by Pete Earley

Share your favorite books on mental illness and recovery in the comments.

My take on meds

Feel free to ignore this post if you don't want an opinion piece. I just feel that since I will be talking about medication, it's probably best that I explain my stance to provide some context. 

There's so much good that has come from modern medicine. This includes a wide assortment of medications that help treat and even prevent certain conditions. These include entire categories dedicated to mental health issues. Due to the fact that we don't know enough to not be experimental, new discoveries are made by chance. For instance, anti-seizure medication can be used in the treatment of personality disorders. It's a frontier we have yet to conquer.

I have a great level of respect for those who dedicate their lives to finding ways to improve and extend our lives. Unfortunately, the pharmaceutical industry as a whole is not run by philanthropists who throw money at it. It's a business. This means that they have to make money. The competition can be healthy in terms of innovation, but it has to be financed. This is how Prozac got renamed Sarafem and prescribed for PMS. Once the original use for a drug has been tapped into, it's time to find ways to keep making money off of the same formula. Do you have to take four pills a day? We just made a different one that does the same thing, but you only have to take it once! You think anti-psychotics are reserved for schizophrenia? No, they're also used for autism, dementia and even insomnia.

Honestly, it's a really complex system and I'm not here to preach about it. But since medication is a significant aspect of the mental health industry, I can't ignore it. In order to offer a respectful climate for discussion of something so attached to opinion, this is the perspective I am coming from:

• Medication has the potential to significantly improve and even save lives in the mental health field.

• Some people need medication. They have exhausted all their options and cannot find anything else that is sufficiently effective.

• It is not our job to judge whether or not someone needs medication. Don't think your sister needs lithium? It's the job of her and her doctor to figure that out. Think your friend needs some anti-anxiety pills? It's not your call.

• Side effects are a factor that should be taken into consideration when prescribing medication.

• When it comes to children, teenagers and young adults, special precautions need to be taken and other approaches should be more carefully considered. While the body and mind are still developing, a cost-benefit analysis is definitely warranted.

• Are we overprescribing? Probably. I refuse to believe all my classmates who take Ritalin or Aderall actually have attention deficit hyperactivity disorder (ADHD), a childhood disorder that doesn't spontaneously emerge in college.

• Never encourage or support someone in going off their medication without proper medical supervision. Not only may it be inappropriate in terms of treatment, but not regulating the tapering off of a substance can cause withdrawal symptoms and other serious – possibly permanent – complications.

• There are alternative approaches that can be taken, and that's okay, too.

• Ultimately, it's about getting better. Whatever works (and is relatively healthy) is great!

I understand completely if you disagree. I don't claim to be an expert. I'm just being honest about where I'm coming from so that any biases I have are pre-announced. 

15 Best Picture winners about mental illness

The entertainment industry has a tremendous power in shaping the public view of mental health topics. With Silver Linings Playbook, a romantic comedy featuring a protagonist with bipolar disorder, up for eight awards at tonight's Academy Awards, attention is currently being focused on the challenges faced by those affected by mental health conditions. 

It is the first movie nominated for all of the "Big Five" awards (Best Picture, Best Director, Best Screenplay, Best Actor and Best Actress) and all four acting awards (add Supporting Actor and Actress). While it is highly unlikely that it will receive all of the awards, Jennifer Lawrence is considered a frontrunner for Best Actress for her portrayal of a young widow facing a her own set of complications following the traumatic death of her husband. After seeing how the film fares tonight, I intend to write a commentary on it in the coming days. It has a lot of interesting implications.

Looking back, however, mental health conditions have definitely had their place in creating award-winning movies. Starting with the early days of the Oscars, here are fifteen films that emphasize a variety of aspects mental health and illness.

All Quiet on the Western Front (1929/30)

Showing World War I from the perspective of the Germans, this film deals with the expectations and realities of war, including the psychological aspects. Well before PTSD was officially defined, elements of it can be gleaned from previous wars, as demonstrated in this production.

Gone with the Wind (1939)

In this epic, the effects of personality disorders on oneself and others can clearly be seen. Critics have noted that heroine Scarlett O'Hara displays characteristics of narcissistic, histrionic, anti-social and borderline personality disorders. In other words, she's the epitome of the cluster B subsection. In addition, leading lady Vivien Leigh, who played O'Hara, struggled with bipolar disorder.

Rebecca (1940)

Hichcock's psychological dramatic noir thriller (thank you, Wikipedia) features characters who certainly have some significant problems. Based on the novel by Daphne du Maurier by the same name, it also handles themes such as grief, manipulation and suicide.

The Lost Weekend (1945)

With its plot centering on a writer's struggle with alcoholism, The Lost Weekend is, according to the Library of Congress, "a landmark social-problem film" with "an uncompromising look at the devastating effects of alcoholism." While the premise might seem like a cliché nowadays, it received significant opposition when it was being produced.

The Best Years of Our Lives (1946)

In the wake of World War II, a new group of veterans had to learn to adjust to civilian life. This movie follows three of them as they struggle to find normalcy. One of them, Homer, lost both hands in the war (which actually hard happened to the actor, Harold Russell). His struggle to deal with a physical handicap that he believes makes him unfit for his fiancée is metaphoric for a lot of the psychological aspects of living through a prolonged trauma like combat. Part of this film's strength is in how it shows the role of social support, both between fellow veterans and those around them.

One Flew over the Cuckoo's Nest (1975)

Because the film takes place in a mental institution, there is a lot of psychological material to draw from. The characters struggle with different conditions, but they also develop a community. The tyrannical Nurse Ratched is a legendary villain and under her reign, the viewer is exposed to a lot of the treatments that have historically (and presently) been used to treat mental illnesses. It's also one of only three movies to win all of the "Big Five" Academy Awards.

Annie Hall (1977) 

Considered one of Woody Allen's greatest and most influential films, Annie Hall follows the anxious and neurotic Alvy Singer as he tries to find out why his relationship with the title character failed. This film is worth noting because while Alvy has what appears to be a clear case of generalized anxiety disorder, he has actually lived a relatively normal life. This helps show that mental illness is not just reserved for those with traumatic histories or psychotic symptoms.

Ordinary People (1980)

An upper-middle class family struggles with the accidental loss of one son and attempted suicide of another. It tackles family dynamics in a stressful environment where each individual handles grief in his own way. Since one person with mental health issues will impact the entire family, this film is important in its portrayal of the struggle for normalcy without clear direction.

Amadeus (1984)

While Amadeus is not very historically accurate, it does tackle the interesting issue of delusional obsession. As contemporary composers, Antonio Salieri cannot overcome his jealousy of Mozart's talent. The film shows how Salieri creates a worldview in which he feels justified in using a vengeful plot to gain some sort of "victory" over both Mozart and God Himself. Obsession is usually portrayed in a romantic context, making this film all the more fascinating.

Rain Man (1988)

After his father's death, the narcissistic Charlie finds out that he has a brother, Raymond, who is more or less inheriting everything from their father. An autistic savant, Raymond lives in a mental institution. The question of why Charlie was not told about his brother points directly at the issue of stigma against mental illness, even within families. 

The Silence of the Lambs (1991)

The only horror film to ever win an Oscar for Best Picture, The Silence of the Lambs is the most recent winner of the "Big Five" awards. It features Hannibal Lecter, who is both a psychiatrist and a cannibalistic serial killer. The epitome of genius and (criminal) insanity combined, this character has been deemed the greatest villain in movie history by the American Film Institute.

Forrest Gump (1994)

In this beloved movie, Tom Hanks plays Forrest Gump, a man with an intellectual developmental disability. The film displays a very positive attitude towards Forrest, giving him his own talents and showing how he contributed to a variety of historically significant events. It tackles both the challenges and joys experienced by the title character, offering a glimpse into how society treats those who are intellectually challenged.

A Beautiful Mind (2001)

Based on the Nobel-prize winning mathematician John Nash, this film tackles the role of schizophrenia in the protagonist's life. It follows the onset of the illness, which commonly manifests in early adulthood, its identification and how it affects Nash personally and professionally. It acknowledges the permanent nature of the condition, showing that he could achieve success while still experiencing symptoms.

The Hurt Locker (2009)

The effects of war are tackled again, this time with the Iraq War. The film, which made Kathryn Bigelow the first female to win Best Director, covers the acute stress experienced in a war zone and how it affects decision making. Instead of having the focus on the posttraumatic symptoms likely experience by the characters after the story's end, the movie gives insight into its development. This is a valuable perspective, considering the current public discussion surrounding PTSD.

The King's Speech (2010)

Not all mental illnesses are defined by mood or disconnect with reality. Stuttering is categorized as a mental health condition and can be comorbid with other disorders. In telling the story of King George VI, The King's Speech shows that not even royalty is immune to these challenges. With the help of a speech therapist, George admirably demonstrates the effort that goes into recovery.

Who do you think will win best picture this year? What awards do you think the cast and crew of Silver Linings Playbook might take home tonight?