The DSM-5 — or the latest version of the psychiatry bible — was released in May to much fanfare. It’s taken over a decade for the American Psychiatric Association to revise its detailed manual of disorders, which largely dictates mental health care. Yet since many in the field question the DSM’s validity, the manual’s future is unclear.
For my part, I’ve decided to set aside valuable critique of the psychiatric establishment and put the DSM to a stronger test: How well does it diagnose classic side characters from one of TV’s greatest accomplishments, The Simpsons? (Taking some neurobiology into account, of course.)
1. Crazy Cat Lady (Eleanor Abernathy, MD/JD)
Evidence: Crazy Cat Lady yells gibberish at Lisa Simpson, while tossing her many cats.
Though schizophrenia is often associated with multiple personalities, the term more broadly describes people with abnormal interpretations of reality. Symptoms include delusions, hallucinations, disorganized speech and thought as well as social withdrawal. In other words: Crazy Cat Lady, the local Harvard and Yale graduate who eventually burned out and slipped into madness.
Neurobiology: Schizophrenia’s symptoms may be caused by disruptions to brain development and plasticity.
2. Troy McClure (“you may remember him from such films as…”)
Evidence: McClure introduces himself by his celebrity resume.
Diagnosis: narcissistic personality disorder
Because character traits can be so subjective, personality disorders are notoriously tricky to diagnose. Nonetheless, washed-up movie star Troy McClure seems written straight from the DSM description: self-important, grandiose, entitled and exploitative. Histrionic personality disorder was another candidate, but that has more to do with hungering for approval at all times. And Troy McClure will just tell you himself that he’s too handsome to wear glasses.
Neurobiology: NPD may have a genetic component, but not one that points to a defined neurological disorder.
3. Sideshow Bob (Robert Terwilliger)
Evidence: Bob lies about the meaning behind his German tattoo.
Diagnosis: antisocial personality disorder
Ah, Sideshow Bob — the cultured ex-children’s entertainer and ex-convict who is always trying to kill Bart. Like a true sociopath, Sideshow Bob displays surface charms that mask his underlying contempt for pretty much all humanity. He’s cynical and arrogant, and he won’t deign to ask folks’ opinions before killing them (though he may pause to sing selections from the comic opera H.M.S. Pinafore).
Neurobiology: APD has been linked with mixed deficits in brain regions that regulate executive control, memory, emotion and communication between the left and right hemispheres.
4. Principal Seymour Skinner (Armin Tamzarian)
Evidence: Over Springfield Elementary’s intercom, Skinner recalls a tragic wartime moment.
Diagnosis: posttraumatic stress disorder
On the surface, Skinner is just a hapless principal constantly bested by students, his domineering mother and Superintendent Chalmers. Yet his seemingly random, always disturbing flashbacks of serving in the Vietnam War point to PTSD, which can afflict people who have experienced horrors like war, abuse and deadly natural disasters. Among other symptoms, PTSD causes repression of traumatic memories, vivid flashbacks, nightmares, anxiety and guilt.
Neurobiology: PTSD patients have shown irregular responses in their hypothalamic-pituitary-adrenal axis, the main neuroendocrine stress response system.
5. (Barry) Duffman
Evidence: Duffman’s need to start every conversation with a thrust.
Permanently clad in a skin-tight superhero suit, red cap and sunglasses, this doltish mascot for Duff Beer has got be an exhibitionist. In other words, he constantly wants to expose his genitals to strangers. As a cartoon character who airs on Fox, he can’t go actually through with this. But he must want to — after all, why else would he end all social interactions with pelvic thrusting and the hearty cry of “Oh yeah!”?
Neurobiology: Unsurprisingly, compulsive sexuality involves abnormalities in the dopamine system that mediates our sense of reward, as well as in the frontal lobe system that inhibits certain behaviors.
Leon Kompowsky: he was (sort of) sane. Check out video here.
One standout from the Simpsons’ stellar repertoire of celebrity cameos is a 1991 appearance by Michael Jackson. Jackson voices the character Homer Simpson befriends in a mental asylum. Despite being a huge white guy, the character speaks and sings like the pop star and publicly claims to be him, which suggests severe delusions and identity issues. But by the episode’s end, he shares his true identity as Leon Kompowsky and admits that he only kept up the Michael Jackson act because it made people like him. Instead of having any diagnosable condition, he turns out to be a self-aware imposter.