Evaluating independent sources on psychological disorder approaches

Cut is a young adult novel by Patricia McCormick. Like Girl, Interrupted, Cut addresses issues related to the psychiatric treatment of adolescents as well as to adolescent psychiatric issues. Therefore, the novel offers young readers insight into their conditions, how and why certain treatments are used, and how systems of treatment might help them. Most importantly, the book helps young readers with psychiatric problems feel less alone and more willing to open up about their problems. However, it is important to evaluate novels like Cut in light of relevant empirical evidence. How well a novel reflects reality is essentially how important the novel is from an educational standpoint; otherwise the book is a complete work of fiction and has no relevance for meaningful study.

Cut addresses a whole gamut of psychiatric issues that impact girls. Therefore, the gender variable is critical to discuss within the framework of adolescent psychology. Several of the behaviors described in Cut are more prevalent among female than male teenagers. The primary psychological disorder covered in the book is, of course, cutting or self-mutilation. Psychologists usually refer to self-mutilation as non-suicidal self-injury: "Often there is no suicidal intent; rather, the action is used for one or more reasons that relate to reducing distressing affect, inflicting self-punishment and/or signaling personal distress to important others," (Wilkinson & Goodyer, 2011, p. 103). Although the gender gap with self-mutilation is not huge, there is a slight but significant difference between prevalence rates among adolescent females vs. males. Recent research reveals that 56% of self-reported self-mutilators are females (Zetterqvist, Lundh, Dahlstrom & Svedin, 2013). With regards to eating disorders, which are also covered in Cut, prevalence rates remain higher among females but there are a considerable number of male sufferers too (Claes, et al., 2011).

In fact, McCormick (2000) could have created a more compelling protagonist, or at least more compelling support characters, if she had introduced more comorbidity into the picture. Most of the characters in Cut have one clearly defined disorder rather than expressing comorbidity. As Claes et al. (2011) and Zlotnick et al. (2010) point out, comorbidity of self-mutilation with eating disorders, substance abuse, and conduct disorders is common. In fact, the DSM has yet to distinguish non-suicidal self-injury as a unique disorder and instead classifies it as a syndrome that can manifest alongside many different disorders (Wilkinson & Goodyer, 2011). The recognition of NSSI as a syndrome is new.

In Cut, the author is too eager to segregate the various psychiatric disorders expressed by the characters, which oversimplifies adolescent psychology to an unnecessary degree. Especially among patients who experience trauma, comorbidity is more likely than the expression of a singular syndrome or behavior (Zlotnick et al., 2010). Likewise, the author also oversimplifies the state of adolescent psychiatric treatment and paints a picture far rosier than realistic. Although research is unfortunately scant in the area of adolescent perceptions toward there care, many adolescents report mixed feelings regarding their care and often do not agree with their parents' assessments of the treatment(s) received (Biering, 2009). Having said that, the gaps in the literature are being slowly filled by qualitative studies aiming to gather measurable and meaningful data on adolescent perceptions of their psychiatric care. For example, Biering & Jensen (2009) performed exploratory research that illuminates variables that impact adolescent patient satisfaction with the quality of psychiatric care. The variables most closely linked with positive perception of psychiatric care include the perception of a secure place, the use of a "tough love," technique with regards to counseling and interaction with family, peer solidarity, self-expression, and a "person not patient" approach (Biering & Jensen, 2009). These findings corroborate and substantiate McCormick's (2000) fictional accounts of adolescent care in Cut.