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M. FREEDMAN
Abstract
Charlize Theron won a Best Actress Oscar for her portrayal of serial killer, Aileen Wuornos in
the film, Monster (Jenkins, 2003) her There have been some who have argued about her
mental state and whether a specific diagnosis is apt. The following is an initial assessment taken
after Aileen was remanded to death row. A clinical diagnosis based on criteria in the DSM-5
follows. Aileen Wuornos was a 37-year-old Caucasian female. Before incarceration, she was in
a relationship with a younger woman named Selby Wall. Their relationship ended after Aileen
was taken into custody. She was incarcerated in Florida State Prison and was executed in 2002.
As Ms. Wuornos recalled experiences from her past, significant signs of trauma were
observable. An obvious sign in her body language was tremors. This is a common reaction to
the experience of a traumatic event. Other observable symptoms included her mistrust and
blame of others, as well as a fearful demeanor. Ms. Wuornos exhibited signs of emotional
liability and depressivity. As she recalled experiences from her past, other notable signs included
issues with abandonment, rejection, anxiety, impulsivity, and hostility. Additionally, she was
easily startled and frequently demanded justice for the perceived injustices against her.
These symptoms can be attributed to the trauma of her early childhood. She was sexually
assaulted at the age of eight by a friend of her father. Her father did not believe her allegations.
For the PTSD diagnosis, the following criteria in the DSM-5 (as cited by APA, 2013) are listed:
Criterion A is a stressor. Ms. Wuornos had direct exposure to sexual violence.
Criterion B is intrusion symptoms. Ms. Wuornos evidenced three of the five listed symptoms,
although only one is required for the diagnosis. She re-experienced her traumatic events through
flashbacks. She also had intense distress after repeated exposure to events reminiscent of the
initial trauma. Most notable were the tremors she exhibited. This was a clear sign of
physiological reactivity.
Criterion C is avoidance. Both traumatic feelings and reminders were evident as sub-criteria.
Although only one sub-criterion is required, she exhibited both of the two listed.
Criterion D is negative alterations in cognitions and mood. Two of seven sub-criteria are
required; three were fulfilled. Ms. Wuornos had persistent and distorted negative beliefs about
herself and the world. She had a distrust of men and blamed them for both the traumatic event
and for her subsequent behaviors. Persistent anger, fear, and shame were also expressed.
Criterion E is alterations in arousal and reactivity. Two behaviors are required and Ms.
For the BPD diagnosis, the following criteria in the DSM-5 (as cited by APA, 2013) are listed:
Criteron A is personality functioning. Ms. Wuornos' self-functioning abilities are impaired due
to unrealistic goals and career plans. This demonstrates that she lacked self-direction. Her
interpersonal functioning was also impaired, as she had issues with abandonment. Her
relationships were marked by both mistrust and neediness.
Criterion B is pathological personality traits. Unlike Criterion A, the following criteria must be
met in order to diagnose a patient. Negative affectivity is characterized by emotional liability,
anxiousness, separation insecurity, and depressivity. Ms. Wuornos exhibited unstable emotional
reactions and frequent mood changes. Also exhibited was anxiety in reaction to interpersonal
stressors. She focused on both the past unpleasant experiences and future negative possibilities.
She feared rejection and separation from Selby and expressed frequent periods of depression,
hopelessness, shame, and thoughts of suicide. Ms. Wuornos' acts of disinhibition were
Treatment options that might be effective are limited under the circumstances. The
efficacy of the suggested treatments would be more apt without the variable of incarceration and
impending execution. For the treatment of PTSD (Butcher et. al., 2014), emotional disclosure
and meditation may be mildly effective. Emotional disclosure, or the process of bringing
feelings to the surface via writing, could have alleviated some of the mental stress and physical
symptoms Ms. Wuornos experienced in prison. Antidepressant and anti-psychotic medication
could have also be indicated. Intervention or counseling by a member of the clergy, if requested
by Ms. Wuornos, could provide a sense of comfort in this stressful environment.
If Ms. Wuornos was being treated on an outpatient basis, other forms of therapy would be
References
Butcher, J. Hooker J., Mineka, S. (2014). Abnormal Psychology, Boston. 152-155, 344-352
Jenkins, P.. (Director) (2003) Monster [Motion picture]. United States. Germany. Media 8
Entertainment and DEJ Productions