Shinji Ijichi, M.D. & Naomi Ijichi, M.D.
Forrest Gump has autism
The criteria for autistic disorder in the 4th edition of the diagnostic and statistical manual of mental disorders (DSM-IV) had been introduced in order for a diagnosis of autism to be made with a reasonable balance of sensitivity and specificity and with a convenience for both clinical and research purposes (1). This criteria are still never ultimate and attempts at farther understanding of the disease should be continued. However, the relatively concise and efficient manner of the autism definition in DSM-IV may allow better evaluation of autistic individuals when the details of patient's personal information are unavailable.
The DSM-IV for autistic disorder was applied to assess the autistic behaviors of an idiot savant, Forrest Gump, one of new American heroes. All items of information were obtained from the novel by Winston Groom (2). Forrest's qualitative impairments in social interaction include gross impairment in ability to develop peer relationships appropriate to developmental level (He says "When I was little, mama kep me inside a lot, so as the other kids wouldn't bother me"), and it does not seem likely that he was motivated to share enjoyment, interests or achievements with other people at least at ages of primary school. He dropped out from the public school and was institutionalized for 5 or 6 years. His impairments in communication include a delay in the development of spoken language and marked impairment in the ability to sustain a conversation with others, and some of which are unchanged throughout his life ("I ain't too good at long conversation"). His famous line or "I got to pee" can be evaluated as a stereotyped and idiosyncratic use of language. His behavioral problems maybe include an inflexible adherence to routines or plans and a lack of comprehensive grasp of objects. For example, it took an hour or more for him to decide to buy a can of peaches instead of some limes of which he intended to make limeade, and to squeeze juice from the peaches he used one of his unwashed socks. He has these problems described above with onset prior to age 3 years (He says "I been a idiot since I was born"), and his disturbance is not accounted for by Rett's disorder (characterized by stereotyped peculiar hand movements) or childhood disintegrative disorder (characterized by loss of previously acquired skills). In result, a total of six items could be confirmed and his childhood characteristics fulfill DSM-IV criteria for autistic disorder. In addition, all his natures including these items are frequently observed in individuals with autistic disorder. These features include innocence, frankness, generosity, credulity, excellent rote memory, and a talent for music, as well as an escape tendency from his favorites.
The dissociation between his IQ (approximately 70) and incredible intellectual achievements and his behavioral autistic tendencies are, so far, ignored and his cognitive features are misread as mental retardation, maybe contrary to the author's intention. Here we demonstrated that Forrest has autistic disorder and that might impress this fiction as a more plausible and real story.
1. Volkmar FR, Klin A, Siegel B, et al. Field trial for autistic disorder in DSM-IV. Am J Psychiatry 1994;151:1361-67.
2. Groom W. Forrest Gump. New York: Pocket Books, 1994.
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