Inspired by our December 12 trek through New Mexico, The Hills Have Eyes, Wrong Turn is a
horror movie depicting medical student, Chris Flynn, and his unfortunate rendezvous with five
motorists stranded in the West Virginia “holler.” Just when you might be tempted to argue that
Silent Hill (2006) is a more deserving horror movie in West Virginia, we are made aware of the
role of the main character. Since the medical student has WV license plates, he most likely
attends West Virginia University. Any horror movie depicting a WVU medical student warrants
top billing in 52in52 (with all due respect to Silent Hill)!

While it’s near impossible to mention “West Virginia’ and “medical student’ in the same
sentence without thinking about Morgantown (or Charleston), it’s the film’s rural setting that
allows for a sinister, if not prejudicial, backdrop for horror, with the archetypal, prosocial
warning to “be careful taking the path less beaten.” Scott even references Deliverance (1972)
despite that film being set in Georgia (he would have done well to check out April 3 on our
itinerary). While the history of the cannibalistic, half-feral, mutants is disclosed in subsequent
sequels, the following post is based solely on the original film.


Wrong Turn serves to review the algorithm on how to diagnostically approach mental illness. The 3-step process includes ensuring that a patient’s chief complaint is not due to a) another general medical condition or b) the direct physiologic effects of a substance. The DSM-5 lists potential substances as medications, drugs, or toxins. Only after these are ruled-out should a psychiatrist c) attribute the patient’s symptoms to mental illness.

A. Rule-out Another Mental Disorder

As early as the opening credits, we are reminded of the effects genetics play in the predisposition of mental illness. Signs and symptoms such as “psychosis” and violent outbursts” appear in a montage of newspaper articles along with hints of the role of genetics.

B. Rule-out the Direct Physiologic Effects of a Substance

Immediately following the opening credits, we see Chris Flynn driving to Raleigh. The music on the car radio references whiskey, and serves as foreshadowing to alcohol’s influence on the plot. When his route is blocked by a chemical (toxin) spill, viewers are left to wonder if the highway is a corridor for the transport of hazardous materials and if so, whether previous spills are the cause of the mutants’ pathology. In this sense, Wrong Turn may be viewed as a rhetorical case study of a substance- or toxin-induced psychotic disorder. Soon after he crashes into the hikers’ truck, they refer to Fran and Evan as “stoners,” and Jessie calls Chris a “mule.”

C. Mental Illness

Once A and B above have been ruled-out, psychiatrists will begin to formulate the most likely diagnosis based on current, recent, and past signs and symptoms. Since it’s established that the prominent symptoms are psychotic, our most likely and differential diagnoses will come from the Schizophrenia and Related Disorders chapter.

Since Wrong Turn is likely a case study of a toxin-induced psychotic disorder (choice B above), elaboration on a primary psychotic disorder is beyond the scope of this post. Interestingly, alcohol use also figured prominently in many adaptations of the blood feud between the West Virginia family, the Hatfields, and their Kentucky rivals (McCoys). Wrong Turn then is another cautionary tale in West Virginia folklore about the hazards of excessive alcohol use.

Characters from Wrong Turn fitting into Joss Whedon’s Archetypes
Cabin in the Woods archetype Character from Wrong Turn
The Slut Francine
The Athlete Jessie Burlingame
The Scholar Chris Flynn
The Fool Evan
The Virgins Scott and Carly (we had to improvise)

Last week’s movie: An American Crime (2007)
Next week’s movie: Night of the Living Dead (1968)



An American Crime is a drama based on the true story of Sylvia Likens by an Indianapolis housewife, and is told through a series of flashbacks of eye witnesses during 1966 trial of Gertrude Baniszewski.

The movie accounts the life of sisters, Sylvia and Jenny Likens after their father leaves them in the custody of Gertrude so that he can travel with the carnival through Indiana. The carnival has long been the setting for folkloric myths intertwined with mental illness. From the human novelty exhibition of Joseph Merrick (the Elephant Man), to Erik from Gaston Leroux’s 1910 novel The Phantom of the Opera, both man and mystery are “one combined.” However, the carnival has never been as unsettling of a backdrop as the one it provides for An American Crime.


We are first introduced to Gertrude (Gerti) Nadine Baniszewski upon her returning from church when she tells a fellow parishioner that she “is better,” and that now, she can pick-up more ironing as she tries to make ends meet. While the conversation on the bus establishes a history of mental illness, we are not initially provided any further details.

In addition to psychiatric themes such as Nicotine Use Disorder, and possibly Pedophilic Disorder, the focus of the film is Gerti’s disorganized behavior (impulsively whipping Sylvia when payment is late) which is initially observed upon adopting the responsibility of Sylvia and Jenny Likens. Despite Mr. Likens’s $20 coming soon after, Gerti’s violent behavior continues and progresses to torture. Further evidence of her denial occurs when she confronts Sylvia, “you flirt with Andy’I saw you!” What was a neutral interaction between Sylvia and Gerti’s ex-boyfriend was imparted a fixed belief shrouded in jealousy. While Gerti demonstrates psychotic symptoms as described above, she likely does not have a primary psychotic disorder given that she appears cognitively intact. As a formal thought disorder, we would expect Gerti to demonstrate deficits in attention, memory or speech if she was afflicted with a psychotic illness such as Schizophrenia.

Later, Gerti discloses that she’s addicted to Phenobarbital and Chlorpheniramine (an antihistamine). Taken together, Gerti’s chronic cough is likely due to asthma (and possible gastroesophageal reflux disease, GERD), both of which are worsened by cigarette smoking. Her self-medicating with the above drugs exacerbated psychotic and antisocial traits that directly contributed to the torture, rape, and death of Sylvia Likens. Given that Coricidin contains acetaminophen in addition to chlorpheniramine, liver toxicity (rule-out encephalopathy) may have further contributed to Gerti’s behavior.

The film may also be viewed through the eyes of the other children, who choose not to intervene when Sylvia is repeatedly tortured. Here, 2 characters deserve special mention; Johnny and Ricky. Johnny demonstrates cruelty to animals and a motivated disregard for others’ safety. Given his age, 13, he is therefore likely afflicted with Conduct Disorder. Conversely, Ricky’s behavior is likely the result of the Stockholm syndrome; stress resulting in his loss of identity and consequent identification with the aggressors.

Finally, the film itself appears to be an artistic expression of the double bind, a family dynamic where a person receives simultaneous mixed messages. For example, a child receives two conflicting messages about their relationship when a mother tells her son that she loves him, while at the same time turning her head away in disgust. In An American Crime, the disturbing content is balanced by the equal and opposite music from a soundtrack that includes Petula Clark’s Downtown and Lesley Gore’s You Don’t Own Me.

Last week’s movie: The Return of the Living Dead (1985)
Next week’s movie: Wrong Turn (2003)