The Dunning-Kruger effect and mental illness

The Dunning-Kruger effect and mental illness


The Dunning-Kruger effect and mental illness: In some cases, the worse someone’s mental illness becomes, the less likely they are to believe that they are mentally ill.

Before I start, let me say that no one is perfect. Just as no one has a perfect body, no one is free of mental quirks. And sometimes, even the most mentally stable people exhibit behavior that could be described as neurotic.

The question that I’m trying to address is: Why, in some cases, do profoundly mentally ill people refuse to seek or accept the help that they need? Think, for example, of a mentally ill homeless person who refuses to go to a shelter in the depths of winter and freezes to death on the sidewalk.

A variation of the Dunning-Kruger effect can help to explain what’s going on: The more removed that one becomes from reality, the less likely one will know that his or her mind is not sound. Even worse than that, as the depth of one’s mental illness increases, the less likely it is that one would even believe that he or she is suffering from mental illness. If someone, even a doctor, pointed out the deviation of the person’s perception from reality, he or she may be convinced that the doctor was lying.

In 1999, Drs. Dunning and Kruger, working at Cornell University in New York reported that people tend to hold unduly favorable views of their abilities in many social and intellectual domains. In other words, their performance stinks, but they think it’s great.  Worse, if the discrepancy is pointed out to them, they believe the critic is wrong. The investigators recruited volunteers to participate in tests in several domains including humor, grammar, and logic. The most incompetent of the subjects demonstrated a cognitive bias whereby they were unable to recognize their own incompetence and felt confident that they actually were competent. For example, after the investigators administered a 20 item grammar tests, the volunteers estimated how their ability to “identify grammatically correct standard English” compared with others. Those who scored in the bottom ten percent believed their grammar abilities to be in the top third of the group. The scientists suggested that this cognitive error occured because individuals who were unskilled in these domains suffered a dual burden: Not only did they reach erroneous conclusions and make unfortunate choices, but their intellectual incompetence robbed them of the ability to realize it. The scientists also described a paradox: improving the skills of participants, and thus increasing their competence, helped them recognize the limitations of their abilities. 

The Dunning-Kruger effect can be applied to mental illness: If a person has a mild to moderate neurosis (for example, depression or schizophrenia) he or she will understand that there is something wrong. He or she will often be willing to seek help from friends, family or health care professionals. But if the illness becomes too grave and deepens into a full blown psychosis, the affected person may no longer be able to understand that there is anything wrong with his or her sanity. If offered help, he or she may believe that there is a conspiracy or a confederacy aligned against him or her.

Sometimes it’s not enough to try to help someone. You must first help him or her get to a state such that he or she is able to accept help.