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The Line (also called an I-Block) is one of the tetrominoes in the video game Tetris, of which there is well over 100 officially licensed versions. In Tetris, all pieces are made up of four squares, with a total of seven variations. The Line consists of all four squares being placed side-by-side. The objective in Tetris is to align blocks so that they fit into each other and leave no gaps. When an entire horizontal segment is filled with pieces, that segment is erased and the player is awarded points. If rows are not cleared then the screen will become full of pieces and the game ends. This game design gives The Line the greatest potential for scores as it offers the only way to erase four rows at once (a feat known as a "Tetris"). Due to the high score potential associated with The Line, other pieces are often strategically placed in order to give a slot for The Line to enter. The Line often arrives much later than desired and results in the screen being filled with pieces as rows cannot be cleared without it.
It should be noted that I have not interviewed The Line in person. However, after examining many hours of data provided over three decades, my diagnosis can be made with a reasonable degree of confidence.
My initial diagnostic impressions include:
-Oppositional Defiant Disorder
-Mixed Receptive-Expressive Language Disorder
ANOREXIA NERVOSA, RESTRICTING TYPE
The essential features of Anorexia Nervosa are that the individual refuses to maintain a minimally normal body weight, is intensely afraid of gaining weight, and exhibits a significant disturbance in the perception of the shape or size of his or her body.
Diagnostic Criteria:
A: Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
B: Intense fear of gaining weight or becoming fat, even though underweight.
C: Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
D: In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles.
Analysis of Criteria
The Line is notably underweight. It is twice as thin as the other pieces in it's environment (criteria A). Due to a lack of speech and traditional means of expression, it is unclear if The Line has an intense fear of gaining weight or becoming fat (criteria B). There may be a disturbance in the way in which The Line experiences it's weight or shape (criteria C), which will be discussed below. Criteria D cannot be assessed since the sex of The Line is unknown.
Factors contributing to Anorexia Nervosa are complex, but often involve issues of control and societal pressures or standards. The Line may be reacting to societal factors as the other pieces often align themselves in such a way that The Line needs to be skinny in order to "fit in." These cultural expectations may cause a disturbance in the way The Line experiences it's shape (criteria C). The Line also only orients itself in two ways, almost as if to say "I'm either tall and skinny or I'm short and fat!" This behavior may be in reaction to societal expectations.
In the Diagnostic and Statistical Manual of Mental Disorders (DSM), it states the following in the section for Anorexia Nervosa: "In determining a minimally normal weight, the clinician should consider . . . the individual's body build and weight history." There is no evidence to suggest that The Line has ever had a different body type, and thus it appears as if The Line may simply have a tall and thin frame. It is alternatively possible that The Line has been anorexic for over 30 years but this seems a less likely explanation than that of natural body type. In light of this and previously mentioned information, The Line does not meet criteria for the diagnosis of Anorexia Nervosa.
OPPOSITIONAL DEFIANT DISORDER
The essential feature of Oppositional Defiant Disorder is a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months and is characterized by the frequent occurrence of at least four of the following behaviors: losing temper, arguing with adults, actively defying or refusing to comply with the requests or rules of adults, deliberately doing things that will annoy other people, blaming others for his or her own mistakes or misbehavior, being touchy or easily annoyed by others, being angry and resentful, or being spiteful or vindictive.
Diagnostic Criteria:
A: A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:
(1) often loses temper
(2) often argues with adults
(3) often actively defies or refuses to comply with adults' requests or rules
(4) often deliberately annoys people
(5) often blames others for his or her mistakes or misbehaviors
(6) is often touchy or easily annoyed by others
(7) is often angry or resentful
(8) is often spiteful or vindictive
Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
B: The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
C: The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder
D: Criteria are not met for Conduct Disorder, and, if the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder.
Analysis of Criteria
For reference, Oppositional Defiant Disorder is on an unofficial scale measuring antisocial behavior. The diagnosis describing the least severe issues is Oppositional Defiant Disorder, the diagnosis describing moderate issues is Conduct Disorder (see the diagnoses for Link and Mario), and the diagnosis describing severe issues is Antisocial Personality Disorder (see the diagnosis for Kratos).
As mentioned previously, The Line is an integral part of the game Tetris as it is the only way to clear four rows at once. Consequently, pieces are often arranged to allow a place for The Line. While this technique can yield high rewards, it is risky because once a space has been created for The Line no other pieces can fit in the open space, and thus no rows can be cleared. Most people who have played Tetris have become annoyed (criteria A4) at the absence of The Line when desperately needed. Sometimes players will even shout at their game and demand that The Line arrive, but this has no effect (criteria A3). It is possible The Line does not show up in order to be spiteful or vindictive (criteria A8). The age and developmental level of The Line is unknown, making it difficult to ascertain if it's behavior is more frequent than is exhibited by it's peers (see Note for criteria A).
The Line's behavior does not appear to cause clinically significant impairment in any major life domain (criteria B). The Line does not appear to have a Mood or Psychotic Disorder (criteria C). Given the above information, it is unlikely criteria would be met for either Conduct Disorder or Antisocial Personality Disorder (criteria D).
Though The Line's behavior often irritates and annoys others, criteria is not met for Oppositional Defiant Disorder. However, due to the fact that The Line has annoyed and disobeyed others for over three decades, a diagnosis of Disruptive Behavior Disorder Not Otherwise Specified may be warranted.
MIXED RECEPTIVE-EXPRESSIVE LANGUAGE DISORDER
The essential feature of Mixed Receptive-Expressive Language Disorder is an impairment in both receptive and expressive language development as demonstrated by scores on standardized individually administered measures of both receptive and expressive language development that are substantially below those obtained from standardized measures of nonverbal intellectual capacity.
Diagnostic Criteria:
A: The scores obtained from a battery of standardized individually administered measures of both receptive and expressive language development are substantially below those obtained from standardized measures of nonverbal intellectual capacity. Symptoms include those for Expressive Language Disorder as well as difficulty understanding words, sentences, or specific types of words, such as spatial terms.
B: The difficulties with receptive and expressive language significantly interfere with academic or occupational achievement or with social communication.
C: Criteria are not met for a Pervasive Developmental Disorder.
D: If Mental Retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.
Coding Note: If a speech-motor or sensory deficit or a neurological condition is present, code the condition on Axis III.
Analysis of Criteria
Standardized tests have not been individually administered to The Line, and thus assessing criteria A is not possible. However, The Line neither speaks nor appears to understand the communication of others. It is unclear if these deficits have significantly interfered with occupational achievement or social interaction, though it's frequent absence has caused the work of it's peers to be for naught (criteria B). Due to a lack of information, it is also unclear if criteria are met for a Pervasive Developmental Disorder or Mental Retardation (criterion C and D).
So why is it that The Line doesn't talk? It appears that the most likely explanation for The Line's lack of production and comprehension of speech is that it has physiological deficiencies. Diagnostically, it seems a mental disorder is an inappropriate assessment and that The Line's issues in this area are better explained by a Medical Condition. Though a medical doctor is the most appropriate assessor of this situation, it bears noting that The Line appears to lack a voice box and, more crucially, a central nervous system.
Final Diagnosis:
Axis I: 312.9 Disruptive Behavior Disorder Not Otherwise Specified
Axis II: V71.09 No Diagnosis on Axis II
Axis III: Lack of central nervous system
Axis IV: None noted
Axis V: GAF=11
