Understanding Subjects With Paranoid Schizophrenia Research

Introduction

Police officers often meet with people suffering from paranoid schizophrenia. Most of them are dressed in many layers of clothes, others hardly wear anything, and others dress in tattered clothing. They have poor personal hygiene and mostly live on the streets eating leftovers. Others might be privileged to live in a home. Despite this rough outward appearance most of them are harmless. On the good side, this condition currently can be managed by physicians through medications. However, these individuals may remain in this deplorable state because they may refuse to take the medication, deny that they suffer from any condition, and may not afford the medication. During this stage, they may be at high risk to engage in violent attacks and have an encounter with police officers. Officers who are first responders and negotiators should understand people diagnosed with paranoid schizophrenia by learning the characteristics they may present with to handle this situation amicably and peacefully.

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Symptoms

Paranoid schizophrenia symptoms persist in individuals who are untreated or remain unresponsive to medication. They cause individuals to have relationship difficulties, disrupt normal daily activities such as bathing, running errands, and eating which causes work and social dysfunction. Individuals present with one or more symptoms.

• Delusions
• Hallucinations
• Disorganized speech
• Disorganized behavior
• Negative symptoms
• Suicidal thoughts

Delusions are beliefs that are untrue that result from misjudgment of perceptions or experiences. It may be grandeur where individuals believe they have super capabilities, or delusion of control where people think they're being controlled by an external force such as aliens CITATION Har12 \l 1033 (Haralanova, Haralanov, Moller, & Hennig-Fast, 2012). There is also a delusion of reference where a person believes that an item or message was explicitly designed for them and the delusion of persecution where they think that everyone is out to get you or is conspiring against you.

Hallucinations are sensations of things that one may perceive to be real, but they do not exist. Frequently auditory hallucinations are common. A person claims to hear a particular voice which is different from their thoughts and is usually threatening, criticizing, and demoralizing. Disorganized speech occurs, and individuals might repeat phrases or words or start talking in the middle of a sentence. One may even come up with his own words. Disorganized behavior is an inability to keep one action in check in the natural setting of a home, and work. Negative symptoms are said to be lack of reactions in patients. It includes blunted expression, lack of emotions, and reduced interests in the world.

Paranoid schizophrenia is mainly characterized by delusions and auditory hallucinations. In this conditions delusions and paranoia, thoughts are centered on an organized theme. Arguments, anger, and anxiety are associated with this illness. Persecutory delusions make this individual suicidal. However, a combination of persecutory and grandiose delusions predisposes them to violence.

Prevalence, Cause, and Treatment

Schizophrenia is a condition that is suffered by over 21 million people globally. It affects males more with 12 million affected and 9 million females affected. It also starts at an earlier age in men (World Health Organisation, 2016). About 3.5 million Americans have schizophrenia, and approximately a third of them have paranoid schizophrenia. Its onset occurs at the age of 18 years and in the mid-30s (National Institute of Mental Health, 2018). Hallucinations and delusions are centered on people's cultures and beliefs. It is partly genetic as there is substantial evidence that shows if one is affected other close family members are likely to get the disease but it is a weak observation.

Research shows environment also contributes to the development of the disease. A combination of genetically predisposed individuals and environmental factors makes such individuals more vulnerable to the condition. Some of these environmental factors are exposure to the virus during infancy, sexual or physical abuse during childhood, early parental loss or separation, and hypoxemia during birth.

Treatment currently follows a recovery program that is termed as coordinated specialty care. It involves a group of trained professions who work with the patient to create a personalized treatment plan. It involves guardians' education, education and works support depending on the individual, and psychotherapy for family and the patient, drug intervention during psychotic episodes (Bengston, 2016). Decisions are made involving all these stakeholders. Electroconvulsive therapy is also being used and social skills development. In severe cases hospitalization is necessary.

Pharmacological therapy involves the antipsychotic medications that reduce delusions and hallucinations by controlling dopamine levels in the brain. Commonly used drugs are chlorpromazine, fluphenazine, haloperidol, and perphenazine. Drugs take 4 to 6 weeks for their effects to be observed while others take even 12 weeks. Various medications are changed to suit the condition of an individual thus the physician may adjust these drugs from time to time (National Institute of Mental Health, 2018). Adverse effects of this medication include weight gain, uncontrollable movements, drowsiness, and nausea and vision changes. When these side effects are observed a doctor's consultation is essentia (Mohandie & Duffy, 1999). Medication compliance even when symptoms have reduced is paramount for a better quality of life to be achieved since it is a long-term disease. Eating regularly balanced diet is crucial to avoid worsening of symptoms brought about by hypoglycemia. Fish oil, omega-3 fatty acids from fatty fish, and flaxseeds aid in mood balancing and improve concentration. Currently, hospitalization of these patients has reduced due to medication availability, cost of admission, mentally challenged homes, and acceptance of the community of these individuals.

Dealing With Paranoid Schizophrenia Subjects

Research has shown that people with paranoid schizophrenia involvement in violence are five times higher in them than in healthy individuals. It is exacerbated by various factors such as alcohol and drug of abuse, and possession of weapons to protect themselves against conspirators. These factors combined with their distrust of everyone poses to make them dangerous and may injure officers (Haralanova, Haralanov, Moller, & Hennig-Fast, 2012). Law enforcers find it difficult to control these individuals since some have voices that instruct them to injure people, and others think people want to hurt and make the first strike. It proves that these people are violent and law enforcers are at risk while dealing with them.

Early prevention of future violence is the idealistic way to follow. It may be achieved by recognition of an ongoing problem. A pattern has been observed that before an act of violence these individuals make phone calls, write letters, and other means of communication to send a message to members of the community (National Institute of Mental Health, 2018). Family members may bring these individuals to law enforcers who might indulge them in activities that stop them from acting. However, when society members raise such concerns, police officers overlook them missing an opportunity for evaluation and early intervention. Law enforcers may collaborate with psychiatrists in assessing people in the community who have been observed with problematic and deteriorating behavior to identify these individuals early enough. Police departments should have a unit to monitor these individuals on their threat levels. In case of an emergency, the officer receiving the distress call must record sufficient details on the mental health status of the victim and give it to the responders (Mohandie & Duffy, 1999). More information should be gathered from his physician on medical history to avoid fulfilling any delusion as these may escalate the violence. When the officers arrive where the incident is occurring, a hostage situation or self-violence, they should try to use negotiation skills.

Law enforcers should ensure they remain respectful when making conversation with these individuals and in their physical interactions. It is essential to use a soft and soothing tune because establishing a rapport is crucial during the incident. Negotiators should make an effort in comprehending the contexts of the individual comments. Despite bizarre delusions, officers should try to remain calm and not laugh or criticize these individuals. Officers should not argue their reality versus the delusions of the client (Haralanova, Haralanov, Moller, & Hennig-Fast, 2012). Active listening skills should be employed such as 'I understand your concern' empathy also should be used it helps to lower the aggressiveness of the subject. Creating a diversion to the current situation may come in handy to reduce their attention these might include asking them if they have eaten. Subjects have been known to verbally direct their frustrations to negotiators. It should be encouraged as it continues to lower down their guard. Subject's body space should be maintained when one tries to invade it may provoke them to act irrationally. After a rapport has been established, terms such as we and us should be used. After the situation has been successfully intervened on promises made to these patients should be fulfilled. When employing physical tactics, they should try not be seen as these might make them more paranoia. Pets and other possessions of the subject should be handled with caution as their destruction may exacerbate the situation.

Paranoid schizophrenia currently is being managed successfully through teamwork and use of medication. Officers who undertake training in handling these patients and situations have been more successful in their intervention compared to the time they had no these experience. Establishing rapport during negotiations with these individuals has proven to be essential in managing these incidences and talking to them over an extended period has helped in reducing these behaviors.

References

Bengston, M. (2016, May 15). Paranoid Schizophrenia. Retrieved from PsychCentral: https://psychcentral.com/lib/paranoid-schizophrenia/

Haralanova, E., Haralanov, S. B., Moller, H.-J., & Hennig-Fast, K. (2012). Subjective Emotional Over-arousal to Neutral Social Scenes in Paranoid Schizophrenia. European Archives of Psychiatry & Clinical Neuroscience, 59-68.

Mohandie, K., & Duffy, J. (1999). Understanding Subjects with Paranoid Schizophrenia. FBI Law Enforcement Bulletin, 8-16.

National Instite of Mental Health. (2018, february 19). Transforming the understanding and treatment of mental illnesses. Retrieved from National Instite of Mental Health: https://www.nimh.nih.gov/health/statistics/schizophrenia.shtml

World Health Organisation. (2016, April 20). Schizophrenia. Retrieved from World Health Organisation: http://www.who.int/mediacentre/factsheets/fs397/en/