Brief History of the Patient and the Diagnosis
Richard Kuklinski, nicknamed “The Iceman,” was an American serial killer who was prosecuted of four capital murder in 1988 and a fifth in 2003, although he subsequently admitted to killing at least a hundred more and working as a contract killer for the Mafia in a sequence of press interviews. He was born on April 11, 1935, in Jersey City. Both of Kuklinski’s parents were physically abusive to him and his siblings. He said that as a boy, he killed neighborhood cats and that his first homicide occurred while he was in his teenage years. He dropped out of school around eighth grade, and according to his narrative, he went on to have a diverse existence of side jobs and criminal endeavors accompanied by a large number of murders perpetrated using various methods (Monckton, 2020). Bootlegging porn material was one of his illegal activities, and it was through this practice that he would become involved with criminal organizations.
Kuklinski gave several interviews to psychologists, criminologists, reporters, and authors while in custody, sharing the story of what happened and detailing how and why he executed hundreds of killings. Afterward interviews revealed that he alleged to have murdered a growing number of people, many of whom were members of criminal gangs. Kuklinski was diagnosed by both schizoid and obsessive personality disorders, and paranoid disorder. On the 5th of March 2006 and in Trenton, New Jersey Kuklinski died.
Substance Abuse, Addiction and Violence Issues Surrounding the Patient
Schizoid Personality Disorders
Schizoid personality disorder is an illness in which individuals evade interrelating with people and social activities. It is a condition that begins in early adulthood. Persons with this condition shy away from interacting with others. Schizoid disorder is characterized by inflexibility of a person’s personality which can in turn cause distress and many life areas interference such as work functioning and social. People with personality disorders face difficulties in forming healthy relationships and have poor coping skills. The symptoms of this type of disorder include one not desiring or enjoying close relationships, choosing to do activities alone and preference to live alone, not experiencing pleasure, and having difficulty in reacting to situations appropriately and expressing one’s feelings (Wang et al.,2020).
Obsessive Personality Disorder
Obsessive personality disorder is a health condition that is characterized by neatness, order, and extreme perfectionism in all aspects of life. Persons with this condition have beliefs which are dysfunctional which are thought to be established in adolescence stage and in turn causes one to hold high standards (Gurok et al.,2019). This disorder is characterized by extreme attention to detail, overwhelming punctuality need, being extremely frugal with money, formal, rigid, or stiff mannerisms, being extremely devoted to work at the expense of social relationships and family, and perfectionism that goes to the point of impairing with the ability to finish tasks.
It is a psychotic disorder which involves mental illness. Persons with this type of disorder have no ability to differentiate what is imagined and what is real. Delusions can persist for months or years although the disorder can end. This disorder is characterized by hallucinations, on-bizarre delusions, and irritability, anger and low moods. Substance abuse, addiction and violence issues surrounding paranoid, schizoid, and obsessive personality disorder exist. Drugs increases the chances for violence and mental illness. Studies have shown that mental illnesses pose a greater risk for violence.
Appropriate Nursing Interventions for the Patient
The nursing interventions for schizoid personality disorder include medications, psychotherapy, and group therapy. Anti-depressants can be used in treating anxiety or depression although there is no specific drug for schizoid personality disorder. Psychotherapy can be applied to develop close relationship with the clients who are having schizoid personality disorder so as to change their behaviors and beliefs that are problems and help them open up since some find it difficult to share about their inner lives. Group therapy is done to ensure social skills improvement and provision of support structure.
Interventions for obsessive personality disorder include structuring the clients daily activities through making a written schedule which has appointments, time for going for a walk, allocation for shopping, and allocating time for reading, reshaping patterns of thinking which involves helping patients to recognize negative feelings and thoughts and replacing them with positive thinking patterns which helps to alter self-critical or the process of negative thought patterns ,helping clients to control and cope with emotions, teaching communication skills which are effective, therapeutic relationship promotion ,promotion of the client’s safety, and establishment of boundaries in relationships (Wang et al.,2020).
The nursing interventions for paranoid disorder include physiological intervention such as provision of IV fluids to dehydrated patients, therapeutic interventions such as developing intimacy, partnership, and reciprocity the relationship between a nurse and the client, comforting and caring, physical intervention, alternative health practices and environmental manipulation, and teaching.
Progression of the Criminal Behavior
The difference between schizoid personality, paranoid disorder, and obsessive personality disorder and criminal behavior is the lack of interventions to reduce the hallucinations and delusions that directed Kuklinski to kill his friends. If the correct interventions were made at the early stage of the conditions, this would have led to the relief of the symptoms. Studies have shown that mental illnesses such as schizoid disorder and paranoid disorder increase the chances of committing crimes due to the command of unreal pressures (Monckton,2020). The progression to criminal behavior results from failure to seek treatment or poor interventional strategies.
The diagnosis revealed that the altered sensory perceptions of the client were related to neurological and biochemical changes. This was evidenced by the patient’s behavior of turning violent and committing numerous murders which included his close associates (Monckton,2020). Other evaluations included disturbed thought process associated with chemical imbalances, lack of social support system, and stressful life events as demonstrated by the individual’s delusions and inaccurate environment interpretation. Finally, the defensive coping mechanism of the patient related to the perception of others as a threat as indicated by his hostility, homicidal ideations, and aggression.
Gurok, M. G., Korucu, T., Kilic, M. C., Yildirim, H., & Atmaca, M. (2019). Hippocampus and amygdalar volumes in patients with obsessive-compulsive personality disorder. Journal of Clinical Neuroscience, 64, 259-263. Web.
Monckton Smith, J. (2020). Intimate partner femicide: Using Foucauldian analysis to track an eight stage progression to homicide. Violence Against Women, 26(11), 1267-1285. Web.
Wang, C., Shao, X., Jia, Y., Zhang, B., Shen, C., & Wang, W. (2020). Inhibitory brainstem reflexes under external emotional-stimuli in schizoid and histrionic personality disorders. Personality and Individual Differences, 158, 109-843. Web.