Three Dynamic Roles of the Clinical Psychologist on the Acute Closed Psychiatric Ward
Meidan Turel, Michael Siglag, Alexander Grinshpoon in Clinical Psychology in the Mental Health Inpatient Setting, 2019
Paranoia is a state of mind characterized by delusions of persecution. Melanie Klein and her followers showed that every human being may, at times of stress and primitive anxiety, return (or regress) to paranoid-schizoid positions. That is, modes of relating to our inner and outer reality via unconscious mechanisms of splitting, denial, projection, projective identification, accompanied by experiences of hyper-vigilance and heightened suspiciousness (Segal, 1979). Behind the closed doors of the psychiatric ward, where a large proportion of admitted patients are prone to suffer from paranoid ideation and action, it is expected that an atmosphere of paranoia will prevail (see Sharfstein, 2009). Searles (1979c) addresses this phenomenon in his paper “Paranoid processes among members of the therapeutic team.” In the opening vignette of this chapter, the secretary expressed some paranoid ideas in relation to Dr. Rachel, whom she accused of logging on to her computer and tampering with the data. In practice, however, people usually tend to ward off such feelings by activating them in others through the mechanism of projective identification (Segal, 1979).
Stimulants
G. Hussein Rassool in Alcohol and Drug Misuse, 2017
Some of the effects of synthetic cathinones include (NIDA 2016): Paranoia – extreme and unreasonable distrust of others.Hallucinations – experiencing sensations and images that seem real though they are not.Increased sociability.Increased sex drive.Panic attacks.Excited delirium – extreme agitation and violent behaviour. In addition, there are other health effects including nosebleeds, sweating, nausea, delirium dehydration, breakdown of skeletal muscle tissue and kidney failure. Intoxication associated with snorting or needle injection from synthetic cathinones has resulted in death (NIDA 2016). The psychoactive substances are associated with cravings and severe withdrawal symptoms. The withdrawal symptoms may include: depression, anxiety, tremors, insomnia and paranoia.
Mental Maladies in the Twentieth Century
Petteri Pietikainen in Madness, 2015
Karl Kahlbaum, the great unsung hero of modern psychiatry, also described a condition he named paranoia. This was another remarkable diagnostic innovation, for paranoia has become perhaps the most well-known form of mental disorder and a symbol of madness in the public imagination. Paranoid persons seem to behave quite normally in many ways and they do not necessarily display symptoms of insanity until something comes up, be it a topic of discussion, a memory of something or a name of someone. In this very instant paranoia ‘conquers’ personality and abruptly changes the mode of thinking. In this state of mind, paranoid persons are immune to reasoning that is contrary to their strongly felt beliefs about someone trying to poison them, spies shadowing them, a landlord scheming to kill them, everybody being brainwashed and so forth. Other basic symptoms of paranoia are delusions of grandiosity: individuals with paranoia are kings and queens, prophets and sages, millionaires and generals or they are rulers of the universe or inventors of perpetual motion machines. To Kahlbaum, paranoia was a form of partial insanity manifesting itself in difficult life situations.
Mild-to-moderate schizotypal traits relate to physiological arousal from social stress
Published in Stress, 2021
Preethi Premkumar, Prasad Alahakoon, Madelaine Smith, Veena Kumari, Diviesh Babu, Joshua Baker
People with high schizotypal traits could experience more stress in close interpersonal interaction than public-speaking situations because they feel paranoid in interpersonal situations (Horton et al., 2014). Paranoia constitutes suspiciousness, perceived hostility, and blaming others in ambiguous social situations, having less social engagement and more social problems (Combs et al., 2013). Individuals with a moderate level of paranoia are more alert to social threat from strangers and exhibit more momentary paranoia than those with a low level of paranoia (Collip et al., 2011b). High paranoia in adolescents with social anxiety disorder would further suggest that paranoia is a part of social anxiety (Pisano et al., 2016). People with high schizotypal traits are more anxious in interpersonal situations than people with depression-like tendencies (Miller & Lenzenweger, 2012). Hence, interpersonal sensitivity could be a hallmark of schizotypy.
Paranoia and Suicidality: A Cross-Sectional Study in the General Population
Published in Archives of Suicide Research, 2022
Carmen M. Carrillo de Albornoz, Blanca Gutiérrez, Inmaculada Ibanez-Casas, Jorge A. Cervilla
The term paranoia comes from the Greek words para (side) and gnous (knowledge) denoting “parallel or aberrant thought” and has been used since the classical era to connote madness. Kahlbaum rescued the term paranoia for psychiatry in the 19th Century, providing a more specific meaning referring to an exaggerated and/or unfounded distrust of others or the external environment (Kahlbaum, 1863). Paranoid thinking is the most frequent topic among delusional and delusion-like phenomena and subclinical paranoia seems to be a rather common trait in the general population (Freeman, 2006). From a clinical viewpoint, patients with delusional disorder present varying degrees of “paranoia vera” (de Portugal et al., 2013), a paranoid dimension that also expresses dimensionally in most psychotic disorders to varying extents (Muñoz-Negro et al., 2015). In all, there is sufficient evidence to consider that paranoia can be understood as a psychological dimension present in the general population which, in extreme cases, acquires a true psychopathological/dysfunctional level (Bebbington et al., 2013; Freeman, 2016) As described in the general population, it includes persecutory, self-referential elements of interpersonal “sensitivity” and distrust (Bebbington et al., 2013).
Anxiety and Adverse Life Events in Professional Creative and Early Psychosis Populations
Published in Psychiatry, 2020
Julie Crabtree, Jennifer L. Hudson, Toby Newton-John
Anxiety disorders often precede psychosis partly due to their early presentation (Yung et al., 2003). In a systematic review of studies investigating the relationship between current anxiety symptoms and psychosis, delusions and hallucination (Hartley et al., 2013), the authors noted that anxiety is specifically related to the severity of paranoia and delusions. Furthermore, anxiety was linked to an increase in auditory hallucinations (Delespaul et al., 2002). One possible explanation for the association between anxiety and psychotic symptoms is that anxiety increases safety behavior, which is driven and reinforced by paranoid beliefs (Freeman et al., 2007). In non-clinical populations, anxiety was found to moderate the relationship between experimentally induced stress and paranoia; indicating that those with elevated anxiety and at times of elevated stress, were more likely to experience paranoia and vulnerability to psychosis (Lincoln et al., 2009). In further support of the link between anxiety and psychoses, elevated rates of comorbid anxiety have been identified in Scz and BP populations. Merikangas et al. (2007) report that as many as 86.7% of bipolar patients (BP1) may have lifetime comorbid anxiety disorders. Cosoff and Hafner (1998) also recorded a similarly high one-month prevalence of anxiety disorders (42–45%) across 100 Scz, SczA, and BP inpatients.
Related Knowledge Centers
- Anxiety
- Delusion
- Irrationality
- Phobia
- Psychosis
- Social Anxiety
- Suspicion
- Fear
- Attribution Bias
- Victim Mentality