RUTH KAMANDE AND THE GROWING CRISIS OF CRIMES OF PASSION COULD BE EXPLAINED BY PERSONALITY DISRODERS AND INSTITUTIONS OF HIGHER LEARNING MUST GUIDE STUDENTS SAYS MOKAYA ONSASE

RUTH KAMANDE AND THE GROWING CRISIS OF CRIMES OF PASSION, LOVE CAN BE EXPLAINED BY PERSONALITY DISORDERS.
BY DR.MOKAYA ONSASE.

Ruth Kamande who was convicted of murder for capital offence. 

          There comes a time in our lives when our desire for each other could have led us to an asylum or prison had it not been sanctioned by mutual asset. During her mitigation hearing, Ruth Kamande said she was a model prisoner who never got into trouble,but during her sentencing the judge described her as manipulative and controlling and showed no remorse during the court process. Ruth Kamande represents a culmination of a case that has gripped the attention of the country since 2015 when the 21 year old kamande stabbed her boyfriend Faria Mohamed to death after a quarrel at his home in buru buru. She is a beauty who won the Ms langata women's prison title in 2016 and is articulate and we'll spoken, able to authoritatively address the court and give her side of the story. To many she just does not fit the profile of what they imagine a killer looks like. not surprisingly, because statistics show that most killers are men, mostly from disadvantaged backgrounds, with minimal education and have commuted other crimes.

Mokaya onsase the medical student head currently pursuing medicine and surgery at Egerton 

          Having served as a student leader and at a position to influence human character, today I would love to take this platform to educate the public on personality disorders that could explain human behavior and while data from 2014 shows that while the rates of violence against women have remained generally the same over the years, the rates of violence against men are going up across the country. this was her first crime, but follows a dangerous trend that shows that there has been a significant rise of intimate partner crimes committed by women.  The knife is the preferred weapon when lovers turn against each other, but women are more likely to use poison too. Well it's death for the deadly queen of langata. A majority of Kenyas flocked Kenya's social media to give their comments about the case scenario but I felt it is advisable to clear the air of what could explain human behavior.
Did you know that your personality disorder could land you in jail? Ruth kamande just represents a sample of a population with a given personality disorder known as cluster B personality disorders and more specific histrionic type.

          I want to categorically state that ruth kamande is a classical example of a person whose personality disorder led her to jail. Like a rainmaker in Umuofia, she needs no introduction for her deeds are conspicuous both to the allies and foes. Such vices in society can be corrected by psychotherapy and counselling in institutions of higher learning. However institutions of higher learning have done little to curb such issues that influence people's social life.

          Since her arrest in 2015, Kamande has become some sort of celebrity exciting media houses and blogs into frenzy of intentions headlines, playing to an incredulous audience that finds it hard to believe that someone who looks like her could commit such a grisly crime. Below is what you need to know about personality disorders and identifying where you fall could be a great idea on a world where technology is closely associated with levels of anxiety, depression and anger.

PERSONALITY DISORDER
– defined as enduring subjective experience and behavior that deviate  from cultural standard they are rigidly pervasive.
Have an onset in adolescence  or early adulthood. Are stable through time and
lead to unhappiness and impairment.

 Personality disorders are grouped int 3 clusters
CLUSTER A
(a)Paranoid
(b)Schizoid
(c) Schizotypal
People with this personality disorder are often perceived as odd and eccentric

  CLUSTER B

(a) Antisocial

(b)  borderline

(c)  histrionic

(d) Narcissistic

People with this disorder   often seem dramatic, emotional and erratic.they could be seriou serial killers of lovers, show surprise instead of remorse.

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CLUSTER C

(a) Avoidant

(b) Dependent

(c) Obsessive-compulsive

People with  this disorder  are often fearful and tearful.

Other category includes

Personality disorder not otherwise specified such as

(a)Passive-aggressive 

(b) Depressive personality disorder

let's briefly look at this personality disorders and it's my belief that the general public and students in particular shall benefit alot from this.

CLUSTER A

PARANOID PERSONALITY DISORDER

     Characterised by long standing suspiciouness and mistrust of people in general.

They are often hostile, irritable and angry and often interpret the actions of others as being deliberately deaming or threatening.

They  tend to be pathological jealous and augmentative.They May have fidelity issues

They are usually unemotional and fail to maintain friendly relationship.

In some cases may show stubbornness  and feeling of self importance.

They pay close attention to power and rank

Prevalence 0.5-2.5 in general population

Relatives of patients with schizophrenia show high incidence of this disorder than do control.

More common in men than in women.

High incidence found  in minority group, immigrants or people who are deaf than it is in general population.

Clinical features include:

1. Interpretation of other people actions as deliberately, deaming or threatening.

2. They  frequently dispute without any justification friends or associate loyalty or trustworthiness.

3. They  are pathologically jealous and for no reason question the fidelity of their spouses or sexual partners. 

4. They lack any warmth and are impressed with and pay close attention to power and rank.

5. They express  disdain for those who are seen as weak,sickling ,impaired or in some way defective.

-Life long.

-Occupational and marital problem are common.

Most of the people benefit from Psychotherapy.

Therapist should be straight forward when dealing with this patients.

An honest apology when in the wrong  and not excuses is required eg lateness for appointment.

They  do not fit in group therapy and individual psychotherapy is indicated which requires a professional and not overly warm style from therapist.

SCHIZOID PERSONALITY DISORDER

People with this type display  a life long pattern of social withdrawal.

They are often seen by others as eccentric , isolated or lonely.

-Affect 7.5% of general population

- Sex ratio is unknown.

-Some studies report  a 2:1 male to female ratio.

-Affected person gravitate towards solitary jobs that involve little or no contact with others

-May prefer night work to day work so that they need not deal with many people.

People with this personality disorder present with the following clinical features:

1. They are cold and aloof.

2. They show no involvements with everyday events and the concerns of others

3. They appears queit, distant, seclusive and unsociable.

4. They may pursue their lives with little need or longing for emotional  ties.

5. They are the last to be aware of changes in popular fashion.

6. Have solitary interest and success at non competitive lonely jobs  that others find difficult to tolerate.

7. Their sexual life may exist exclusively in fantasy.

8. They are often seen as aloof but such people can sometimes conceive, develop and give to the world  genuinely original creative ideas.

SCHIZOTYPICAL PERSONALITY DISORDER

People with this disorder are eccentric, suspicious and show poor interpersonal relationship.

Magical thinking,  peculiar notions, ideas of reference, illusions and derealization  are part of a schizotypal person’s everyday world.

-Prevalence rate 3% of the population.

-Sex ratio unknown

-Greater association among relatives with schizophrenia.

-Higher incidences among monozygotics twins.

-10% commit suicide.

-Schizotypal according to the current clinical thinking is premorbid personality of the patient with a condition called schizophrenia.

CLUSTER B

ANTISOCIAL PERSONALITY DISORDER

People with this personality disorder have an Inability to conform to the social norms that govern many aspects of people’s adolescence and adult behavior.

-Prevalence 3% in men 1% in women.

-More common in poor urban areas.

-In prison population prevalence may be as high as 75%.

-Familial pattern is present the disorder is 5 times more common in first degree relatives than among the control.

People with this disorder have the following clinical features:

1. Patient  with antisocial personality disorder may present as normal and even pleasant.

2. However they have a history of disregard for and violation of the right of others

3. They are often  known to steal, fight and abuse substances.

The disorder begin in child hood with symptoms occuring ealier in girls than in boys.

As adults they cannot and do not adhere to social norms.

They often fail to sustain relationship and have no concern for the feelings of others.

They have a tendency to violence and may get involved in repeated crimes.

It runs in unremitting course the height of the antisocial behaviour occuring in late adolescence.

Symptoms may decrease as person grows older.

Depressive disorder, alcohol use disorder and other substance abuse are common.

BORDERLINE PERSONALITY DISORDER 

People with this dosorder stand on the border between neurosis and psychosis.

They are characterised by extraordinary unstable affect, mood, behavior object relation and self image.

Affect about 1-2% of population.

Sex ratio 2.1 female to male. 

1st  degree relatives have increased frequency of mood disorder, alcohol use and other substance use.

Patient with this disorder always appear to be in a state of crisis.

Mood  swings are common.

Patient can be augumentative at one moment, depressed at the next and later complains of having no feelings.

Many have short lived psychotic episodes (so called micropsychotic) rather than full blown psychotic symptoms.

The painful nature of their lives is reflected in repetitive self destrutive acts such as they may slash their wrist and perform other self mutilation to elicit help from others or to express anger.

They are unable to maintain a relationship.

A stable diagnosis with little change over time

Patient may  change to schizophrenia and others have high incidence of mood disorder

Diagnosis is made before the age of 40 when the pt are attempting to make occupational, marital and other choices and are unable to deal with normal stages of the life cycle.

HISTRIONIC PERSONALITY DISORDER

People with this disorder are characterised by excessive display of emotions and behave in a colourful, dramatic and extoverted fashion.

The individual has attention seeking behavior and are over-concerned with physical attractiveness.

Their relationship is superficial and don’t last long.

They tend to be dependent on others, they are demanding and have endless need for reassurance.

Prevalence 2-3% of general population.

More common in women than in men.

Has an association with somatization disorder and alcohol use disorders.

People with this disorder have the following clinical features:

1. Show high degree of attention seeking behavior.

2. They tend to exaggerate their thoughts and feelings and make everything sound more important than it really is.

3. They display temper tantrums ,tears and accusations when they are not the  center of attention or are not receiving praise and approval.

4. Sexual fantasies about important  or famous people with whom they are involved are common.

5. But most histrionic patients may have psychosexual dysfunction eg women  may be anorgasmic and men may be impotent

In interviews they may be cooperative and earger to give details, make frequent slips of the tongue and generally use very colourful language what in kenya can be termed as slay queen character. 

6. Symptoms decrease with age.

7. People with this disorder are sensation seeker and may get into trouble with the law, abuse substance and act promiscuously.

NARCISSISTIC PERSONALITY DISORDER 

People who have this personality are Characterised by heightened sense of self importance and entittlement and grandiose feeling of uniqueness. They like bragging. 

-Prevalence less than 1% in general population.

-People with the disorder may impart to their children an unrealistic sense of omnipotence, grandiosity, beauty and talents thus offsprings of such parents may have  a higher than usual risk of developing the disorder.

They have the following clinical features:

1. Have a grandiose sense of self importance.

2.They consider themselves special and expect special treatment.

3.They believe they are unique in some way and behave accordingly.

4. They are envious of others, arrogant and expect favous from others but do not reciprocate these favours.

5. They are unable to show empathy and feign sympathy only to achieve their selfish ends.

6. Interpersonal difficulties,occupational problems,rejection and loss are among the stresss nacissistic commonly produce by their behavior– stress they are least able to handle.

7. They are prone to depression.

-It is chronic and difficult to treat

-These patients handle aging poorly as they inappropriately cling to youthful attributes and values( for example beauty and strength).

-They are therefore more vulnerable to mid life crisis.

CLUSTER C

AVOIDANT PERSONALITY DISORDER 

These people  show an extreme sentivity to rejection and may lead a socially withdrawn life.

-They are shy and show a great desire for companionship.

-But they need unusually strong guarantees of uncritical acceptance.

-Such people are commonly described as having an inferiority complex.

-it is very common.

-Prevalence is 1-10% of the general population.

-No information available on sex ratio or familial pattern.

-Pt are able to function in a protected environment.

-Some marry, have childen and live their lives surrounded only by family members

-If support systems  fail they are subject to depression anxiety and anger.

-They also present with social phobia.

Most people with this personality disorder present with the following clinical features:

1. Hypersentivity to rejection by others is the central clinical feature of avoidant personality disorder and their main personality traits is timidity.

2. They desire the warmth and security of human companionship but avoid relationship due to fear of rejection.

3. When taking to someone they express uncertainty, show lack of self confidence and may speak in a self effacing manner.

4. Because they are hypervigilant about rejection they are afraid to speak up in public or to make request from others

They avoid occupation requiring close interpersonal contact only become involved if they are certain to be liked.

DEPENDENT PERSONALITY DISORDER 

People in this category subordinate their own needs to those of others.

Get others to assume responsibility for major areas  of their lives.

Lack self confidence and may experince intense discomfort when alone for more than a brief period.

More common in women.

Account for 2-5% of all personality disorder.

More common in young children than older ones.

People with chronic physical illness in childhood may be most prone to the disorder.

They present with the following clinical features:

1. Characterised by pervasive patterns of dependent and submissive behavior related to an excessive need to be taken care of

2. They are indecisive, lack initiative and avoid position of responsibility and become anxious if asked to assume a leadership role

3. They fear being alone and usually seek others on who they can depend.

4. They are often pessimistic, passive and cannot express agressive feelings.

5. They cling to others for fear of abandonment and often persevere maltreatment for long periods.

In shared psychotic disorder one member of the pair usually suffers from this condition. The submissive partner takes on the more aggressive assertive partner on whom he or she is dependent.

An abusive  unfaithful or alcoholic spouse may be tolerated for long periods in order not to disturb the sense of attachment.

Course unknown.

Have impaired occupational functioning because of their inability to act independently and without close supervision.

Social relationship are limited to those on whom they can depend and may suffers physical or mental abuse because they cannot assert themseselves.

May suffer from depression if they lose the person they depend on.

OBSESSIVE COMPULSIVE PERSONALITY DISORDER

Characterised by emotional constriction, orderliness, perseverance ,stubbornness and indeciveness.

The essential features of the disorder is pervasive pattern of perfetionism and inflexibility.

They have the following clinical features:

1. Person with OCPD are preoccupied with rules regulations neatness order and achievement of perfection.

2. The individual are mostly formal serious and generally lack a sense of humor.

3. They marginalise or alienate other people and are often uncompromising.

4. Their fear of mistake render’s them  indecisive.

5. They can tolerate prolonged routine work and any distubance or change of their routine cause them considerable anxiety.

6. They alienate people; are unable to compromise and insist that others submit to their needs.

7. They are however eager to please those whom they see as more powerful than themselves and they carry out these people’s wishes in an authoritarian manner.

The course is variable and unpreditable.

From time to time people may develop obsessions or compulsions in the course of their disorder.

Some adolescence with OCPD  evolve into warm and loving adults others may develop schizophrenia or decade later major depressive disorder.

          Having passed this with alot of contempt I can therefore agree with Dr Kagucia Kago a consultant psychiatrist at mater hospital distinguishes cold blooded killing from which he says are commited by people who have exhibited sociaopathic or psychiatric traits usually fronts early childhood. According to him, psychopaths have no moral faculty. They feel no guilt over actions that might lead other people to feel guilty. They are cunning, manipulative and proficient lies. In conclusion many women who kill their spouses claim to do so in sled defence, just like kamande did. This defence has become so common that some jurisdictions call it "battered women syndrome" therefore institutions of higher learning should be areas of social behavioral change to change our society lest we will consume One another. 

. Dr.Mokaya Onsase is a Kenyan trained medical doctor and medical journalist, a novelist, public speaker, short story writer, blogger and an opinion shaper on contemporary societal matters.