Paranoia/Paranoid Personality
Disorder

Paranoia/Paranoid Personality Disorder: Overview

This condition manifests itself as an unwarranted tendency to interpret the actions of other people as deliberately threatening or demeaning.  People with a paranoid personality disorder are suspicious of other people, and they are usually unable to acknowledge their own negative feelings towards others. The word personality describes deeply ingrained patterns of behavior and the manner in which individuals perceive, relate to, and think about themselves and their world.  Personality traits are conspicuous features of personality and are not necessarily pathological, although certain styles of personality traits may cause interpersonal problems.  Personality disorders are rigid, inflexible, and maladaptive behavior patterns of sufficient severity to cause significant impairment in functioning or internal distress.  Personality disorders are enduring and persistent styles of behavior and thought, not atypical episodes.

Paranoid personality disorder is an unwarranted tendency to interpret the actions of other people as deliberately threatening or demeaning.  The disorder, surfacing by early adulthood, is manifested by an omnipresent sense of distrust and unjustified suspicion that yields persistent misinterpretation of others' intentions as being malicious.  People with a paranoid personality disorder are usually unable to acknowledge their own negative feelings towards others but do not generally lose touch with reality.  They will not confide in people, even if they prove trustworthy, for fear of being exploited or betrayed.  They will often misinterpret harmless comments and behavior from others and may build up and harbor unfounded resentment for an unreasonable length of time.

Causes and Development; Contributing Risk Factors

The specific cause of this disorder is unknown.  Paranoid personality disorder can result from negative childhood experiences fostered by a threatening domestic atmosphere.  It is prompted by extreme and unfounded parental rage and/or condescending parental influence that cultivate profound child insecurities.

Incidence appears increased in families with a schizophrenic member.  Histories of paranoid behavior are common.

Signs and Symptoms

Symptoms include:
  • Suspicion
  • Concern with hidden motives
  • Expects to be exploited by others
  • Inability to collaborate
  • Social isolation
  • Poor self image
  • Detachment
  • Hostility
  • Poor sense of humor.
People with this disorder typically exhibit a strong need for self-sufficiency, are rigid and often litigious.  Because of their avoidance of closeness with others, they may appear calculating and cold.  Usually men are diagnosed with it more than women.

Diagnosis and Tests

A psychological evaluation is needed to confirm the diagnosis.

Treatment and Prevention

Treatment of paranoid personality disorder is difficult because the person's traits make it difficult to form a professional relationship.  The health care provider should respect interpersonal distance, and avoid defensiveness or attempts at humor.

Treatment can be very effective in controlling the paranoia but is difficult because the person may be suspicious of the doctor.  Medications and therapy are common and effective approaches to alleviating the disorder.

Comprehensive treatment, which includes services that exist outside the formal treatment system, is crucial to ameliorate symptoms, assist recovery, and, to the extent that these efforts are successful, redress stigma.  Consumer self-help programs, family self-help, advocacy, and services for housing and vocational assistance complement and supplement the formal treatment system.  Consumers, that is, people who use mental health services themselves, operate many of these services.  The logic behind their leadership in delivery of these services is that consumers are thought to be capable of engaging others with mental disorders, serving as role models, and increasing the sensitivity of service systems to the needs of people with mental disorder.

Medications
Medications for paranoid personality disorder are generally not encouraged, as they may contribute to a heightened sense of suspicion that can ultimately lead to patient withdrawal from therapy.  They are suggested, however, for the treatment of specific conditions of the disorder, such as severe anxiety or delusion, where these symptoms begin to impede normal functioning.  Medications prescribed for precise conditions should be used for the briefest interval possible to successfully control them.

Psychotherapies
Psychotherapy is the most promising method of treatment for Paranoid Personality Disorder.  People afflicted with this disorder have deep foundational problems that necessitate intense therapy.  A confident therapist-client relationship offers the most benefit to people with the disorder, yet is extremely difficult to establish due to the dramatic skepticism of patients with this condition.  People with paranoid personality disorder rarely initiate treatment and often terminate it prematurely.  Likewise, building therapist-client trust requires great care and is complicated to maintain even after a confidence level has been founded.

Self Care
Self-care approaches to paranoid personality disorder are not likely to be effective forms of treatment.  The high levels of suspicion and mistrust pervasive in people with this disorder make the work of support groups improbably helpful and potentially damaging.

The means of preventing this disorder are unknown.

Prognosis; Complications

The long-term projection for people with paranoid personality disorder is bleak; people with this disorder tend to resist treatment.  Most patients experience predominant symptoms of the disorder for the duration of their lifetime and require consistent therapy.  Without treatment this disorder will become chronic.

The social consequences of serious mental disorders – family disruption, loss of employment and housing-can be calamitous.

Signs, symptoms & indicators of Paranoia/Paranoid Personality Disorder:

Symptoms - General

Counter-indicators

Symptoms - Mind - Emotional

(Very) angry/hostile disposition may be a sign or symptom of Paranoia/Paranoid Personality Disorder (Very) angry/hostile disposition

Argumentativeness and hostility are possible signs of paranoid personality disorder.

Symptoms - Mind - General

A suspicious nature is often a sign or symptom of Paranoia/Paranoid Personality Disorder A suspicious nature

Symptoms of paranoid personality disorder include suspicion, concern with hidden motives and expecting to be exploited by others.

Moderate/low tolerance of other people may be a sign or symptom of Paranoia/Paranoid Personality Disorder Moderate/low tolerance of other people

Being unforgiving is a possible symptom of paranoid personality disorder.

Being an unsocial person may be a sign or symptom of Paranoia/Paranoid Personality Disorder Being an unsocial person

The inability to collaborate with others and social isolation are possible symptoms of paranoid personality disorder.

Being detached from reality may be a sign or symptom of Paranoia/Paranoid Personality Disorder Being detached from reality

Being detached can be a symptom of paranoid personality disorder.

Counter-indicators
Being a sociable person may contraindicate Paranoia/Paranoid Personality Disorder Being a sociable person

The inability to collaborate with others and social isolation are possible symptoms of paranoid personality disorder.

Counter-indicators
A trusting nature often contraindicates Paranoia/Paranoid Personality Disorder A trusting nature

Symptoms of paranoid personality disorder include suspicion, concern with hidden motives and expecting to be exploited by others.

Conditions that suggest Paranoia/Paranoid Personality Disorder:

Mental

Risk factors for Paranoia/Paranoid Personality Disorder:

Family History

Schizophrenia in family members may increase risk of Paranoia/Paranoid Personality Disorder Schizophrenia in family members

The incidence of paranoid personality disorder appears increased in families with a schizophrenic member.

Paranoia/Paranoid Personality Disorder can lead to:

Mental

Recommendations for Paranoia/Paranoid Personality Disorder:

Psychological

KEY

Weak or unproven link: may be a sign or symptom of; may suggest; may increase risk of
Weak or unproven link:
may be a sign or symptom of; may suggest; may increase risk of
Strong or generally accepted link: is often a sign or symptom of; often leads to
Strong or generally accepted link:
is often a sign or symptom of; often leads to
Weakly counter-indicative: may contraindicate
Weakly counter-indicative:
may contraindicate
Strong counter-indication: often contraindicates
Strong counter-indication:
often contraindicates
Very useful: is highly recommended for
Very useful:
is highly recommended for