Paranoid Personality Disorder
By Lubna Ghazanfar
People with paranoid personality disorder are generally characterized by having a long-standing pattern of pervasive distrust and suspiciousness of others. This suspicion influences relationships with family, colleagues and casual acquaintances. Individuals with this disorder assume that other people will exploit, harm, or deceive them, even if no evidence exists to support this expectation.
Individuals with Paranoid Personality Disorder are generally difficult to get along with and often have problems with close relationships because of lack trust in others; they have an excessive need to be self-sufficient and a strong sense of autonomy. They are often rigid, critical of others, and unable to collaborate, and they have great difficulty accepting criticism.
This disorder is different from paranoid schizophrenia because other symptoms of schizophrenia, such as hallucination, are not present and there is less impairment in social and occupational functioning (Kring, Davison, Neale & Johnson, 2005).
causes of paranoid personality disorder
Researchers today don’t know what causes paranoid personality disorder. There are many theories, however, about the possible causes of paranoid personality disorder.
Most professionals subscribe to a bio-psychosocial model of causation that are likely
- Biological and genetic factors; Endocrine (hormone), immune and neurotransmitter system functioning.
- Social factors: such as how a person interacts in their early development with their family and friends and other children. (Experiencing Traumatic events, early separation or lack of social support etc)
- Psychological factors: the individual’s personality and temperament shaped by their environment and learned coping skills to deal with stress. (Negative pattern of thinking, deficit in coping skills, judgment problems and impaired emotional intelligence).
This suggests that no single factor is solely responsible rather; all three factors are important.
Specific Culture, Age and Gender Feature of Paranoid Personality Disorder
- Some behaviors that are influenced by socio cultural context or specific life circumstances may be labeled as paranoid and may even be reinforced by the process of clinical evaluation.
- Members of minority groups, immigrants, or individuals of different ethnic background may display guarded or defensive behavior due to unfamiliarity (e.g., language barrier or lack of knowledge about rules and regulation) or in response to the perceived neglect.
- These behaviors can, in turn, generate anger and frustration in those who deal with these individuals, thus setting up a vicious cycle of mutual mistress, which should not be confused with paranoid personality disorder.
- Paranoid personality disorder may be first apparent in childhood and adolescence with poor peer relationships, social anxiety, hypersensitivity, peculiar thought and language. These children may appear to be odd and eccentric. This disorder appears to more commonly diagnose in males.
Prevalence of Paranoid Personality Disorder
- The prevalence of Paranoid personality disorder has been reported to be 0.5% – 2.5% in the general population.
- 10%-30% among those in inpatient psychiatric settings.
- 2%-10% among those in outpatient’s mental health clinics.
DSM-5 CRITERIA FOR diagnosing Paranoid personality disorder
According to the DSM-5, there are two primary diagnostic criterion for Paranoid Personality Disorder of which criterion A has seven sub features, four of which must be present to warrant a diagnosis of PPD:
A: Global mistrust and suspicion of others motives which commences in adulthood.
- The person with PPD will believe others are using, lying to, or harming them, without apparent evidence thereof.
- They will have doubts about the loyalty and trustworthiness of others,
- They will not confide in others due to the belief that their confidence will be betrayed.
- They will interpret ambiguous or benign remarks as hurtful or threatening, and
- Hold grudges,
- In the absence of objective evidence, believe their reputation or character are being assailed by others, and will retaliate in some manner and
- Will be jealous and suspicious without cause that intimate partners are being unfaithful.
B: Above symptoms will not be during a psychotic episode in schizophrenia, bipolar disorder, or depressive disorder with psychotic features,
A qualifier is that if the diagnostic criteria for PPD is met prior to the onset of Schizophrenia, it should be noted Paranoid Personality Disorder was pre-morbid (American Psychiatric Association, 2013).
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Washington, DC.
- American Psychiatric Association. (2000). Diagnostic and Statistical Manual Of Mental Disorders (4th ed., text rev.). Washington, DC.
- Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Abnormal psychology. Hoboken, NJ: John Wiley & Sons.
- Psych Central. (2014). Paranoid Personality Disorder Symptoms. Psych Central. Retrieved on November 11, 2015, from http://psychcentral.com/disorders/paranoid-personality-disorder-symptoms/