Paranoid Personality Disorder
What is paranoid personality disorder?
Paranoid personality disorder (PPD) is one of a group of conditions called
eccentric personality disorders. People with these disorders often appear odd or
peculiar. People with PPD also suffer from paranoia, an unrelenting mistrust and
suspicion of others, even when there is no reason to be suspicious. This
disorder usually begins by early adulthood and appears to be more common in men
than in women.
What are the symptoms of PPD?
People with PPD are always on guard, believing that others are constantly
trying to demean, harm, or threaten them. These generally unfounded beliefs, as
well as their habits of blame and distrust, might interfere with their ability
to form close relationships. People with this disorder:
- Doubt the commitment, loyalty, or trustworthiness of others,
believing others are using or deceiving them
- Are reluctant to confide in others or reveal personal information
due to a fear that the information will be used against them
- Are unforgiving and hold grudges
- Are hypersensitive and take criticism poorly
- Read hidden meanings in the innocent remarks or casual looks of
- Perceive attacks on their character that are not apparent to
others; they generally react with anger and are quick to retaliate
- Have recurrent suspicions, without reason, that their spouses or
lovers are being unfaithful
- Are generally cold and distant in their relationships with
others, and might become controlling and jealous
- Cannot see their role in problems or conflicts, believing they
are always right
- Have difficulty relaxing
- Are hostile, stubborn, and argumentative
What causes PPD?
The exact cause of PPD is not known, but it likely involves a combination of
biological and psychological factors. The fact that PPD is more common in people
who have close relatives with schizophrenia suggests a genetic link between the
two disorders. Early childhood experiences—including physical or emotional
trauma—are also suspected to play a role in the development of PPD.
How is PPD diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a
complete medical history and physical examination. Although there are no
laboratory tests to specifically diagnose personality disorders, the doctor
might use various diagnostic tests to rule out physical illness as the cause of
If the doctor finds no physical reason for the symptoms, he or she might
refer the person to a psychiatrist or psychologist, health care professionals
who are specially trained to diagnose and treat mental illnesses. Psychiatrists
and psychologists use specially designed interview and assessment tools to
evaluate a person for a personality disorder.
How is PPD treated?
People with PPD often do not seek treatment on their own because they do not
see themselves as having a problem. The distrust of others felt by people with
PPD also poses a challenge for health care professionals because trust is an
important factor of psychotherapy (a form of counseling). As a result, many
people with PPD do not follow their treatment plan.
When treatment is sought, psychotherapy is the treatment of choice for PPD.
Treatment likely will focus on increasing general coping skills, as well as on
improving social interaction, communication, and self-esteem.
Medication generally is not used to treat PPD. However, medications—such as
anti-anxiety, antidepressant or anti-psychotic drugs—might be prescribed if
the person’s symptoms are extreme, or if he or she also suffers from an
associated psychological problem, such as anxiety or depression.
What are the complications of PPD?
The thinking and behaviors associated with PPD can interfere with a person’s
ability to maintain relationships, as well as their ability to function socially
and in work situations. In many cases, people with PPD become involved in legal
battles, suing people or companies they believe are "out to get them."
What is the outlook for people with PPD?
The outlook for people with PPD varies. It is a chronic disorder, which means
it tends to last throughout a person’s life. Although some people can function
fairly well with PPD and are able to marry and hold jobs, others are complete
disabled by the disorder. Because people with PPD tend to resist treatment, the
outcome often is poor.
Can PPD be prevented?
Although prevention of the disorder might not be possible, treatment can
sometimes allow a person who is prone to this disorder to learn more productive
ways of dealing with situations.
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