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Paranoid Personality Disorder (PPD): Causes, Symptoms, Diagnosis And Treatment

A personality disorder is a type of mental disorder, which causes the affected individual to have an unhealthy pattern of functioning, behaving and thinking. They struggle with understanding and perceiving people and incidents, causing problems and often limiting them from leading a normal, healthy and happy life.

Personality disorders are grouped into different clusters (A, B & C), based on similar characteristics and symptoms. Cluster A personality disorders are characterized by odd, eccentric thinking or behaviour, which includes paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder [1] .

Today, the article will take a detailed look into one of the cluster A personality disorders, paranoid personality disorder.

What Is Paranoid Personality Disorder?

A type of eccentric personality disorder, paranoid personality disorder (PPD) causes the individual affected by it to seem odd or unusual to others. An individual with a mental disorder are suspicious of other people, lack trust in others and believe that others want to harm them.

The relentless mistrust of others is rooted in no specific reason at all. For people suffering from the condition, they are not able to and do not believe that their behaviour is different from that of the normal [2] .

In most people, paranoid personality disorder begins in childhood or early adolescence. Paranoid personality disorder is common in men than in women. According to studies, the condition affects about 2 per cent to 4 per cent of the general population.

What Are The Causes Of Paranoid Personality Disorder?

Doctors assert the cause to be a combination of biological and psychological factors. The exact cause of paranoid personality disorder is not known. The mental disorder is largely found in individuals who have close relatives with schizophrenia. The genetic link between the two conditions is being studied [3] .

A history of delusional disorders is also associated, along with early childhood trauma being another one.

What Are The Symptoms Of Paranoid Personality Disorder?

An individual with paranoid personality disorder will never understand or realise the symptoms. However, it is the people around them who will be able to understand the condition - the lack of trust and unwarranted anger [4] .

People with the condition will always be on guard and will behave as if everyone around them is trying to harm them, resulting in hampering their ability to develop meaningful and close relationships.

People with this disorder [5] :

  • are reluctant to confide in other people and find it extremely difficult to share personal information,
  • are hypersensitive and take criticism poorly,
  • lack the ability to forgive and hold grudges,
  • doubt commitment, loyalty, or trustworthiness of others,
  • read hidden meanings in simple things (such as innocent remarks or casual looks of others),
  • generally, react with anger,
  • are suspicious of everything and everybody with no apparent reason,
  • are unable to be close in a relationship (tend to be distant and cold),
  • can become controlling and jealous in relationships,
  • are unable to see their role in problems or conflicts and believe they are always right,
  • have difficulty relaxing, and
  • are argumentative and stubborn.

Some of the symptoms of paranoid personality disorder can be similar to symptoms of Schizophrenia and borderline personality disorder.

How Is Paranoid Personality Disorder Diagnosed?

The doctor will begin by asking about the symptoms and medical history. A physical evaluation will be carried out to check for any other medical conditions.

Based on the symptoms, you will be referred to a psychiatrist, psychologist, or another mental health professional for further testing [6] [7] .

The mental health professional will perform a comprehensive assessment, which will include questions about your childhood, school, work, and relationships. The assessment also includes response tests, where you will be asked to respond to a certain situation.

According to the diagnosis and its assessment, the mental health professional will develop a treatment plan for you.

How Is Paranoid Personality Disorder Treated?

Usually, people with the condition do not seek treatment on their own because they do not see themselves as having a problem.

However, psychotherapy is the most effective form of treatment for paranoid personality disorder. It is a form of counselling and will focus on increasing general coping skills, improving social interaction, communication, and self-esteem of the individual [8] [9] .

The treatment can be often challenging, as the individuals have trouble trusting others.

Medications can also be helpful, especially if the person has other related conditions such as depression or anxiety disorder. The medications include anti-anxiety, antidepressant or antipsychotic drugs.

FAQs On Paranoid Personality Disorder

Q. Does paranoid personality disorder get worse with age?

Ans: Yes, most personality disorder can worsen with age.

Q. What triggers paranoid personality disorder?

Ans: Although it is not clear, early childhood experiences, including physical or emotional trauma could act as triggers.

Q. How do you know if you are paranoid?

Ans: Some identifiable of individuals with symptoms of paranoia include mistrust, defensive attitude in response to imagined criticism, difficulty with forgiveness, fear of being deceived or taken advantage of, inability to relax, or are argumentative [10] .

Q. Can anxiety make you paranoid?

Ans: Yes. If you have anxiety, you are more likely to be paranoid and experience paranoid thoughts.

View Article References
  1. [1] van der Wal, S. J., Bienvenu III, O. J., Romanoski, A. J., Eaton, W. W., Nestadt, G., & Samuels, J. (2018). Longitudinal relationships between personality disorder dimensions and depression in a community sample.Neurology, Psychiatry and Brain Research,30, 56-61.
  2. [2] Haghighatfard, A., Andalib, S., Amini Faskhodi, M., Sadeghi, S., Ghaderi, A. H., Moradkhani, S., ... & Ghadimi, Z. (2018). Gene expression study of mitochondrial complex I in schizophrenia and paranoid personality disorder.The World Journal of Biological Psychiatry,19(sup3), S133-S146.
  3. [3] Lenzenweger, M. F., Clarkin, J. F., Caligor, E., Cain, N. M., & Kernberg, O. F. (2018). Malignant narcissism in relation to clinical change in borderline personality disorder: an exploratory study.Psychopathology,51(5), 318-325.
  4. [4] Lee, R. J. (2017). Mistrustful and misunderstood: a review of paranoid personality disorder.Current behavioral neuroscience reports,4(2), 151-165.
  5. [5] Furnham, A., & Crump, J. (2015). A Big Five Facet Analysis of a Paranoid Personality Disorder.Journal of Individual Differences.
  6. [6] Hörz-Sagstetter, S., Diamond, D., Clarkin, J. F., Levy, K. N., Rentrop, M., Fischer-Kern, M., ... & Doering, S. (2018). Clinical characteristics of comorbid narcissistic personality disorder in patients with borderline personality disorder.Journal of personality disorders,32(4), 562-575.
  7. [7] Muñoz‐Negro, J. E., Prudent, C., Gutiérrez, B., & Cervilla, J. A. (2019). Paranoia and risk of personality disorder in the general population.Personality and mental health,13(2), 107-116.
  8. [8] Bateman, A. W., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorder.The Lancet,385(9969), 735-743.
  9. [9] Becker, D. F., & Grilo, C. M. (2015). Comorbidity of mood and substance use disorders in patients with binge-eating disorder: associations with personality disorder and eating disorder pathology.Journal of psychosomatic research,79(2), 159-164.
  10. [10] Sher, L., Rutter, S. B., New, A. S., Siever, L. J., & Hazlett, E. A. (2019). Gender differences and similarities in aggression, suicidal behaviour, and psychiatric comorbidity in borderline personality disorder.Acta Psychiatrica Scandinavica,139(2), 145-153.
Story first published: Saturday, September 21, 2019, 11:30 [IST]
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