Paranoid personality disorder
Encyclopedia
Paranoid personality disorder is a psychiatric
diagnosis characterized by paranoia
and a pervasive, long-standing suspiciousness and generalized mistrust
of others.
Those with the condition are hypersensitive, are easily slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions to validate their prejudicial ideas or biases. Paranoid individuals are eager observers. They think they are in danger and look for signs and threats of that danger, disregarding any facts. They tend to be guarded and suspicious and have quite constricted emotional lives. Their incapacity for meaningful emotional involvement and the general pattern of isolated withdrawal
often lend a quality of schizoid isolation to their life experience. Simply put, people with this particular disorder have a tendency to bear grudges, suspiciousness, tendency to interpret others actions as hostile, persistent tendency to self-reference, and a tenacious sense of personal right.
The World Health Organization
's ICD-10
lists paranoid personality disorder as Paranoid personality disorder.
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
Cultural sensitivities
World Health Organization
, in the ICD-10, points out for different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations.
identified five subtypes of paranoid. Any individual paranoid may exhibit none or one of the following:
, antidepressant
s, antipsychotic
s and anti-anxiety medications can play a role when an individual is receptive to intervention.
A large long-term Norwegian
twin study
found paranoid personality disorder to be modestly heritable and to share a portion of its genetic and environmental risk factors with schizoid
and schizotypal personality disorder
.
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
diagnosis characterized by paranoia
Paranoia
Paranoia [] is a thought process believed to be heavily influenced by anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself...
and a pervasive, long-standing suspiciousness and generalized mistrust
Mistrust
Mistrust means "to doubt, to lack confidence in". It does not necessarily imply any serious suspicion of malice or bad faith.This can happen in everyday life in situations where the parties otherwise trust each other, but find themselves questioning that trust...
of others.
Those with the condition are hypersensitive, are easily slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions to validate their prejudicial ideas or biases. Paranoid individuals are eager observers. They think they are in danger and look for signs and threats of that danger, disregarding any facts. They tend to be guarded and suspicious and have quite constricted emotional lives. Their incapacity for meaningful emotional involvement and the general pattern of isolated withdrawal
Social isolation
Social isolation refers to a lack of contact with society for members of social species. There may be many causes and individuals in numerous generally social species are isolated at times, it need not be a pathological condition. In human society, in those cases where it is viewed as a pathology,...
often lend a quality of schizoid isolation to their life experience. Simply put, people with this particular disorder have a tendency to bear grudges, suspiciousness, tendency to interpret others actions as hostile, persistent tendency to self-reference, and a tenacious sense of personal right.
Causes
A genetic contribution to paranoid traits and a possible genetic link between this personality disorder and schizophrenia exist. Psychosocial theories implicate projection of negative internal feelings and parental modeling.WHO
The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
's ICD-10
ICD-10
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
lists paranoid personality disorder as Paranoid personality disorder.
- It is characterized by at least three of the following:
- excessive sensitivity to setbacks and rebuffs;
- tendency to bear grudges persistently, i.e. refusal to forgive insults and injuries or slights;
- suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous;
- a combative and tenacious sense of personal rights out of keeping with the actual situation;
- recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner;
- tendency to experience excessive self-importance, manifest in a persistent self-referential attitude;
- preoccupation with unsubstantiated "conspiratorial" explanations of events both immediate to the patient and in the world at large.
-
- Includes:
- expansive paranoid, fanatic, querulant and sensitive paranoid personality (disorder)
- Includes:
-
- Excludes:
- delusional disorderDelusional disorderDelusional disorder is an uncommon psychiatric condition in which patients present with circumscribed symptoms of non-bizarre delusions, but with the absence of prominent hallucinations and no thought disorder, mood disorder, or significant flattening of affect...
- schizophreniaSchizophreniaSchizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
- delusional disorder
- Excludes:
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
Cultural sensitivities
World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
, in the ICD-10, points out for different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations.
Millon's subtypes
Theodore MillonTheodore Millon
Theodore Millon is an American psychologist known for his work on personality disorders.-Biography:Millon was born in 1928, the only child of immigrant Jewish parents from Lithuania and Poland. His 19th-century ancestors came from the town of Valozhyn, then a part of the Russian Empire...
identified five subtypes of paranoid. Any individual paranoid may exhibit none or one of the following:
- fanatic paranoid - including narcissisticNarcissistic personality disorderNarcissistic personality disorder is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity...
features - malignant paranoid - including sadisticSadistic personality disorderSadistic personality disorder is a diagnosis which appeared only in an appendix of the revised third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders . The current version of the DSM does not include it, so it is no longer considered a valid...
features - obdurate paranoid - including compulsiveObsessive-compulsive personality disorderObsessive–compulsive personality disorder is a personality disorder characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.- Signs and symptoms :The primary symptoms of OCPD...
features - querulous paranoid - including negativistic (passive-aggressive) features
- insular paranoid - including avoidantAvoidant personality disorderAvoidant personality disorder is a personality disorder recognized in the Diagnostic and Statistical Manual of Mental Disorders handbook in a person characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of...
features - litigious paranoia - including a form of paranoia in which the person seeks legal proof or justification for systematized delusions
Differential diagnosis
The following conditions commonly coexist (comorbid) with paranoid personality disorder:- very brief psychotic episodes (lasting minutes to hours)
- delusional disorderDelusional disorderDelusional disorder is an uncommon psychiatric condition in which patients present with circumscribed symptoms of non-bizarre delusions, but with the absence of prominent hallucinations and no thought disorder, mood disorder, or significant flattening of affect...
- schizophreniaSchizophreniaSchizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
- major depressive disorder
- agoraphobiaAgoraphobiaAgoraphobia is an anxiety disorder defined as a morbid fear of having a panic attack or panic-like symptoms in a situation from which it is perceived to be difficult to escape. These situations can include, but are not limited to, wide-open spaces, crowds, or uncontrolled social conditions...
- obsessive-compulsive disorderObsessive-compulsive disorderObsessive–compulsive disorder is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing the associated anxiety, or by a combination of such obsessions and compulsions...
- alcohol and substance-related disorders
- schizoid personality disorderSchizoid personality disorderSchizoid personality disorder is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness, and sometimes apathy, with a simultaneous rich, elaborate, and exclusively internal fantasy world...
- schizotypal personality disorderSchizotypal personality disorderSchizotypal personality disorder, or simply schizotypal disorder, is a personality disorder that is characterized by a need for social isolation, anxiety in social situations, odd behavior and thinking, and often unconventional beliefs.-Genetic:...
- narcissistic personality disorderNarcissistic personality disorderNarcissistic personality disorder is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity...
- avoidant personality disorderAvoidant personality disorderAvoidant personality disorder is a personality disorder recognized in the Diagnostic and Statistical Manual of Mental Disorders handbook in a person characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of...
- borderline personality disorderBorderline personality disorderBorderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...
Treatment
Because of reduced levels of trust, there can be challenges in treating paranoid personality disorder. However, psychotherapyPsychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
, antidepressant
Antidepressant
An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. According to Gelder, Mayou &*Geddes people with a depressive illness will experience a therapeutic effect to their mood;...
s, antipsychotic
Antipsychotic
An antipsychotic is a tranquilizing psychiatric medication primarily used to manage psychosis , particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s...
s and anti-anxiety medications can play a role when an individual is receptive to intervention.
Epidemiology
Paranoid personality disorder occurs in about 0.5%-2.5% of the general population. It is seen in 2%-10% of psychiatric outpatients. It occurs more commonly in males.A large long-term Norwegian
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...
twin study
Twin study
Twin studies help disentangle the relative importance of environmental and genetic influences on individual traits and behaviors. Twin research is considered a key tool in behavioral genetics and related fields...
found paranoid personality disorder to be modestly heritable and to share a portion of its genetic and environmental risk factors with schizoid
Schizoid personality disorder
Schizoid personality disorder is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness, and sometimes apathy, with a simultaneous rich, elaborate, and exclusively internal fantasy world...
and schizotypal personality disorder
Schizotypal personality disorder
Schizotypal personality disorder, or simply schizotypal disorder, is a personality disorder that is characterized by a need for social isolation, anxiety in social situations, odd behavior and thinking, and often unconventional beliefs.-Genetic:...
.
See also
- DSM-IV codes (personality disorders)
- ICD-10 codes (personality disorders)
- Delusions of reference