Wednesday, January 16, 2013

Paranoid Personality Disorder

Paranoid Personality disorder is a long term psychiatric disorder with the extensive and unjustifiable suspicious characteristics that other people (especially spouse or partner) are aggressive and argumentative. These doubtful behaviors are persistently continues even in the absence of any real supporting evidence. American Journal of psychotherapy revealed that suspiciousness, feeling mistreated, and grandiosity constitute the classical triad associated with paranoid personality. According to DSM-IV-TR, at least four of the following criteria have to be fulfilled:
• Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
• Preoccupied with unjustified doubts about the loyalty or trust-worthiness of friends or associates
• Reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
• Reads benign remarks or events as threatening or humiliating
• Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
• Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
• Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
Characteristics of Paranoid Personality
·         Outwardly, paranoid individuals are demanding, arrogant, mistrustful, driven, unromantic, moralistic, and acutely alert towards the external environment.
·         Internally, they are frightened, timid, self-doubting, gullible, inconsiderate, vulnerable to erotomania, and cognitively unable to grasp the totality of actual events.
The actual causes of paranoid personality disorders are unknown, but this disorder is more prevalent in a person who has family history of mental disorders. In addition, children who are exposed to adult anger and rage with no way to predict the outbursts and no way to escape or control them develop paranoid ways of thinking in an effort to cope with the stress. It would emerge when this type of thinking becomes part of the individual's personality when child becomes adult.
Although people with paranoid personality disorder do not have any hallucinations or delusions, they often feel insecure, remain isolated and misinterpret compliments. They search for the evidence to support their suspicions. They perceive day to day communication and inoffensive comments as an insult and blame others because they lack insights of real environment. Some symptoms are:
·         feelings of certainty, without justification or proof, that others are intent on harming or exploiting them
·         Unfriendly, grandiosity, aggressive, isolated,
·         Likely to blame others without strong reason
·         Suspiciousness and distrust of others
·          Questioning hidden motives in others
Paranoid Personality Disorder is diagnosed on the basis of their symptoms, but there are no blood tests or genetic tests that can confirm the diagnosis. The diagnosis and treatment should be done by psychiatrist or mental health professionals.
The treatment for paranoid personality patient is very difficult because patient of this disorder are suspicious and untrusting towards doctors and not likely to seek therapy by themselves. The role of patient's family members or relatives is crucial to encourage him or her to seek professional treatment. If treatment is accepted, talk therapy and medications can often be effective, but the nature of the disorder poses very serious challenges to therapists. The patients may actively resist or refuse to cooperate with others who are trying to help them. The best use of medication may be given for specific complaints of patients to develop trust worthy relationship with the patient. Once the patient start trusting the therapist enough, he/she will ask for relief from particular symptoms.
Psychotherapy, antidepressants, mood stabilizers, antipsychotics, anti-anxiety medications are effective for treating paranoid personality disorder. Encyclopedias of mental disorders mentioned that the selective serotonin reuptake inhibitor (fluoxetine or Prozac) can help to reduce anxiety, angriness, irritable and suspiciousness behaviors.
Akhtar, S. (1990). Paranoid personality disorder: a synthesis of developmental, dynamic, and descriptive features. American Journal of Psychotherapy. Retrieved from
Encyclopedias of mental disorders. (2013). Paranoid Personality Disorder. Retrieved from
U.S. National Library of Medicine. (2010). Paranoid personality disorder: PubMed Health. Retrieved from

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