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Paranoid Personality Disorder:

A paranoid personality disorder is a behavior pattern characterized by an unreasonable distrust and suspiciousness towards other individuals thinking other people’s intentions are hostile. [1] People with paranoid personality disorder always assume that people are planning to harm them, so they always look for situations in which they can suspect others, even when there are no sufficient reasons. Usually, doctors diagnose this behavior by the presence of suspecting behavior among individuals. This behavior is usually common among men. It is also said that this behavior runs in families and is more common among people with a history of childhood abuse.


Paranoid Personality Disorder- A Misunderstood Behavior:

Paranoid personality disorder has been neglected historically by scientists, but its prevalence was always high, and it had a negative association with clinical outcomes. In addition, different studies suggest that paranoid personality disorder has a crucial link with childhood traumas and childhood abuse, violence, and racism. [2]


Diagnosis of Paranoid Personality Disorder:

A healthcare professional use guidelines provided by American Psychiatry Association. It is important for doctors to recognize that for diagnosis of PPD, a person must consistently represent the behavior of suspiciousness. A person suffering from PPD shows the following behavior, at least four to five of them:

  • They always have unjustified doubts about the loyalty of their friends and co-workers.
  • They always suspect their spouse of being unfaithful, even with no reason to suspect them.
  • They always hold grudges when they feel like someone has insulted them.
  • They always think someone has tried to attack their reputation or character, and in return, they try to counteract.
  • They may also misinterpret the situations or remarks and take them as they are attacked. [3]


Comorbid Disorders with PPD:

The occurrence of other personality disorders, along with paranoid personality disorder, is usually common. However, antisocial personality disorder is the most common comorbid condition with PPD. Other conditions which may occur along are depression, social anxiety, and delusional disorder.


Strategies to Deal with a Person Suffering from PPD:

  • Differential diagnosis is critical in managing patients with a paranoid personality disorder because of comorbid conditions.
  • The treatment aim should help the patient recognize their feelings, enhance their self-worth, and develop trust in others.
  • Individuals suffering from paranoid personality disorder may present aggression towards clinicians, so it is important for clinicians not to respond to them or counterattack them.
  • It is usually seen that others bring people with PPD to the clinicians for treatment, but it is quite important to save their face and make them realize that they have control over their life and treatment.
  • While giving treatment, the clinician should be alert to the patient’s mood and be able to change their mood if required.
  • Boundary management should be considered with paranoid people, and very warm behavior by clinicians should be avoided. They must also have a close eye on them, and more than the usual amount of body space should be provided to the paranoid individuals.
  • Psychotherapy: Individual supportive psychotherapy and schema therapy are recommended for people suffering from a paranoid personality disorder. [4]
  • Pharmacotherapy: The use of pharmacotherapy in managing PPD is not well established, but some pharmacological options are used for comorbid conditions like depression, etc.

[1] Paranoid Personality Disorder – Mental Health Disorders. (n.d.). MSD Manual Consumer Version. https://www.msdmanuals.com/home/mental-health-disorders/personality-disorders/paranoid-personality-disorder

[2] Lee, R. J. (2017). Mistrustful and Misunderstood: a Review of Paranoid Personality Disorder. Current Behavioral Neuroscience Reports, 4(2), 151–165. https://doi.org/10.1007/s40473-017-0116-7

[3] Shedler, J., & Westen, D. (2004b). Refining Personality Disorder Diagnosis: Integrating Science and Practice. American Journal of Psychiatry, 161(8), 1350–1365. https://doi.org/10.1176/appi.ajp.161.8.1350

[4] Carroll, A. (2009). Are you looking at me? Understanding and managing paranoid personality disorder. Advances in Psychiatric Treatment, 15(1), 40–48. https://doi.org/10.1192/apt.bp.107.005421



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©2022 Teletherapeutics Health