Paranoid Personality Disorder

About Paranoid Personality Disorder

Paranoid personality disorder is a pervasive pattern of distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood. Features include suspecting without sufficient basis that others are exploiting, harming or deceiving them, preoccupation with unjustified doubts about the loyalty of friends or associates, reluctance to confide in others for fear that information will be used against them, reading hidden demeaning or threatening meanings into benign remarks, persistently bearing grudges, perceiving attacks on their character or reputation that are not apparent to others and reacting quickly with anger, and recurrent unjustified suspicions about the fidelity of a partner. Unlike delusional disorder or schizophrenia, the suspiciousness does not reach the level of persistent delusions or involve sustained psychotic symptoms. It is grouped with schizoid and schizotypal personality disorders in the odd or eccentric cluster and is more common among relatives of people with schizophrenia spectrum conditions. People with the disorder rarely seek treatment for the personality pattern itself, and their distrust can make it difficult to form a therapeutic relationship. When treatment occurs, it emphasizes building trust through a consistent, transparent and respectful approach, often with supportive therapy or cognitive behavioral therapy addressing suspicious interpretations, and medication may be used for co occurring anxiety, depression or severe agitation.