Paranoid Personality Disorder

Written by Janelle Martel | Published on July 10, 2012
Medically Reviewed by George Krucik, MD

What Is Paranoid Personality Disorder?

Paranoid personality disorder (PPD) is a type of eccentric personality disorder. This means the behavior may seem odd or unusual to others. An individual with paranoid personality behavior has extreme suspicion of others.

PDD usually appears in early adulthood. According to the National Institutes of Health (NIH), it is more common in males than females (NIH, 2010).

What Are the Causes?

The cause of paranoid personality disorder is not known. However, it is thought that paranoid personality is a combination of biological and environmental factors.

The disorder is found more often in families with a history of schizophrenia and delusion disorders. Early childhood trauma may be a contributing factor.

What Are the Symptoms?

Many individuals with paranoid personality disorder are not aware of their problem. Suspicions of others may seem completely rational to a person with PPD. However, others around him or her may deem this distrust of others unwarranted.

Symptoms include:

  • believing that others have hidden motives or are out to harm you
  • doubting the loyalty of others
  • being hypersensitive to criticism
  • having trouble working with others
  • being quick to become angry and hostile
  • becoming detached or socially isolated
  • being argumentative and defensive
  • having trouble seeing your own problems
  • having trouble relaxing

How Is a Diagnosis Made?

Your doctor will begin by asking you about your symptoms and history. He or she will also conduct a physical evaluation to look for any underlying medical conditions. Your doctor may refer you to a psychiatrist or psychologist for further testing.

The psychiatrist or psychologist will conduct a psychological assessment. He or she may ask about childhood, school, work, and relationships. He or she may also ask you several hypothetical questions. This is to gauge how you react to certain situations. For example, he or she may ask what you would do if you found somebody’s wallet on the sidewalk. The psychiatrist or psychologist will use your responses to make a diagnosis and form a treatment plan.

How Is It Treated?

Treatment for PPD can be very successful. However, most individuals with this condition have trouble accepting treatment. If an individual is willing to accept treatment, talk therapy or psychotherapy will be used. These methods will:

  • help the individual learn how to cope with the disorder
  • learn how to communicate with others in social situations
  • help reduce feelings of paranoia

Medications can also be helpful, especially for severe symptoms of PPD. Medications include:

  • antidepressants
  • benzodiazepines
  • antipsychotics

Combining medication with talk therapy or psychotherapy can be very successful.

What Is the Long-Term Outlook?

The outlook depends on whether the individual is willing to accept treatment. Individuals who accept treatment can function normally. However, treatment needs to continue throughout the individual’s lifetime because there is no cure for PPD.

Those who are resistant to treatment for PPD tend to live less functional lives. PPD may interfere with their ability to hold down a job or have positive social interactions.

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