Paranoid Personality Disorder
Paranoid personality disorder is included in the Cluster A types of personality disorders. The person diagnosed with paranoid personality disorder will display an intense distrust in others and their possibly malevolent motives. They may seem peculiar to others, as their heightened sense of suspicion is considered odd or unwarranted. They often put off a sarcastic or hostile air, which causes others to distance themselves.
Paranoid personality disorder usually emerges in early adulthood and affects more men than women. People with the disorder tend to be argumentative and defensive, and they do not accept criticism well. This causes problems in the workplace, as these individuals are considered difficult to work with. If someone with paranoid personality disorder is open to improving their interactions with others at work or in relationships the disorder can be managed. There is no cure for paranoid personality disorder, so lifelong interventions would be needed.
Symptoms of Paranoid Personality Disorder
Someone with paranoid personality disorder would have at least four of the following symptoms:
- Believes that others are out to cause them harm. Suspects they have hidden motives or are deceiving them
- Unjustifiably doubts loyalty or trustworthiness of colleagues or friends
- Very sensitive to criticism
- Rarely confides in anyone for fear that the person will use the information against him or her
- Reads negative intentions into casual comments
- Is unforgiving of insults, holds grudges
- React with anger and retaliation to perceived character attacks
- Suspect without cause that their spouse or partner is being unfaithful
- Behave in a hostile, argumentative, and stubborn manner with others
- Do not admit wrongdoing, think they are always right
- Distant and cold in their relationships
- Become jealous and controlling in relationships to avoid being betrayed
- Has trouble working with others
Although there has not been a specific cause for developing paranoid personality disorder, it is believed that it is caused be a combination of biological, social, and psychological factors. These might include early childhood development and how the person interacted with family members, temperament, and coping skills developed to manage stress.
Diagnosis and Treatment of Paranoid Personality Disorder
Paranoid personality disorder can be diagnosed by a mental health professional who will assess the individual based on the presentation of symptoms and a discussion of their childhood and life events. Many with paranoid personality disorder do not seek out psychological help until the symptoms begin to cause serious problems in their job or relationships. In order for treatment to be successful, the individual must be open and accepting to receiving help.
Treatment for paranoid personality disorder will focus mostly on psychotherapy, although the therapist will have the hurdle of first gaining the patient’s trust. Until the individual feels they can trust the intentions of the therapist they will stubbornly resist treatment. However, once trust has been established there is hope for an improvement in quality of life.
Psychotherapy will be centered on helping the individual improve general coping skills, communication skills, learn better social interaction skills, improve self-esteem, and to become more trusting and empathetic. Cognitive behavioral therapy is the therapy of choice for treating paranoid personality disorder. CBT helps the individual change maladaptive thoughts and harmful behaviors, and also to better manage the way they respond to others. Learning new ways to respond that are socially acceptable, versus the hostile and distrustful responses, can help them improve interpersonal relationships.
Medication is rarely used for treating paranoid personality disorder, unless there is a co-occurring mental health disorder such as depression or anxiety. If that is the case then antidepressants, anti-anxiety medications, or antipsychotics may be included in the treatment plan.
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