Paranoid personality disorder is a mental
disorder characterized by paranoia and a pervasive, long-standing suspiciousness and
generalized mistrust
of others. Individuals with this personality disorder may be hypersensitive,
easily feel slighted, and habitually relate to the world by vigilant scanning
of the environment for clues or suggestions that may validate their fears or
biases. Paranoid individuals are eager observers. They think they are in danger
and look for signs and threats of that danger, potentially not appreciating
other evidence. They tend to be guarded and suspicious and have quite
constricted emotional lives. Their reduced capacity for meaningful emotional involvement
and the general pattern of isolated
withdrawal often lend a quality of schizoid
isolation to their life experience. People with this particular disorder may or
may not have a tendency to bear grudges, suspiciousness, tendency to interpret
others actions as hostile, persistent tendency to self-reference, or a
tenacious sense of personal right.
Causes
A genetic contribution to paranoid traits and a
possible genetic link between this personality disorder and schizophrenia
exist. Psychosocial theories implicate projection of negative internal feelings
and parental modeling.
Diagnosis
WHO
The World Health Organization's ICD-10 lists
paranoid personality disorder as (F60.0)
Paranoid personality disorder.
It is characterized
by at least three of the following:
1.
excessive
sensitivity to setbacks and rebuffs;
2.
tendency
to bear grudges persistently, i.e. refusal to forgive insults and injuries or
slights;
3.
suspiciousness
and a pervasive tendency to distort experience by misconstruing the neutral or
friendly actions of others as hostile or contemptuous;
4.
a
combative and tenacious sense of personal rights out of keeping with the actual
situation;
5.
recurrent
suspicions, without justification, regarding sexual fidelity of spouse or
sexual partner;
6.
tendency
to experience excessive self-importance, manifest in a persistent self-referential
attitude;
7.
preoccupation
with unsubstantiated "conspiratorial" explanations of events both immediate
to the patient and in the world at large.
Includes:
Excludes:
It is a requirement of ICD-10 that a diagnosis of
any specific personality disorder also satisfies a set of general personality disorder criteria. It is
also pointed out that for different cultures it may be necessary to develop
specific sets of criteria with regard to social norms, rules and obligations.
APA
The American Psychiatric Association's
DSM-IV-TR
has similar criteria. They require in general the presence of lasting distrust
and suspicion of others, interpreting their motives as malevolent, from an
early adult age, occurring in a range of situations. 4 of 7 specific issues
must be present, which include different types of suspicions or doubt (such as
of being exploited, or that remarks have a subtle threatening meaning), in some
cases regarding others in general or specifically friends or partners, and in
some cases referring to a response of holding grudges or reacting angrily.
Other
Various researchers and clinicians may propoose
varieties and subsets or dimensions of personality related to the official
diagnoses. Psychologist Theodore Millon has proposed five subtypes of
paranoid personality:
- fanatic
paranoid - including
narcissistic features
- malignant
paranoid - including
sadistic features
- obdurate
paranoid - including
compulsive features
- querulous
paranoid - including
negativistic
(e.g. discontentment) features
- insular
paranoid - including
avoidant features
