Paranoid Personality Disorder
Paranoid disorder belongs to the category of personality disorders. The latter, according to the Mayo Clinic, are a type of mental disorder that include a rigid and unhealthy pattern of thinking, functioning and behaviour.
People suffering from a personality disorder experience impairments in perceiving and relating to various situations and people. This leads to various difficulties and important limitations in several areas such as relationships, social or professional activities (at work, school, etc.).
In terms of groups of disorders, paranoid personality disorder belongs to the bizarre-excentric group of disorders, which also includes schizoid and schizotypal personality disorders. Disorders in this group are primarily described by thinking(or by conduct) strange, unusual, eccentric.
Psychopathology and psychiatry treatises point out that the prevalence of the disorder is 0.5% – 2.5%, and the incidence is higher in families of probands with schizophrenia and delusional disorders. In addition, it is noted that the disorder occurs more frequently in men than in women.
Main features
People with this disorder open up with much greater difficulty, whether or not the person to whom they are confessing is close – they cannot even open up easily to their own friends (or even family).
The reason why confession is so difficult is that people suffering from paranoid disorder are constantly afraid that those around them might use them for personal gain. Thus, they find themselves more and more on the defensive and are constantly looking for reasons to reinforce their beliefs (e.g. they look for signs that others are betraying them). These behaviours can, for example, cause sufferers of paranoid disorder to make assumptions that their partners are cheating on them.
Symptoms of paranoid disorder:
First of all, in order to recognize a person suffering from paranoid disorder we must be aware that people who have this disorder are always “on guard”, actually having strong and repeated beliefs that those around them wish to demean or harm them.
Usually the beliefs are unfounded, making it difficult for them to build strong long-term relationships and bonds.
Most prevalent indicators of paranoid personality disorder
- Lack of confidence and increased suspicion of others;
- Unfounded suspicion about the actions of others;
- Fear of trusting others;
- Irrational suspicion that others may use the information they have about you against you;
- Increased tendency to hold grudges;
- Angry reactions based on irrational fears about the behaviour of others;
- The behaviour of others is perceived as an attack on oneself;
- Continuous restlessness, increased anxiety, difficulty relaxing;
- Development of negative stereotypes towards people, especially those who are different in terms of ethnicity, religion, etc;
- Other people’s opinions can be turned into hidden meanings about yourself.
Causes / Risk factors
The causes of paranoid disorder are not known with certainty. However, they most likely involve a number of biological and psychological factors. Given that sufferers are more likely to have close relatives diagnosed with either schizophrenia or delusional disorder, it may indicate a genetic link.
In another vein, we must bear in mind that personality disorders generally make their presence felt when a person has an irrational way of relating to reality, understanding reality and perceiving the world. From this idea, we need to think about how we come to have these reality-altering beliefs. Thus, one of the possible causes may be rooted in the early years of life.
In other words, our beliefs can be formed in childhood, especially when we have been abused – physically, verbally or sexually (and we have learned from this that we should trust no one) or insulted for our difficulties – hit, punished (and we have learned from this to always be “on guard” to prevent potential hurt).
Diagnosis
In order to make an optimal diagnosis, first of all a complete medical history should be investigated. When physical problems are ruled out for the presence of symptoms, psychiatrists/psychologists will use various tools specifically aimed at detecting a personality disorder.
It is important to distinguish between paranoid personality disorder and psychotic-type disorders (paranoid schizophrenia and persistent delusional disorder). The main aspect that distinguishes the disorders is that in paranoid disorder there are no delusions, hallucinations or other psychotic features.
Treatment
Paranoid disorder is often treated with psychotherapy sessions. Especially through cognitive behavioural therapy (CBT). Provided patients follow the treatment they will be able to manage their symptoms and eventually manage to be effective in their daily lives. The therapy can be built around developing empathy, self-esteem, social relationships, and increasing communication skills. During the psychological intervention, patients will be able to identify for themselves the destructive patterns that further have a negative influence on their behaviour in everyday life.
According to the Cleveland Clinic, ingrained paranoid beliefs, along with maladaptive thoughts, play a particularly important role in maintaining this disorder. That’s why addressing thoughts and beliefs through cognitive behavioural therapy can have a positive impact.
In addition to psychotherapy, the treatment of paranoid disorder may (in some cases) include medication. This may only be useful in situations where symptoms are severe and at least one other condition – such as anxiety or depression – is also present. In this sense, the medication may contain antidepressants, anti-anxiety or antipsychotic drugs. However, it should be noted that medication without psychotherapy is not recommended for personality disorders.
Prognosis
Paranoid disorder is chronic. Most people will have it for life, but the symptoms can be kept under control to some extent with treatment.
This allows people to live their lives normally: they can get married, have a job, etc. However, without proper treatment, people suffering from this disorder can become disconnected from reality and may not be socially functional.
Sources:
Mayo Clinic
Cleveland Clinic
Tudose, F., Tudose, C., & Dobranici, L. (2011). Treatise on psychopathology and psychiatry for psychologists. Three Publishing House.
Sperry, L. (2018). DSM-5 personality disorders. Assessment, case conceptualization and treatment.
Author: Tudor-Daniel Huțul – Psychotherapist
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