Cluster A PD: Paranoid Personality Disorder Flashcards
(10 cards)
Cluster A
- Odd or eccentric
- About 6% of people with Cluster A dx, also have a dx from aother cluster
Related characteristics
- Distrust
- Suspiciousness
- Other’s motives are interpreted as malevolent (i.e., mean, spiteful, unkind)
Paranoid PD
Diagnostic Criteria
A. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
4. Reads hidden demeaning or threatening meanings into benign remarks or events.
5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.
Note: If criteria are met prior to the onset of schizophrenia, add “premorbid,” i.e., “paranoid personality disorder (premorbid).
Individual characteristics
- Pervasive distrust and suspicion of others
- Believes others are out to harm, exploit, or deceive them
- Often reads hidden threats or insults into harmless remarks
- Reluctant to confide in others, fears betrayal
- Holds grudges and is unforgiving
- May be pathologically jealous and controlling in relationnships
- tends to be hostile, stubborn, and sarcastic
- Emotionally guarded, self-sufficient, and critical of others
Diagnostic features
- Core feature: deep, long-standing distrust of others
- Often lacks objective evidence for their suspicions
- Surprised when people show genuine loyalty
- Patterns begin in early adulthood and affect multiple areas of life
Differential dxs
- Psychotic disorders (Schizophrnia, delusional disorder): PD must precede psychosis and persist when psychosis remits
- Medical conditions affecting CNS (Brain injury, etc)
- Substance use disorders
- Physical handicaps (e.g., hearing loss may cause guarded behavior)
- Other PDs
- Schizotypal PD: includes magiacl thinking, unusual perceptual experiences, and odd behavior
- Schizoid: Socially aloof but lacks paranoia
associated features
- Difficult to get along with, strained relationships
- Often involved in legal disputes
- Seek to confirm negative beleifs about others
- Preoccupied with power, control, and perceived slights
- May be seen as “fanatics”
- Can have brief psychotic episodes under stress
- Frequently comborbid with schizotypal, schizoid, narcissistic, avoidant, and borderline PDs
Gender and prevalence
- More Common in men
- Prevalence
- 2.3%-4.4%
Cultural consideration
- Guarded suspicious behavior may be culturally appropriate for minority groups, immigrants, refugees, or those facing discrimination
- Clinicians should consider context before diagnosing paranoia
Early signs (risk factors)
- May be noticeable in childhood or adolescence
- Traits include:
- Solitary behavior
- Poor peer relationships
- Hypersensitivity
- Social anxiety
- Underachievement in school
- Peculiar thinking and language
- Often seen as “odd” or “eccentric” and may be teased by peers
- Higher rates in those with family history of schizophrenia or delusional disorder
