What is a personality disorder?
an enduring pattern of inner experience and behavior that
- deviates markedly from the expectations of the individual'sculture
- is pervasive and inflexible
- has an onset in adolescence or early adulthood
- is stable over time
- leads to distress or impairment
What is the essential feature of paranoid personality disorder?
a pattern of distrust and suspiciousness such that others' motives are interpreted as malevolent
What are criteria A1 and A2 of paranoid personality disorder?
A1. they assume other people will exploit, harm, or deceive them, even if no evidence exists to support this expectation
A2. they are preoccupied with unjustified doubts about the loyalty or trustworthiness of their friends and associates, whose actions are minutely scrutinized for evidence of hostile intentions
What are criteria A3 and A4 of paranoid personality disorder?
A3. they are reluctant to confide in others because of unwarranted fear that the information will be used maliciously against them
A4. they read hidden demeaning or threatening meanings into benign remarks or events
What are criteria A5 and A6 of paranoid personality disorder?
A5. they persistently bear grudges (are unforgiving of insults, injuries, or slights)
A6. they perceive attacks on their character or reputation that are not apparent to others and are quick to react angrily or counterattack
What is criterion A7 of paranoid personality disorder?
A7. they have recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner
How many of the A criteria of paranoid personality disorder must be present to result in diagnosis?
four or more
What is the associated feature of paranoid personality disorder?
does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, or another psychotic disorder, and is not due to the direct effects of a general medical condition
What are common characteristics of someone with paranoid personality disorder?
difficult to get along with
may act guarded, secretive, or devious
cold appearance and lacking tender feelings
predominant hostile, stubborn, or sarcastic expressions
combative and suspicious nature
What disorders are commonly comorbid with paranoid personality disorder?
major depressive disorder
alcohol and substance abuse
schizotypal, schizoid, narcissistic, avoidant and borderline personality disorders
In some cases, paranoid personality disorder may appear as the premorbid antecedent of __________ or ___________.
schizophrenia; delusional disorder
Who is at risk for being misdiagnosed with paranoid personality disorder?
minority members of society, who may be guarded or defensive in response to the majority culture
- racial minorities
- political and economic refugees
Children and adolescents with paranoid personality disorder often exhibit what characteristics?
poor peer relationships
underachievement in school
peculiar thoughts or language
may appear odd or eccentric
may attract teasing
How can a differential diagnosis be made between paranoid personality disorder and delusional disorder, persecutory type, schizophrenia, paranoid type, and mood disorder with psychotic features?
The latter disorders all require a period of persistent psychotic symptoms, like delusions or hallucinations.
Paranoid personality disorder may be an additional diagnosis to these disorders, but symptoms of the personality disorder must have been present before psychotic symptoms, and must persist during remission periods of psychotic symptoms.
Paranoid personality disorder must be distinguished from what other symptoms of larger disorders?
personality change due to a general medical condition
symptoms that may develop in association with chronic substance abuse
paranoid traits associated with the development of physical handicaps
How can paranoid personality disorder be distinguished from schizotypal personality disorder?
Schizotypal personality disorder includes symptoms such as magical thinking, unusual perceptual experiences, and odd thinking and speech, and paranoid personality disorder does not.
How can paranoid personality disorder be distinguished from schizoid personality disorder?
Individuals with schizoid personality disorder do not tend to have prominent paranoid ideation.
How can paranoid personality disorder be distinguished from borderline or histrionic personality disorder?
Borderline and histrionic personality disorders are not generally associated with pervasive suspiciousness.
How can paranoid personality disorder be distinguished from avoidant personality disorder?
People with avoidant personality disorder do not confide in people out of fear of being embarrassed or found inadequate rather than out of mistrust.
How can paranoid personality disorder be distinguished from antisocial personality disorder?
Antisocial behavior in paranoid personality disorder is due to a desire for revenge, while it is more motivated by desire for personal gain in antisocial personality disorder.
How can paranoid personality disorder be distinguished from narcissistic personality disorder?
In narcissistic personality disorder, suspiciousness is displayed due to fear of having their imperfections or flaws revealed.