Tuesday, December 13, 2016

What is Paranoid Personality Disorder?

Continuing through the personality disorders, let's take a moment to review the criteria for paranoid personality disorder. Paranoia is a feature in other disorders (e.g., schizophrenia). What makes that paranoia a personality disorder?

Read on. The disorder is characterized by "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."

Four of the following are required for a diagnosis of paranoid personality disorder to be made:

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.

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.

Symptoms cannot appear exclusively during the course of schizophrenia, bipolar I or II, or depressive disorder with psychotic features.

When you see a list of rule-outs like that, you know it's time to stare at them an imagine a question like this:

A social worker who sees a client who [LIST OF PARANOID SYMPTOMS]...What is the MOST likely diagnosis for this client.

A. Schizophrenia

B. Bipolar disorder

C. Depressive disorder with psychotic features

D. Paranoid personality disorder.

Different contents of those brackets will get you different correct answers. Before answering D) Paranoid personality disorder, be sure that paranoid attitudes are pervasive and in multiple contexts. Attributing malice and deceit to a single political candidate, for instance, isn't criteria-meeting. Believing in unprovable conspiracies also isn't a fit. (Delusions are not a criteria in this disorder.) What you should look for is a life-long pattern of extreme suspiciousness regarding a wide range of people. Non-delusional, far reaching, long-lasting. That's paranoid personality disorder.

More reading here:

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