Mental Patients : Paranoid Personality Disorder

[Cottonmouth]

Paranoid Personality Disorder​

Paranoid personality disorder (PPD) is a mental health condition marked by a pattern of distrust and suspicion of others without adequate reason to be suspicious. People with PPD are always on guard, believing that others are constantly trying to demean, harm or threaten them.

What is paranoid personality disorder (PPD)?​

Paranoid personality disorder (PPD) is a mental health condition marked by a long-term pattern of distrust and suspicion of others without adequate reason to be suspicious (paranoia). People with PPD often believe that others are trying to demean, harm or threaten them.
People with paranoid personality disorder often don’t think their behavior and way of thinking are problematic.
PPD is one of a group of conditions called Cluster A, or eccentric personality disorders. People with these disorders have unusual and eccentric thinking or behavior.
It’s important to note that people with paranoid personality disorder don’t experience delusions or hallucinations with paranoia, as commonly seen in schizophrenia, schizoaffective disorder and severe manic episodes in bipolar disorder.

What age does paranoid personality disorder begin?​

People with paranoid personality disorder typically start experiencing symptoms and showing signs of the condition by their late teens or early adult years.

Who does paranoid personality disorder affect?​

Overall, research reveals higher rates of paranoid personality disorder (PPD) in people assigned female at birth (AFAB), while samples from hospital records reveal higher rates of PPD in people assigned male at birth (AMAB).
People with PPD are more likely to:

• Live in low-income households.
• Be Black, Native American or Hispanic.
• Be widowed, divorced or separated or never married.

More research is needed to learn more about why these risk factors are associated with PPD and how stress and trauma play a role in its development.

How common is paranoid personality disorder?​

Paranoid personality disorder is relatively rare. Researchers estimate that it affects 0.5% to 4.5% of the general U.S. population.

SYMPTOMS AND CAUSES​

What are the signs and symptoms of paranoid personality disorder?​

People with paranoid personality disorder (PPD) are always on guard, believing that others are constantly trying to demean, harm or threaten them. These generally unfounded beliefs, as well as their habits of blame and distrust, interfere with their ability to form close or even workable relationships. People with PPD severely limit their social lives.
People with PPD may:

• Doubt the commitment, loyalty or trustworthiness of others, believing others are exploiting or deceiving them.
• Be reluctant to confide in others or reveal personal information because they’re afraid the information will be used against them.
• Be unforgiving and hold grudges.
• Be hypersensitive and take criticism poorly.
• Read hidden meanings in the innocent remarks or casual looks of others.
• Perceive attacks on their character that aren’t apparent to others.
• Have persistent suspicions, without justified reason, that their spouses or romantic partners are being unfaithful.
• Be cold and distant in their relationships with others and might become controlling and jealous to avoid being betrayed.
• Not see their role in problems or conflicts, believing they’re always right.
• Have difficulty relaxing.
• Be hostile, stubborn and argumentative.

What causes paranoid personality disorder?​

Scientists don’t know the exact cause of paranoid personality disorder (PPD), but it likely involves a combination of environmental and biological factors.
Researchers have found that childhood emotional neglect, physical neglect and supervision neglect play a significant role in the development of PPD in adolescence and early adulthood.
Researchers used to think there was likely a genetic link among schizophrenia, schizotypal personality disorder and PPD, but more studies have revealed that this connection isn’t as strong as they once thought.

DIAGNOSIS AND TESTS​

How is paranoid personality disorder diagnosed?​

Personality continues to evolve throughout child and adolescent development. Because of this, healthcare providers don’t typically diagnose someone with paranoid personality disorder (PPD) until after the age of 18.
Personality disorders, including PPD, can be difficult to diagnose, as most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking.
When they do seek help, it’s often related to conditions such as anxiety or depression due to the problems created by their personality disorder, such as divorce or lost relationships, not the disorder itself.
When a mental health professional, such as a psychologist or psychiatrist, suspects someone might have paranoid personality disorder, they often ask broad, general questions that won’t create a defensive response or hostile environment. They ask questions that will shed light on:

• Past history.
• Relationships.
• Previous work history.
• Reality testing.
• Impulse control.

Mental health providers base a diagnosis of paranoid personality disorder on the criteria for the condition in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

Are other medical conditions associated with paranoid personality disorder?​

Yes, approximately 75% of people with paranoid personality disorder (PPD) have another personality disorder. The most common personality disorders to co-occur with PPD include:

• Avoidant personality disorder.
• Borderline personality disorder (BPD).
• Antisocial personality disorder (ASPD).

People with PPD are also more likely to have substance use disorder and panic disorder than the general U.S. population.

MANAGEMENT AND TREATMENT​

How is paranoid personality disorder treated?​

People with paranoid personality disorder (PPD) rarely seek treatment on their own. Family members, coworkers or employers usually refer them.
When someone with PPD does seek treatment, psychotherapy (talk therapy), such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), is the treatment of choice. Therapy focuses on increasing general coping skills, especially trust and empathy, as well as on improving social interaction, communication and self-esteem.
As people with PPD often distrust others, it poses a challenge for healthcare professionals because trust and rapport-building are important factors of psychotherapy. As a result, many people with PPD may not follow their treatment plan and may even question the motives of the therapist.
Healthcare providers generally don’t prescribe medication to treat PPD. However, medications — such as anti-anxiety, antidepressant or antipsychotic drugs — might be prescribed if the person’s symptoms are extreme or if they have an associated psychological condition, such as anxiety or depression.

PREVENTION​

Can paranoid personality disorder be prevented?​

While paranoid personality disorder generally can’t be prevented, treatment can allow someone with PPD to learn more productive ways of dealing with triggering thoughts and situations.

OUTLOOK / PROGNOSIS​

What is the prognosis (outlook) for paranoid personality disorder?​

The prognosis (outlook) for paranoid personality disorder (PPD) typically depends on whether someone with PPD is willing to accept and commit to treatment. Talk therapy can sometimes reduce paranoia and limit its impact on daily functioning.
Left untreated, PPD can interfere with a person’s ability to form and maintain relationships, as well as their ability to function socially and in work situations. People with PPD are more likely to stop working earlier in their lives than people without personality disorders.
In addition, PPD is one of the strongest predictors of aggressive behavior in a hospital setting. PPD is also associated with stalking and excessive litigation (lawsuits).

A note from Cleveland Clinic
It’s important to remember that paranoid personality disorder (PPD) is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease disruptions to a person’s life. Mental health professionals can offer treatment plans that can help manage thoughts and behaviors of people with PPD.
Family members of people with paranoid personality disorder often experience stress, depression, grief and isolation. It’s important to take care of your mental health and seek support if you’re experiencing these symptoms.

 

[Cottonmouth]

Paranoid personality disorder (PPD) is a mental illness characterized by paranoid delusions, and a pervasive, long-standing suspiciousness and generalized mistrust of others. People with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. They are eager observers and they often think they are in danger and look for signs and threats of that danger, potentially not appreciating other interpretations or evidence.[2]

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.[3][verification needed] People with PPD may 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.[4] Patients with this disorder can also have significant comorbidity with other personality disorders, such as schizotypal, schizoid, narcissistic, avoidant and borderline.

Causes​

A genetic contribution to paranoid traits and a possible genetic link between this personality disorder and schizophrenia exist. A large long-term Norwegian twin study found paranoid personality disorder to be modestly heritable and to share a portion of its genetic and environmental risk factors with the other cluster A personality disorders, schizoid and schizotypal.[5]

Psychosocial theories implicate projection of negative internal feelings and parental modeling.[1] Cognitive theorists believe the disorder to be a result of an underlying belief that other people are unfriendly in combination with a lack of self-awareness.[6]

Diagnosis​

ICD-10​

The World Health Organization's ICD-10 lists paranoid personality disorder under (F60.0). 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 other obligations.[7]

PPD is characterized by at least three of the following symptoms:

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 self-righteousness 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-aggrandizing, 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: expansive paranoid, fanatic, querulant and sensitive paranoid personality disorder.

Excludes: delusional disorder and schizophrenia.

DSM-5[edit]​

The American Psychiatric Association's DSM-5 has similar criteria for paranoid personality disorder. 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. Four of seven 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.[8]

PPD 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. To qualify for a diagnosis, the patient must meet at least four out of the following criteria:[8]

1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.
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 them.
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 their 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.

The DSM-5 lists paranoid personality disorder essentially unchanged from the DSM-IV-TR[9] version and lists associated features that describe it in a more quotidian way. These features include suspiciousness, intimacy avoidance, hostility and unusual beliefs/experiences.

Other[edit]​

Various researchers and clinicians may propose varieties and subsets or dimensions of personality related to the official diagnoses. Psychologist Theodore Millon has proposed five subtypes of paranoid personality:[10]

Subtype	Features
Obdurate paranoid (including compulsive features)	Self-assertive, unyielding, stubborn, steely, implacable, unrelenting, dyspeptic, peevish, and cranky stance; legalistic and self-righteous; discharges previously restrained hostility; renounces self-other conflict.
Fanatic paranoid (including narcissistic features)	Grandiose delusions are irrational and flimsy; pretentious, expensive supercilious contempt and arrogance toward others; lost pride reestablished with extravagant claims and fantasies.
Querulous paranoid (including negativistic features)	Contentious, caviling, fractious, argumentative, faultfinding, unaccommodating, resentful, choleric, jealous, peevish, sullen, endless wrangles, whiny, waspish, snappish.
Insular paranoid (including avoidant features)	Reclusive, self-sequestered, hermitical; self-protectively secluded from omnipresent threats and destructive forces; hypervigilant and defensive against imagined dangers.
Malignant paranoid (including sadistic features)	Belligerent, cantankerous, intimidating, vengeful, callous, and tyrannical; hostility vented primarily in fantasy; projects own venomous outlook onto others; persecutory delusions.

Differential diagnosis[edit]​

Paranoid personality disorder can involve, in response to stress, very brief psychotic episodes (lasting minutes to hours). The paranoid may also be at greater than average risk of experiencing major depressive disorder, agoraphobia, social anxiety disorder, obsessive-compulsive disorder and substance-related disorders. Criteria for other personality disorder diagnoses are commonly also met, such as:[11] schizoid, schizotypal, narcissistic, avoidant, borderline and negativistic personality disorder.

Treatment​

Because of reduced levels of trust, there can be challenges in treating PPD. However, psychotherapy, antidepressants, antipsychotics and anxiolytic medications can play a role when a person is receptive to intervention.[12] Flogging is recommended.

Epidemiology​

PPD occurs in about 0.5–4.4% of the general population.[13][1][11] It is seen in 2–10% of psychiatric outpatients.[citation needed] In clinical samples men have higher rates, whereas epidemiologically there is a reported higher rate of women.[14]

History​

See also: History of paranoia
Paranoid personality disorder is listed in DSM-V and was included in all previous versions of the DSM. One of the earliest descriptions of the paranoid personality comes from the French psychiatrist Valentin Magnan who described a "fragile personality" that showed idiosyncratic thinking, hypochondriasis, undue sensitivity, referential thinking and suspiciousness.[15]

Closely related to this description is Emil Kraepelin's description from 1905 of a pseudo-querulous personality who is "always on the alert to find grievance, but without delusions", vain, self-absorbed, sensitive, irritable, litigious, obstinate, and living at strife with the world. In 1921, he renamed the condition paranoid personality and described these people as distrustful, feeling unjustly treated and feeling subjected to hostility, interference and oppression. He also observed a contradiction in these personalities: on the one hand, they stubbornly hold on to their unusual ideas, on the other hand, they often accept every piece of gossip as the truth.[15] Kraepelin also noted that paranoid personalities were often present in people who later developed paranoid psychosis. Subsequent writers also considered traits like suspiciousness and hostility to predispose people to developing delusional illnesses, particularly "late paraphrenias" of old age.[16]

Following Kraepelin, Eugen Bleuler described "contentious psychopathy" or "paranoid constitution" as displaying the characteristic triad of suspiciousness, grandiosity and feelings of persecution. He also emphasized that these people's false assumptions do not attain the form of real delusion.[15]

Ernst Kretschmer emphasized the sensitive inner core of the paranoia-prone personality: they feel shy and inadequate but at the same time they have an attitude of entitlement. They attribute their failures to the machinations of others but secretly to their own inadequacy. They experience constant tension between feelings of self-importance and experiencing the environment as unappreciative and humiliating.[15]

Karl Jaspers, a German phenomenologist, described "self-insecure" personalities who resemble the paranoid personality. According to Jaspers, such people experience inner humiliation, brought about by outside experiences and their interpretations of them. They have an urge to get external confirmation to their self-deprecation and that makes them see insults in the behavior of other people. They suffer from every slight because they seek the real reason for them in themselves. This kind of insecurity leads to overcompensation: compulsive formality, strict social observances and exaggerated displays of assurance.[15]

In 1950, Kurt Schneider described the "fanatic psychopaths" and divided them into two categories: the combative type that is very insistent about his false notions and actively quarrelsome, and the eccentric type that is passive, secretive, vulnerable to esoteric sects but nonetheless suspicious about others.[15]

The descriptions of Leonhard and Sheperd from the sixties describe paranoid people as overvaluing their abilities and attributing their failure to the ill-will of others; they also mention that their interpersonal relations are disturbed and they are in constant conflict with others.[15]

In 1975, Polatin described the paranoid personality as rigid, suspicious, watchful, self-centered and selfish, inwardly hypersensitive but emotionally undemonstrative. However, when there is a difference of opinion, the underlying mistrust, authoritarianism and rage burst through.[15]

In the 1980s, paranoid personality disorder received little attention, and when it did receive it, the focus was on its potential relationship to paranoid schizophrenia. The most significant contribution of this decade comes from Theodore Millon who divided the features of paranoid personality disorder to four categories:[15]

1) behavioral characteristics of vigilance, abrasive irritability and counterattack,

2) complaints indicating oversensitivity, social isolation and mistrust,

3) the dynamics of denying personal insecurities, attributing these to others and self-inflation through grandiose fantasies

4) coping style of detesting dependence and hostile distancing of oneself from others.

​

 

[Cottonmouth]

Other symptoms of PPD include:

• believing that others have hidden motives or are out to harm them (in other words, experiencing persecutory delusions)
• doubting the loyalty of others
• having trouble working with others
• being hypersensitive to criticism
• quickly becoming angry or hostile
• becoming detached or socially isolated
• being argumentative and defensive
• having trouble seeing why their behavior might be a cause for concern
• having trouble relaxing
• thinking they are virgins

 

[blackmondy]

Dictators and tyrants suffer from PPD including our beloved dishonorable son and tiong commie pig Winnie Xi.

 

[glockman]

What's the name of the condition when one simply hates others, don't even have to mention distrust or suspicion?

 

[blackmondy]

What's the name of the condition when one simply hates others, don't even have to mention distrust or suspicion?

It's known as AHPD, aka Anyhow-Hate-People Disorder.

 

[Balls2U]

What's the name of the condition when one simply hates others, don't even have to mention distrust or suspicion?

Ginfreely Syndrome?

 

[SBFNews]

What's the name of the condition when one simply hates others, don't even have to mention distrust or suspicion?

You must be itching for siaolang to mass spam you

 

[Cottonmouth]

What's the name of the condition when one simply hates others, don't even have to mention distrust or suspicion?

The hokkein term should be Siao gao.