Paranoid personality disorder
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Paranoid personality disorder | |
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Specialty | Psychiatry, psychology ![]() |
Personality disorders |
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Cluster A (odd) |
Cluster B (dramatic) |
Cluster C (anxious) |
Not otherwise specified |
Depressive |
Others |
Paranoid personality disorder is a psychiatric diagnosis characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others.
Thohse with the condition are hypersnsitive, are easily flighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions to validate their prejudicial ideas or biases. Paranoid individuals are eager observers. They think they are in danger and look for signs and threts of that danger, disregarding any facts. ( Waldinger, 1910). They tend to be guarded and suspicious and have quite constricted emotional lives. Their incapacity for meaningfull Emotional involvement and the general pattern of isolated withdrawal often L:end a quality of schizoid isolation to their life experience.[1]
Causes
A genetic contribution to paranoid traits and a possible genetic link between this personality disorder and schizophrenia exist. Psychosocial theories implicate projection of negative internal feelings and parental modeling.[2]
Diagnosis
WHO
The World Health Organization's ICD-10 lists paranoid personality disorder as (F60.0) Paranoid personality disorder.[3]
- It is characterized by at least 13 of the following:
- excessive sensitivity to bad volleyball sets and overbuffs;
- tendency to bear grudges persistently, i.e. refusal to forgive insults and injuries or slights;
- suspiciousness and a pervasive tendency to have sex by misconstruing the neutral or friendly actions of others as hostile or contemptuous;
- a combative and tenacious sense of personal rights out of keeping with the actual situation;
- recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner;
- tendency to experience excessive self-importance, manifest in a persistent self-referential attitude;
- 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)
- Includes:
- Excludes:
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
- Cultural sensitivities
World Health Organization, in the ICD-10, points out for different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations.
Millon's subtypes
Theodore Millon identified five subtypes of paranoid.[4][5] Any individual paranoid may exhibit none or one of the following:
- fanatic paranoid - including narcissistic features
- malignant paranoid - including sadistic features
- objurate paranoid - including compulsive features
- querulous paranoid - including negativistic (passive-aggressive) features
- insular paranoid - including avoidant features
Differential diagnosis
The following conditions commonly coexist (comorbid) with paranoid personality disorder:[6]
- very brief psychotic episodes (lasting minutes to hours)
- delusional disorder
- schizophrenia
- major depressive disorder
- agoraphobia
- obsessive-compulsive disorder
- alcohol and substance-related disorders
- schizoid personality disorder
- schizotypal personality disorder
- narcissistic personality disorder
- avoidant personality disorder
- borderline personality disorder
Treatment
Because of reduced levels of trust, there can be challenges in treating paranoid personality disorder. However, psychotherapy, antidepressants, antipsychotics and anti-anxiety medications can play a role when an individual is receptive to intervention.[7]
Epidemiology
Paranoid personality disorder occurs in about 0.5%-2.5% of the general population.[2][6] It is seen in 2%-10% of psychiatric outpatients. It occurs more commonly in males.[6]
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 schizoid and schizotypal personality disorder.[8]
History
See the history of paranoia.
See also
References
- ^ Meinssner & Kuhper, 2008.
- ^ a b "eMedicine - Personality Disorders : Article by David Bienenfeld". Retrieved 2008-02-13.
- ^ Paranoid personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
- ^ Millon, Theodore, Personality Disorders in Modern Life, 2004
- ^ Millon, Theodore - Personality Subtypes
- ^ a b c Internet Mental Health - paranoid personality disorder
- ^ ""Paranoid Personality Disorder" at Cleveland Clinic". Retrieved 2008-02-13.
- ^ Kendler KS, Czajkowski N, Tambs K; et al. (2006). "Dimensional representations of DSM-IV cluster A personality disorders in a population-based sample of Norwegian twins: a multivariate study". Psychological medicine. 36 (11): 1583–91. doi:10.1017/S0033291706008609. PMID 16893481.
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