Paranoid personality disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 27, 2016
StartDiseasesParanoid personality disorder

Paranoid personality disorder is a mental disorder that causes a person to be paranoid, intensely suspicious, and have a general mistrust of other people. Individuals with this condition are always perceiving threats in their environments and attempting to justify irrational fears. They are easily insulted and hypersensitive.


Definition & Facts

Personality involves deep patterns of behavior that define how a person thinks about themselves and others in the world. Personality disorders involve such traits and patterns that cause a person to have interpersonal problems. Paranoid personality disorder describes a person with an enduring pattern of behavior that causes them to interpret the actions of others as deliberately threatening or demeaning.

A person with paranoid personality disorder is often inflexible, rigid and unable to adapt to new situations. It can be severe enough to cause a person to experience intense emotional impairment as well as internal distress. People with this disorder do not confide in others who have proven to be trustworthy; their fear of being betrayed or exploited inhibits forming intimate bonds with others.

Symptoms & Complaints

People who suffer from paranoid personality disorder are always guarded. They believe others are always trying to harm, threaten, or demean them. This causes them to have problems forming close relationships.

They are reluctant to confide in others or share personal information because they fear it will be used against them. They will hold grudges for long periods of time. They have difficulty relaxing and believe they are in the right during every conflict.

Individuals with paranoid personality disorder are often hostile and argumentative. It has been shown that people who have paranoid personality disorder find it difficult to develop and maintain relationships. They often struggle when it comes to functioning socially as well in a work environment.

People with paranoid personality disorder are often engaged in legal battles. They will sue individuals as well as companies they believe are out to get them. They will have a coping mechanism of rejecting any relationship that involves depending on another person.

These individuals will be hostile about distancing themselves from others and often experience social isolation. They will deny their insecurities and believe others are the cause of them. It's possible for them to experience an inflated sense of self-worth.


Exactly what causes a person to develop a paranoid personalty disorder is not yet known. It seems to be a disorder commonly found among people with a family history of other mental disorders. Such disorders could involve delusional disorders and schizophrenia among others.

Genetic factors may also play a major role in a person developing a paranoid personality disorder. A study of twins conducted in Norway showed that this personality disorder has a 28 percent chance of being hereditable. The study also showed that certain regions of the brain are affected in individuals suffering from paranoid personality disorder. It showed the prefrontal cortex of these individuals had lesions. This is the area of the brain that affects decision-making and judgment.

There have also been studies that provide psychological theories positing that parental modeling plays a role in the cause of this disorder. Many experts who have conducted research on this subject agree that the home environment experienced during childhood plays a major role in causing this disorder.

Some cognitive theories are that the disorder is caused by an underlying belief that most people are unfriendly. It has also been shown that individuals with paranoid personality disorder tend to lack self-awareness.

Diagnosis & Tests

As with all personality disorders, there are currently no laboratory, physical, or objective tests available that are able to diagnose paranoid personalty disorder. A physician must utilize a number of diagnostic tests to eliminate any type of physical ailments that could be causing symptoms of this disorder.

If a doctor suspects that paranoid personality disorder is present in one of their patients, they may perform a physical examination. A complete psychiatric history will be requested. When a physician is able to determine there are no physical causes for the symptoms, they will refer their patient to a psychologist, psychiatrist, or other experienced healthcare providers. The patient will need to obtain treatment by someone who has the specialized training necessary for diagnosing and treating individuals with mental illness.

A person suspected of having paranoid personality disorder will participate in a psychological evaluation and be asked to complete a detailed questionnaire. Interviews with the patient's family and friends also help with diagnosis. These questionnaires are designed to carefully screen certain types of behavior for symptoms of paranoid personality disorder.

Treatment & Therapy

It is common for people suffering from paranoid personality disorder to not seek any type of treatment. They do not see themselves as having any type of a problem. Their distrust of others makes treating a person with this condition a challenge. Trust is an essential element for any type of counseling or psychotherapy to be successful. Individuals with this condition often do not follow the treatment plan specifically designed for them.

However, there is evidence showing that talk therapy can be successful. It can enable an individual with this condition to recognize they do have a problem. They can learn different coping skills to help them deal with their thoughts and feelings. Though psychotherapy, some people with this condition can gain the ability to better communicate with other individuals in different types of social settings.

It is also possible for psychiatric medications to be helpful. Medication is very effective when a person with paranoid personality disorder has other types of mental disorders. This could include such illnesses as anxiety disorders and depression among others. People have experienced success with using different types of antipsychotics, antidepressants as well as benzodiazepines and others. When medication is combined with psychotherapy, the chances of successful treatment increase significantly.

Prevention & Prophylaxis

Healthcare professionals agree there is no way to prevent a person from developing a paranoid personality disorder. It is possible with early treatment to help a person from developing some of this disorder's most severe complications such as complete social isolation.

If an individual with this condition commits themselves to a treatment plan, they may be able to lessen their paranoia and improve interpersonal functioning. When a person with this condition does not accept treatment, their chances for any type of successful work or personal relationships in the future is very poor.