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Paranoid Personality Disorder

Paranoid personality disorder (PPD) is one of a group of conditions called "Cluster A" personality disorders which involve odd or eccentric ways of thinking. People with PPD also suffer from paranoia, an unrelenting mistrust and suspicion of others, even when there is no reason to be suspicious.

This disorder usually begins by early adulthood and appears to be more common in men than in women.

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What Are the Symptoms of Paranoid Personality Disorder?

People with 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, might interfere with their ability to form close relationships. People with this disorder:

  • Doubt the commitment, loyalty, or trustworthiness of others, believing others are using or deceiving them
  • Are reluctant to confide in others or reveal personal information due to a fear that the information will be used against them
  • Are unforgiving and hold grudges
  • Are hypersensitive and take criticism poorly
  • Read hidden meanings in the innocent remarks or casual looks of others
  • Perceive attacks on their character that are not apparent to others; they generally react with anger and are quick to retaliate
  • Have recurrent suspicions, without reason, that their spouses or lovers are being unfaithful
  • Are generally cold and distant in their relationships with others, and might become controlling and jealous
  • Cannot see their role in problems or conflicts and believe they are always right
  • Have difficulty relaxing
  • Are hostile, stubborn, and argumentative

What Causes Paranoid Personality Disorder?

The exact cause of PPD is not known, but it likely involves a combination of biological and psychological factors. The fact that PPD is more common in people who have close relatives with schizophrenia suggests a genetic link between the two disorders. Early childhood experiences, including physical or emotional trauma, are also suspected to play a role in the development of PPD.

How Is Paranoid Personality Disorder Diagnosed?

If physical symptoms are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history and, if indicated, a physical exam. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

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