Mistrustful and Misunderstood: a Review of Paranoid Personality Disorder

Abstract

Purpose of review Paranoid Personality Disorder (PPD) has historically been neglected by science out of proportion to its prevalence or its association with negative clinical outcomes. This review provides an update on what is known about PPD regarding its prevalence, demographics, comorbidity, biological mechanism, risk factors, and relationship to psychotic disorders. Recent Findings PPD has long been the subject of a rich and prescient theoretical literature which has provided a surprisingly coherent account of the psychological mechanism of non-delusional paranoia. Available data indicate that PPD has a close relationship with childhood trauma and social stress. Descriptive data on a sample of 115 individuals with Paranoid Personality Disorder is examined in comparison with a group of individuals with Borderline Personality Disorder. The descriptive data largely confirm previously identified relationships between Paranoid Personality Disorder and childhood trauma, violence, and race. We identify important similarities to and differences from Borderline Personality Disorder. Summary PPD continues to be an important construct in the clinic and the laboratory. Available data lead to a reconsideration of the disorder as more closely related to trauma than to schizophrenia.

Paranoia and risk of personality disorder in the general population

“…Moreover, it could contribute to develop some kind of treatment or to implement the community mental health services or preventive strategies in some way. Thus, the attention to social determinants influencing both, paranoia and PD, especially childhood mistreatment could be crucial to design preventive strategies. If the link between paranoia and PD is confirmed, the relevance of treating paranoid symptoms in PD could be increased.…”

“…This formula uses the sociodemographic variables of age, gender, educational level, urban status and geographic region to estimate the participant's IQ. Childhood mistreatment is a variable influencing both, paranoia and PD, for this reason, it was also assessed collecting retrospective data on three types of mistreatment during childhood (psychological and physical mistreatment and sexual abuse) using the abbreviated Childhood Trauma Questionnaire . For the purpose of this report, we dichotomized the existence of any abuse at any time in childhood.…”

Borderline Personality Disorder with Paranoid Features

“…V manifested aspects of paranoid personality disorder (bizarre-eccentric cluster A). In psychiatric nosology, DSM-IV and V describe PPD as a disorder with suspicious and ruminative traits, ICD-10 PPD including traits of excessive importance and hostility [Lee, 2017]. V was distrustful of the last partner's family, their motivations being interpreted as malicious, and he was looking for signs that confirmed the idea of threat.…”

Virtual Reality-based Interventions for Patients with Paranoia

“…Paranoid patients often have suspicious thoughts in social situations and in dealing with people. Anxiety is also one of the main symptom in these people (41). The use of VR has various purposes in the treatment of patients with paranoid, including eliminating the paranoid thoughts, reducing social anxiety, increasing community participation, and changing their negative beliefs about themselves and others.…”