Paranoid Personality Disorder


Paranoid Personality Disorder is the name of a Personality Disorder that is characterised by paranoia and a long-standing suspiciousness and mistrust of others. The disorder is part of the ‘Odd and Eccentric’ cluster of personality disorders. People with Paranoid Personality Disorder are typically very sensitive to criticism, believe they are in danger and often withdraw socially. This article provides a general look at this disorder.


Personality disorders can make life incredibly difficult to cope with



A person with Paranoid Personality Disorder will typically:

  • Find it difficult to confide in people, even their friends.
  • Struggle to trust other people – believing they will take advantage of them.
  • Observe others closely, looking for any sign of betrayal or an act of apparent hostility.
  • Read threats and dangers from everyday situations – which don’t appear to have any foundation or are irrational.
  • Be sensitive to criticism.
  • Hold grudges for considerable time.
  • Be suspicious of others.
  • Often self-reference.



It isn’t entirely known what causes Paranoid Personality Disorder. It is believed a combination of both genetics and environmental factors play a part in the development of Paranoid Personality Disorder. The disorder can sometimes be inherited. It is unclear which particular genes are involved. Experiencing trauma, neglect or other maltreatment as a child appears to contribute to the disorder. Negative social experiences as a child can also contribute to the onset, with the individual perhaps believing that because one social group rejected them, that others will too.



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If you suspect you have a personality disorder, it is generally advisable to see your GP. It is likely that they will refer you to a specialist. This specialist will perform a diagnosis – which will involve asking you several questions about your condition and the impact it has had on your life. Generally, the clinician will use guidelines from the American Psychiatric Association to confirm a diagnosis. There has been some controversy over its suitability for making a diagnosis. The guidelines state a diagnosis can be made if four of the following factors are present.


  1. The individual suspects, despite a lack of evidence, 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 an unwarranted fear that the information given will be used maliciously against him or her.
  4. Reads hidden demeaning or threatening meanings into benign remarks or events.
  5. Persistently bears grudges.
  6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily.
  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.


Source: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (2013). ISBN 978-0-89042-555-8.



It can be difficult to treat an individual with Paranoid Personality Disorder as they may harbour ill feelings or thoughts towards their therapist. In any case, individuals diagnosed with Paranoid Personality Disorder are normally treated with a form of Psychotherapy. The therapy, provided the individual is receptive, will be used with the intention of altering the thoughts and behaviours of the patient. The ultimate aim will be for them to no longer suffer from paranoia, and try to eradicate as many of the ill feelings described above. With the right clinician-patient trust, and a concerted effort from both parties, an improvement and ultimate recovery can take place. Patients who suffer from Anxiety or Depression as a result of the disorder can be given medication – normally an antidepressant or an antipsychotic at a low dose.



Other Personality Disorders: