Paranoid personality, suspicion taken to the extreme

Paranoid personality, suspicion taken to the extreme

People with Paranoid personality disorder are generally characterized by having a generalized distrust pattern and suspicion towards others for a long time. A person with paranoid disorder almost always believes that other people's motives are suspicious or even malicious.


  • 1 Characteristics of the paranoid personality
  • 2 Symptoms of paranoid personality disorder
  • 3 Causes of paranoid personality disorder
  • 4 Treatment of paranoid personality disorder

Characteristics of the paranoid personality

Individuals with this disorder think strongly that other people want to exploit, harm or deceive, even if there is no evidence to support this hypothesis. While it is quite normal that we all have a certain degree of "paranoia" about certain situations in life (such as concerns about an impending dismissal at work, or that your boss treats you worse than others, etc.) , people with paranoid personality disorder take this to an extreme, which includes virtually all areas whether professional, social or even family.

It is frankly difficult to get along with subjects with paranoid personality disorder and often have problems in their close relationships. Their suspicion and excessive hostility can be expressed with numerous arguments, in the form of recurring complaints, or also with calm indifference, although apparently hostile. Because they are hypervigilant, since they are in search of potential threats, they can act in an excessively reserved manner, they protect themselves and they seem to be "cold" people without feelings. They can often seem to be enormously objective, rational and not emotional, as they tend to show little affection, with hostile expressions, stubbornness and sarcasm. Its combative and suspicious nature can provoke a hostile response in others, which, paradoxically, then serves to confirm their original expectations.

Since individuals with paranoid personality disorder lack confidence in others, they have an excessive need to be self-sufficient and a strong sense of autonomy. They also need to have a high degree of control over those around them. They are often rigid, critical of others and unable to collaborate, and they have great difficulty accepting any kind of criticism.

This unpleasant disorder usually leads to anguish, social deterioration, work and other areas of functioning that suffer. The personality pattern of these subjects is stable and long lasting, and its onset dates back to early adulthood or adolescence.

Symptoms of paranoid personality disorder

Paranoid personality disorder is characterized, as we have already seen, by a general mistrust and suspicion towards others, in such a way that their motives are interpreted as malevolent. This occurs in a variety of contexts, which should include four (or more) of the following:

  1. Distrust and general suspicion from the beginning of adulthood, so that the intentions of others are interpreted as malicious, which appear in various contexts, as indicated by four (or more) of the following points:
    1. Suspicion, without sufficient basis, that others will take advantage of them, they will harm them or they will deceive them
    2. Concern for unjustified doubts about loyalty or fidelity of friends and partners
    3. Reluctance to trust in others for unjustified fear that the information they share will be used against them
    4. In the most innocent observations or facts glimpse hidden meanings that are degrading or threatening
    5. Hold grudges for a long timeFor example, do not forget insults, insults or scorn
    6. Perceive attacks on his person or to his reputation that they are not apparent to others and are predisposed to react with anger or to counterattack
    7. Suspect repeatedly and unjustifiably that your spouse or partner is unfaithful
    8. These characteristics do not appear exclusively in the course of a schizophrenia, a mood disorder with psychotic symptoms or other psychotic disorder and are not due to the direct physiological effects of a medical illness.

Paranoid personality disorder is generally not diagnosed when another psychotic disorder has already been diagnosed in the subject, such as schizophrenia or a Bipolar disorder or depression With psychotic characteristics.

Because personality disorders usually have a long duration and stable patterns of behavior over time, they are diagnosed more frequently in adulthood. It is rare to be diagnosed in childhood or adolescence, since a child or adolescent is constantly developing, personality changes and maturation. However, if it is diagnosed in a child or adolescent, the characteristics must have been present for at least 1 year.

Paranoid personality disorder is more common in men than in women, and occurs between 2.3 and 4.4 percent in the general population.

The causes of paranoid personality disorder

Actually it is not yet known what causes paranoid personality disorder. There are many theories about the possible causes of paranoid personality disorder. Most professionals agree on a biopsychosocial model of causality, that is, the causes of are probably due to biological and genetic factors, social factors (for example, how a person interacts in his early development with his family and friends and other children), and psychological (The individual's personality and temperament, shaped by their surroundings and learned skills to deal with coping stress).

This suggests that no factor is responsible, rather, it is the complex and probably intertwined nature of the three factors that are important. If a person has this personality disorder, research suggests that there is a slight increase in the risk for this disorder that is transmitted to their descendants.

Treatment of paranoid personality disorder

Treatment of paranoid personality disorder usually involves long-term psychotherapy with a therapist who has experience in treating this type of personality disorder. Medications may also be prescribed to help with specific worrisome and debilitating symptoms.


As with most personality disorders, psychotherapy is the main treatment of choice. Individuals with paranoid personality disorder, however, rarely show up for treatment. This should not surprise us, because they believe that they have no problem, but that it is the others who conspire against them.

The therapy that emphasizes a simple, client-centered approach to support, as it is best for the patient to gain confidence, although it is quite difficult to achieve. Early termination in these patients, therefore, is common. As the therapy progresses, you will probably begin to trust more. It is then that he begins to reveal some of his strangest paranoid ideations. The therapist must be very careful in finding the balance between being objective with the therapy and respecting these thoughts of the subject, so as not to raise suspicions and to distrust again. It is a difficult balance to maintain, even after a good working relationship has been established.

All doctors and mental health personnel who are in contact with someone suffering from paranoid personality disorder should be very aware of their dealings with this individual. Subtle jokes and allusions to patient information will raise a great deal of suspicion. A concrete and honest approach will probably win the best results, focusing on the current difficulties of life that has led the client in therapy at this time. It is not advisable to ask too deeply about the life or history of the subject, unless directly relevant to clinical treatment.

The long-term prognosis for this disorder is usually not good. People who suffer from this disorder are often affected with symptoms throughout their lives.. It is not uncommon to see these people in day treatment programs or state hospitals. Other modalities, such as family or group therapy, are not recommended.


Medications are generally contraindicated for this disorder., as they may arouse unnecessary suspicion that will normally result in non-compliance with treatment and abandonment. Medications that are prescribed for specific conditions should be made for as short periods of time as possible.

An anxiolytic medication, such as diazepamIt may be appropriate to prescribe if the client suffers from severe anxiety or agitation, which begins to interfere with normal daily functioning. An antipsychotic medication, such as thioridazine or haloperidol, may be appropriate if a patient decomposes with severe agitation or psychotic thinking, which may be harmful to himself or others.

Personal effort

Naturally, there are no self-help support groups or communities for someone suffering from this disorder. Such approaches would probably not be very effective because a person with this disorder is likely to be distrustful and suspicious of others (even if they suffer from the same symptomatology) and their motivations. For this reason the effort to overcome must leave the person himself.

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