Paranoid Personality Disorder

Question 1

What is a personality disorder?

Answer 1

an enduring pattern of inner experience and behavior that

• deviates markedly from the expectations of the individual’sculture
• is pervasive and inflexible
• has an onset in adolescence or early adulthood
• is stable over time
• leads to distress or impairment

Question 2

What is the essential feature of paranoid personality disorder?

Answer 2

a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent

Question 3

What are criteria A1 and A2 of paranoid personality disorder?

Answer 3

A1. they assume other people will exploit, harm, or deceive them, even if no evidence exists to support this expectation

A2. they are preoccupied with unjustified doubts about the loyalty or trustworthiness of their friends and associates, whose actions are minutely scrutinized for evidence of hostile intentions

Question 4

What are criteria A3 and A4 of paranoid personality disorder?

Answer 4

A3. they are reluctant to confide in others because of unwarranted fear that the information will be used maliciously against them

A4. they read hidden demeaning or threatening meanings into benign remarks or events

Question 5

What are criteria A5 and A6 of paranoid personality disorder?

Answer 5

A5. they persistently bear grudges (are unforgiving of insults, injuries, or slights)

A6. they perceive attacks on their character or reputation that are not apparent to others and are quick to react angrily or counterattack

Question 6

What is criterion A7 of paranoid personality disorder?

Answer 6

A7. they have recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

Question 7

How many of the A criteria of paranoid personality disorder must be present to result in diagnosis?

Answer 7

four or more

Question 8

What is the associated feature of paranoid personality disorder?

Answer 8

does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, or another psychotic disorder, and is not due to the direct effects of a general medical condition

Question 9

What are common characteristics of someone with paranoid personality disorder?

Answer 9

difficult to get along with
overt argumentativeness
recurrent complaining

hostile aloofness

may act guarded, secretive, or devious

cold appearance and lacking tender feelings

predominant hostile, stubborn, or sarcastic expressions

combative and suspicious nature

Question 10

What disorders are commonly comorbid with paranoid personality disorder?

Answer 10

• major depressive disorder
• agoraphobia
• obsessive-compulsive disorder
• alcohol and substance abuse
• schizotypal, schizoid, narcissistic, avoidant and borderline personality disorders

Question 11

In some cases, paranoid personality disorder may appear as the premorbid antecedent of __________ or ___________.

Answer 11

schizophrenia; delusional disorder

Question 12

Who is at risk for being misdiagnosed with paranoid personality disorder?

Answer 12

minority members of society, who may be guarded or defensive in response to the majority culture

For example:

• racial minorities
• immigrants
• political and economic refugees

Question 13

Children and adolescents with paranoid personality disorder often exhibit what characteristics?

Answer 13

• solitariness
• poor peer relationships
• social anxiety
• underachievement in school
• hypersensitivity
• peculiar thoughts or language
• idiosyncratic fantasies
• may appear odd or eccentric
• may attract teasing

Question 14

How can a differential diagnosis be made between paranoid personality disorder and delusional disorder, persecutory type, schizophrenia, paranoid type, and mood disorder with psychotic features?

Answer 14

The latter disorders all require a period of persistent psychotic symptoms, like delusions or hallucinations.

Paranoid personality disorder may be an additional diagnosis to these disorders, but symptoms of the personality disorder must have been present before psychotic symptoms, and must persist during remission periods of psychotic symptoms.

Question 15

Paranoid personality disorder must be distinguished from what other symptoms of larger disorders?

Answer 15

• personality change due to a general medical condition
• symptoms that may develop in association with chronic substance abuse
• paranoid traits associated with the development of physical handicaps

Question 16

How can paranoid personality disorder be distinguished from schizotypal personality disorder?

Answer 16

Schizotypal personality disorder includes symptoms such as magical thinking, unusual perceptual experiences, and odd thinking and speech, and paranoid personality disorder does not.

Question 17

How can paranoid personality disorder be distinguished from schizoid personality disorder?

Answer 17

Individuals with schizoid personality disorder do not tend to have prominent paranoid ideation.

Question 18

How can paranoid personality disorder be distinguished from borderline or histrionic personality disorder?

Answer 18

Borderline and histrionic personality disorders are not generally associated with pervasive suspiciousness.

Question 19

How can paranoid personality disorder be distinguished from avoidant personality disorder?

Answer 19

People with avoidant personality disorder do not confide in people out of fear of being embarrassed or found inadequate rather than out of mistrust.

Question 20

How can paranoid personality disorder be distinguished from antisocial personality disorder?

Answer 20

Antisocial behavior in paranoid personality disorder is due to a desire for revenge, while it is more motivated by desire for personal gain in antisocial personality disorder.

Question 21

How can paranoid personality disorder be distinguished from narcissistic personality disorder?

Answer 21

In narcissistic personality disorder, suspiciousness is displayed due to fear of having their imperfections or flaws revealed.