Paranoid personality disorder
Updated onJulia Dobmeier is currently completing her master's degree in clinical psychology. Since the beginning of her studies, she has been particularly interested in the treatment and research of mental illnesses. In doing so, they are particularly motivated by the idea of enabling those affected to enjoy a higher quality of life by conveying knowledge in a way that is easy to understand.
More about the experts All content is checked by medical journalists.Paranoid personality disorder is one of the most serious personality disorders. Those affected are very suspicious of other people. They are convinced that they want to be ill and therefore often behave irritably and aggressively. In therapy, those affected can work out more favorable behaviors and thought patterns together with the therapist. Read here what causes paranoid personality disorder, how to recognize and treat it.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F60
Paranoid personality disorder: description
A paranoid personality disorder is characterized by the fact that those affected have no confidence in other people. They constantly assume that others are trying to harm them without having any evidence to back it up.
For example, if you give a colleague a friendly smile, you feel laughed at. If your partner is not at home, they are convinced that they are cheating. When people with paranoid personality disorder feel threatened, they get angry and counterattack. They are extremely persistent in their hostility and will not be convinced that their suspicions are unfounded.
It is also typical of paranoid personality disorder that those affected are overly sensitive to criticism and always blame other people for failures in their lives. In school it is the teacher who is to blame for the bad grades, in professional life it is the boss if something does not go as expected.
Because of their suspicious and hostile nature, people with paranoid personality disorder are unpopular with others and often quarrel with others. Since they don't trust friends either, they hardly have any social contacts.
There are other personality disorders as well. What they all have in common is that individual personality traits are so extremely pronounced in those affected that it causes problems for the person concerned or with his environment. The problematic personality traits are stable and persistent and can be traced back to adolescence or early adulthood.
Paranoid personality disorder: incidence
Paranoid personality disorder is considered a rare personality disorder. Experts estimate that between 0.4 and 2.5 percent of the general population suffer from it. - Men more often than women. The number of those actually affected is probably higher because only a few seek professional help.
Paranoid personality disorder: symptoms
Personality disorders are basically characterized by the fact that thoughts, perceptions, emotions and behaviors differ significantly from what is socially accepted. They develop in adolescence or early adulthood and are permanent.
In addition to these general criteria of a personality disorder, a paranoid personality disorder according to the international classification of mental disorders (ICD-10) is present if at least four of the following symptoms apply:
The affected:
- are overly sensitive to setbacks
- tend to harbor persistent grudges; they do not forgive insults or disregards
- are very suspicious and twist facts by interpreting neutral or friendly actions of others as hostile or contemptuous
- are contentious and insist on their rights even when it is inappropriate
- often have no confidence in their partner's loyalty, even if there is no reason to be
- are highly self-centered and arrogant
- often deal with conspiracy thoughts with which they explain events in their environment or in the world in general
Paranoid personality disorder: causes and risk factors
The exact causes of personality disorders have not yet been clarified - this also applies to paranoid personality disorder. Experts believe that various influences are involved in the development of the disorder. On the one hand, the genetic predisposition plays a role; on the other hand, upbringing and other environmental influences also contribute to the development of a (paranoid) personality disorder.
These include, in particular, stressful events - they generally prepare the ground for the development of mental disorders. People with a paranoid personality disorder often report traumatic experiences in childhood, for example physical or emotional abuse.
Experts also suggest that children who receive little attention and love can become frustrated and develop aggression as a result. Some then project this onto other people and are suspicious of them as a result. Expecting only bad experiences with other people, they behave aggressively. This behavior in turn creates conflict, which makes them feel validated by others in their bad opinion. The result is a vicious circle that can hardly be broken and which can contribute to the development of a paranoid personality disorder.
A person's temperament also plays a role in the development of paranoid personality disorders. Children, who generally have a high tendency to be aggressive, are particularly at risk.
Paranoid Personality Disorder: Investigations and Diagnosis
People with paranoid personality disorder rarely seek professional help. On the one hand, they do not perceive their perception and behavior as disturbed and, on the other hand, they do not trust psychologists and doctors. If they seek treatment, it is often because of additional psychological disorders such as depression.
anamnese
For the diagnosis of a paranoid personality disorder, several discussions take place between the psychiatrist / therapist and the patient (anamnesis). The specialist can ask the following questions, for example:
- Do you often suspect a hidden meaning behind what others say or do?
- Do you often have the feeling that other people are trying to harm you?
- Do you often think that your partner is cheating on you?
Paranoid personality disorder: test
To diagnose paranoid personality disorder, the psychiatrist / therapist often uses personality questionnaires such as the Freiburg Personality Inventory (FPI). Structured clinical interviews can also be helpful.
Many self-tests for paranoid personality disorder can be found on the Internet. They can help those affected to make a rough assessment, but they are not a substitute for a diagnosis from a therapist or psychiatrist.
In order to rule out that organic problems or drug abuse are causing the symptoms, physical examinations are also necessary - usually blood tests, possibly also magnetic resonance imaging (MRI) of the brain (to rule out possible brain damage).
Paranoid personality disorder: treatment
The paranoid personality disorder is difficult to treat because the affected person is hardly able to confide in other people. For a successful treatment, however, it is necessary for the patient to get involved with the therapist.
Cognitive behavioral therapy
There are several approaches to treating paranoid personality disorder. Cognitive behavioral therapy aims to change unfavorable ways of thinking or thinking patterns. The aim is for the person concerned to question his or her distrust of other people and to learn how to deal with other people socially. Because many of those affected suffer from the isolation that is a result of their behavior. The training of social skills is therefore an important part of the therapy. In order to control the aggressive impulses, the therapist works out new strategies with the patient.
Focal therapy
In the psychoanalytically oriented focal therapy (a short psychotherapy) developed by Balint, the therapist shows the patient his destructive behavior. As a rule, patients distrust the therapist and withdraw or react aggressively to the therapist. Based on this interaction, the therapist can show how mistrust creates problems with other people.
Paranoid personality disorder: loved ones
People with paranoid personality disorder have great difficulty interacting with others. They constantly expect to be betrayed and hurt by others. With this conviction, they create a hostile climate.
For the relatives, the permanent distrust is a heavy burden. They often feel helpless because they cannot influence the person's behavior. But what you as a relative can do is:
- Realize that the person's inappropriate behavior is due to their personality disorder.
- Try not to take attacks personally.
- Get professional help. Even if the person concerned refuses therapy himself, a therapist or a counseling center can offer you support.
Paranoid personality disorder: disease course and prognosis
As with all personality disorders, paranoid personality disorder begins early in life and is chronic. Unlike other mental disorders, personality disorders cannot be cured because they are deeply ingrained in the person concerned.
However, the therapy can help to positively influence unfavorable behavioral patterns. However, the likelihood of a favorable outcome is rather low. On the one hand, those affected rarely seek therapeutic treatment; on the other hand, they have difficulties getting involved in the therapeutic process. However, the sooner paranoid personality disorder is discovered and treated, the better the prognosis.
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