Mental health disorders not only affect the person who suffers from them, but can directly impact the social relationships they establish and those around them. In few cases this collateral impact is more evident than in the case of paranoid disorder of personality.
What is it and what are its causes?
According to the MSD manual, the main reference text in the diagnosis of mental health disorders, paranoid personality disorder is characterized by a pervasive pattern of distrust and suspicious of others. This tendency leads patients to interpret other people’s intentions as malicious; they think they are trying to deceive or directly harm them, even if there is no reasonable evidence of such a thing.
Its causes are unknown, but it is known that there are certain factors that increase the risk of suffering from this disorder: mainly, the male sex and have suffered abuse emotional, physical or sexual in childhood.
What are its symptoms and how is it diagnosed?
Paranoid Personality Disorder does not cause observable physiological symptoms; instead, their signs have more to do with the ideas expressed by the patient or with the behaviors that it displays.
For example, it is common for them to express that have been hurt by others largely and irreversibly. They tend to judge all the words and actions of their close people; and once they interpret that some type of offense or aggression has occurred, they are not capable of forgiving, even going so far as to counterattack or get angry.
Likewise, they can express distrust or celos excessive towards their partner, friends or family, often questioning their actions. When others react negatively to their behavior, they take it as confirmation of their suspicions.
Clinically, this disorder is diagnosed when the patient demonstrates persistent distrust and suspicion of others, manifested through four or more of the following behaviors and beginning in early adulthood:
- Unjustified suspicion that others use, disappoint or harm it.
- Worry about unjustified doubts about the reliability of your friends, co-workers…
- Reluctance to trust others, on the grounds that the information you reveal could be used against you.
- Misinterpretation of innocent statements or events, which the patient perceives as hostile or threatening.
- Resentment for insults or injuries.
- Easy to feel attacked and quick to react with anger.
- Continuous and unjustified suspicions about the infidelity of the couple.
However, it is also necessary to rule out other disorders with similar symptoms but with distinctive features, such as borderline personality disorder (BPD), schizoid personality disorder, schizotypal personality disorder, narcissistic personality disorder, antisocial personality disorder, avoidant personality disorder, delusional disorder, schizophrenia, and depressive or bipolar disorders with psychotic features (schizoaffective disorder).
How is it treated?
The characteristics of this disorder often make it difficult for the patient to adhere to any treatment, but at a general level the strategy may include cognitive behavioral therapy along with drugs (antidepressants, antipsychotics) depending on the specific symptoms. One approach that sometimes works well is for the therapist to grant some degree of validity to his suspicions, thereby forging a kind of ‘alliance’ with the patient that improves adherence to treatment.
References
Mark Zimmerman. Paranoid personality disorder. MSD Manual (2021). Consulted online at https://www.msdmanuals.com/es-es/professional/psychic-disorders%C3%A1tricos/personality-disorders/personality-paranoid-disorder-tpp on 10/04 /2022.