Diagnostic Criteria for Paranoid Personality Disorder
The DSM-IV-TR, which is the diagnostic manual used by
the American Psychiatric Association, lists the following criteria for
a diagnosis of Paranoid Personality Disorder:
A. A pervasive and permanent sense of distrust and
suspicion of others in that their motives are interpreted as both
negative and directed towards the sufferer. The condition develops
in early adulthood and continues throughout life unless treatment
For a diagnosis of PPD to be made at least four or more of the following
criteria must be met:
- Suspicion, without adequate proof, that others are exploiting,
harming, plotting of deceiving the sufferer.
- Is preoccupied with unjustified doubts about the honesty and
integrity of friends, relatives and acquaintances.
- Displays a reluctance to confide in others due to a fear that
the information disclosed will be used against them.
- Reads hidden meanings into harmless conversations and interprets
these remarks or events as threatening to the sufferer.
- Bears grudges and holds anger to those who insult, slight or
hurt them, even if the event was unintentional and the perpetrator
unaware of their actions.
- Perceives attacks on themselves that are not apparent to others
and is quick to react to the perceived attack without thinking.
- Has recurrent suspicious, without actual proof, of the fidelity
of their spouse of sexual partner.
B. The symptoms are not concurrent with the presence
of schizophrenia, mood disorders with psychotic tendencies, or psychotic
disorder, nor are the symptoms due to the ingestion of a prescription
or non-prescription drug.
Case studies of Paranoid Personality Disorder can be found here
and here. Treatment
is difficult because the sufferer finds it almost impossible to develop
the trust relationship that is necessary for successful therapy and
so most sufferers are reluctant to seek treatment. Usually a crisis
event will be the trigger that causes sufferers to enter therapy.
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