Paranoid personality disorder

This article describes paranoid personality disorder. It is not to be confused with paranoid schizophrenia or paranoia .

Classification according to ICD-10
F60.0	Paranoid personality disorder
ICD-10 online (WHO version 2019)

The paranoid personality disorder is characterized by a particular sensitivity to rejection, rebuttal of insults and an exaggerated distrust . There is a tendency to constantly interpret what has been experienced in the direction of hostile tendencies towards oneself. Neutral actions and criticism of others are perceived as hostile, degrading or contemptuous.

In some cases a mania for jealousy can occur: Then stubborn and argumentative insist on unjustified suspicions regarding the sexual loyalty of partners. Often those affected then collect superficial “evidence” to support their jealous suspicions. People with a paranoid personality disorder can also be prone to excessive self-esteem and self-centeredness.

In the DSM-5 , this PS, together with the schizoid and schizotypic personality disorder, belongs to cluster A of schizophrenia- related personality disorders . The term paranoid is also used in the context of paranoid schizophrenia and paranoia . In all three cases, however, there are different mental disorders that are classified separately in the ICD-10 .

description

The main characteristic of paranoid personality disorder is a tendency to interpret neutral or friendly actions of others as hostile. This is done out of a mistrust, which is then confirmed in the corresponding misinterpretation (see also circular reasoning ). Sometimes paranoid personality disorder is accompanied by increased vigilance . Your distrust can be expressed either through open argument or through silent reserve with aggressive complaints.

There is a tendency to be overly sensitive and offended, which often leads to doggedness and argument . Affected people are often very closed because they fear that information disclosed would be used against them. They often have the feeling of being betrayed or taken advantage of. Close people or family members are also suspected and their loyalty is repeatedly called into question.

People with a paranoid personality structure, on the other hand, can be prone to excessive self-esteem and self- centeredness. From a depth psychological point of view, people with paranoid personality disorders have a tendency to ascribe their own aggressions to their fellow human beings and then to perceive them as hostility and fight them ( projection ).

Those affected are often described by their fellow men as astute observers. However, since they often accuse people around them, they themselves cause what they particularly fear and are often marginalized. Because of their low willingness to trust and their uncompromising approach, paranoid personalities have increasing difficulties in developing deep interpersonal relationships.

A frequency of 0.5 to 2.5 percent of those affected in the general population is assumed.

development

This disorder is almost always associated with serious personal and social impairments. Often it is noticeable in childhood and adolescence and persists into adulthood. Hereditary factors are suspected to be the cause , as there is evidence of an accumulation of this personality disorder in relatives of people with schizophrenia and of people with a delusional disorder of the paranoid type. Above all, however, an unfavorable social milieu in childhood and adolescence should be able to lead to a personality development with paranoid tendencies.

Comorbidities

More than three quarters of people with a paranoid personality have other mental disorders ( comorbidities ). The highest additional diagnoses can be found with the schizotypic personality disorder . Other common comorbidities are narcissistic personality disorder , insecure personality disorder , borderline personality disorder, and passive-aggressive personality disorder . It should be noted, however, that there is little research on this topic and, above all, no empirical studies .

Diagnosis

In the ICD-10

ICD-10 requires at least four of the following characteristics or behaviors to be present:

1. Exaggerated sensitivity to rejection;
2. Tendency to hold grudges permanently, that is, subjectively experienced insults, injuries or disregard are not forgiven;
3. Suspicion and a persistent tendency to distort experience by misinterpreting neutral or friendly actions of others as hostile or contemptuous;
4. Disputability and persistent insistence on one's own rights that is inappropriate to the situation;
5. frequent unjustified mistrust regarding the sexual fidelity of the spouse or sexual partner;
6. constant selfishness, especially in connection with extreme arrogance;
7. frequent occupation with unfounded thoughts of conspiracies as explanations for events in the near or far environment.

In the DSM-5

According to DSM-5 , there is profound mistrust and suspicion of others, so that their motives are interpreted as malicious. It starts in early adulthood and the pattern shows up in different situations. At least four of the following criteria must be met:

1. Suspects others, for no reasonable reason, of being taken advantage of, harmed, or deceived by them.
2. is overwhelmed by unjustified doubts about the loyalty and trustworthiness of friends or partners.
3. Reluctantly confides in other people out of an unjustified fear that the information could be used maliciously against him / her.
4. Reads a hidden, derogatory or threatening meaning into harmless remarks or occurrences.
5. Is long resentful (i.e. does not forgive alleged insults, injuries or degradations).
6. Perceives attacks on oneself or one's reputation that are not apparent to others and reacts quickly and angrily or starts a counterattack.
7. Repeatedly suspects the spouse or sexual partner of infidelity without any justification.

Does not occur exclusively in the course of schizophrenia, bipolar disorder, or depressive disorder with psychotic characteristics, or any other psychotic disorder, and is not a result of the physiological effects of a medical disease factor. If the criteria were met before the onset of schizophrenia, add “premorbid”. Example: "Paranoid Personality Disorder (Premorbid)".

literature

• Georg Adler: Paranoid disorders in old age . Schattauer Verlag 2001, ISBN 3-7945-2159-5 .
• Otto F. Kernberg (Ed.): Paranoid personality disorder, paranoid psychosis, everyday paranoia . Schattauer Verlag 2008, ISBN 978-3-7945-2509-6 .
• Peter Fiedler , Sabine C. Herpertz: Personality disorders. 7th edition. Beltz Verlag, 2016, ISBN 978-3-621-28013-6 .

Individual evidence

1. ↑ ^{a b c d} DSM-5 : Descriptive text and criteria for paranoid PS. 2015, ISBN 978-3-8017-2599-0 , pp. 889-894.
2. ↑ Chapter 4 - The Paranoid Personality Disorder . In: Rainer Sachse , Meike Sachse (Hrsg.): Clarification-oriented psychotherapy of schizoid and paranoid personality disorder . Hogrefe, 2017, ISBN 978-3-8017-2844-1 ( limited preview in Google Book Search).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !