Paranoid personality disorder

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Paranoid personality disorder is a psychiatric diagnosis that denotes a personality disorder with paranoid features. It is characterized by an exaggerated sensitivity to rejection, resentfulness, distrust, as well as the inclination to distort experienced events. Neutral and friendly actions of others are often misinterpreted as being hostile or contemptuous. Unfounded suspicions regarding the sexual loyalty of partners and loyalty in general as well as the belief that one’s rights are not being recognized is stubbornly and argumentatively insisted upon. Such individuals can possess an excessive self-assurance and a tendency toward an exaggerated self-reference. The use of the term paranoia in this context is not meant to refer to the presence of frank delusions or psychosis, but implies the presence of ongoing, unbased suspiciousness and distrust of people.

Diagnostic criteria (DSM-IV-TR)

The DSM-IV-TR, a widely used manual for diagnosing mental disorders, defines paranoid personality disorder as a cluster A personality disorder (along with schizoid personality disorder (301.20) and schizotypal personality disorder (301.22)):

301.00 Paranoid Personality Disorder

A. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

• suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
• is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
• is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
• reads hidden demeaning or threatening meanings into benign remarks or events
• persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
• perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
• has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

B. Does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, and is not due to the direct physiological effects of a general medical condition.