Have unhealthy delusions

Paranoid personality disorder

Paranoid personality disorder: description

People with personality disorders perceive the world in a distorted way. Accordingly, they also behave differently than healthy people. For example, people with paranoid personality disorder do not trust other people. They constantly assume that others are trying to harm them without their having to prove it.

If you give a colleague a friendly smile, if you feel laughed at, if your partner is not at home, you are convinced that he is cheating. If they feel threatened, they get angry and start a counterattack. They are extremely persistent in their hostility and will not be convinced that their suspicions are unfounded.

It is 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, they are unpopular with others and often quarrel with others. Since they don't trust friends either, they hardly have any social contacts.

How many people have paranoid personality disorder?

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 paranoid personality disorder. The number of those actually ill is probably higher because only a few people seek professional help. More men than women are affected.

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. Personality disorders develop in childhood or adolescence and persist in adulthood.

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 hold grudges permanently; they do not forgive insults or disregard
  • 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 and have no trust in the loyalty of their partner, 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 it develops due to various influences. On the one hand, the genetic predisposition plays a role, on the other hand, upbringing and other environmental influences also contribute to the development.

In particular, stressful events prepare the ground for the development of mental disorders. People with paranoid personality disorder also often report traumatic experiences in childhood, such as physical or emotional abuse.

Experts believe that children who receive little attention and love become frustrated and develop aggression as a result. They then project their own aggressions onto other people and are then suspicious of them. 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.

A person's temperament also plays a role in the development of paranoid personality disorders. Children who have a high tendency to be aggressive are particularly at risk.

Paranoid Personality Disorder: Investigations and Diagnosis

For the diagnosis of paranoid personality disorder, several discussions take place between the psychiatrist or therapist and the person concerned. The doctor will also do some physical exams to rule out organic problems or substance abuse causing the symptoms. He usually does a blood count. Magnetic resonance imaging (MRI) may also be used to create images of the brain that reveal possible damage to the brain.

Paranoid personality disorder: test

Many self-tests for paranoid personality disorder can be found on the Internet. These can give those affected a rough assessment, but are not a substitute for a therapist or psychiatrist's diagnosis.

Personality questionnaires such as the Freiburg Personality Inventory (FPI) and structured clinical interviews are often used to diagnose paranoid personality disorder.

To diagnose paranoid personality disorder, the therapist might ask the following questions:

  • 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: treatment

People with paranoid personality disorder rarely seek psychological 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 do seek treatment, it is often because of additional psychological disorders, such as depression.

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 of the therapy is that the person concerned questions his / her distrust of other people and learns how to deal with other people socially. Because many of those affected suffer from the isolation that is a result of their behavior.

Contact with other people, for example with friends, contributes to a higher quality of life. 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 psychoanalytically oriented focal therapy, the therapist shows the patient his destructive behavior. As a rule, patients distrust the therapist and withdraw or react aggressively to the therapist. On the basis of the interaction between therapist and patient, the therapist can show how problems with other people arise through mistrust.

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.

What you can do as a relative:

Realize that your loved one's inappropriate behavior is due to their personality disorder. Try not to take attacks personally. See a therapist for advice. Even if the person concerned refuses therapy, the therapist or a counseling center can offer you support.

Paranoid personality disorder: disease course and prognosis

As with all personality disorders, the paranoid personality disorder begins in childhood or adolescence and is chronic. Unlike other mental disorders, personality disorders cannot be cured because the disorder is deeply rooted in the person.

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. The earlier the paranoid personality disorder however, it is discovered and treated, the better the prognosis.

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