How is paranoid personality disorder (PPD) diagnosed?

How is paranoid personality disorder (PPD) diagnosed?

Lab tests can’t diagnose PPD, but your doctor might use different diagnostic tests to rule out physical illness as the cause of the symptoms. If no other illness is found, your doctor may refer you to a psychiatrist or other mental health specialists. They use specially designed interview and assessment tools to evaluate a person for a personality disorder.

https://www.webmd.com/mental-health/qa/how-is-paranoid-personality-disorder-ppd-diagnosed

Paranoia

Paranoid personality disorder is one of the more prevalent personality disorders
but not commonly encountered in clinical settings.
• Paranoid personality disorder is a predictor of disability and is associated with
violence and criminal behavior.
• There are no Food and Drug Administration-approved medications for paranoid
personality disorder.
• Cognitive-behavioral therapy and psychodynamic therapy have been shown to
be effective treatment modalities

https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp-rj.2016.110103

DSM-5 Criteria for 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:

  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends
    or associates.
  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
  4. Reads hidden demeaning or threatening meanings into benign remarks or events.
  5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
  6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual
    partner.
    B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or a depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.

Paranoid Personality Disorder – A Case History

Since the time of Kraepelin, a pervasive and unwarranted mistrust of others has
been considered a cardinal feature of paranoid personality disorder. Other features that have been described prominently in the literature are sensitivity to
criticism, aggressiveness, rigidity, hypervigilance, and an excessive need for autonomy. We present the case of a patient with most of these classic characteristics
that represent key components of the diagnostic criteria for paranoid personality
disorder in the DSM-5 (Table 1).

CASE
“Mr. J” is a 65-year-old Caucasian man with no prior psychiatric history, history of chronic obstructive pulmonary disease, and a benign vocal cord lesion.
He was brought to the emergency department by police for concerns of psychosis and delusions. Records stated that the “patient is delusional, in a state of acute psychosis, easily agitated.”
Upon initial contact with the emergency department psychiatrist, the patient reported feeling that the staff at the hospital were against him. He reported never having seen a psychiatrist before, although he reported having been on a selective serotonin reuptake inhibitor in the past to help equilibrate his “serotonin levels.” He did not fully cooperate with the interview, was guarded and evasive, and often said, “You don’t need
to know.” His mental status examination was notable for disorganized process and paranoid content. During the latter part of the assessment, the patient became loud, intrusive, and agitated.
He pounded his cane on the ground and threw it to the floor in a threatening manner.

https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp-rj.2016.110103

What is paranoia?

“In paranoia, your fears become amplified and everyone you meet becomes drawn into that web. You become the centre of a threatening universe.”

What kind of things can you be paranoid about?

Everyone will have a different experience of paranoia. But here are some examples of common types of paranoid thoughts.

You might think that:

  • you are being talked about behind your back or watched by people or organisations (either on or offline)
  • other people are trying to make you look bad or exclude you
  • you are at risk of being physically harmed or killed
  • people are using hints and double meanings to secretly threaten you or make you feel bad
  • other people are deliberately trying to upset or irritate you
  • people are trying to take your money or possessions
  • your actions or thoughts are being interfered with by others
  • you are being controlled or that the government is targeting you

You might have these thoughts very strongly all the time, or just occasionally when you are in a stressful situation. They might cause you a lot of distress or you might not really mind them too much.

Continue reading “What is paranoia?”

7 Tips for Coping with a Paranoid Partner | Psychology Today

Paranoia can be a symptom of several illnesses including schizophreniabrief psychosis, paranoid personalitypsychotic depressionmania with psychotic features, or substance abuse, chronic or momentary. It can range in intensity from a character style to a severe impairment.

One form of paranoia that is particularly difficult to diagnose and treat is Delusional Disorder of the Persecutory Type. In DDPT, the sufferer is gripped by a delusion (a fixed false belief) that involves a singular situation or person—a “circumscribed” delusion. A wife “knows” that her husband is cheating on her with the neighbor, a person is convinced a co-worker is snooping in his desk, a manager is clear that employees are plotting to get her fired, an adult child is immovable in his belief that his father’s new wife cut him out of the will. The fixed false belief plays out around this one notion or person, while in other ways the afflicted may function just fine.

https://www.psychologytoday.com/us/blog/the-creativity-cure/201601/7-tips-coping-paranoid-partner

Paranoid Personality Disorder

1. 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:

1. suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her

2. is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates

3. is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her

4. reads hidden demeaning or threatening meanings into benign remarks or events

5. persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights

6. perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack

7. has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

PAS programmers who warrant this diagnosis would often satisfy these criteria before the marital separation. A detailed history from the victim parent as well as collaterals may be important because the programming parent is not likely to directly reveal such symptoms. They may, however, reveal them in the course of the evaluation, because they are such deep-seated traits, and are so deeply embedded in their personality structure, that they cannot be hidden. Most people involved in protracted child-custody litigation become “a little paranoid,” and this is often revealed by elevations on the paranoid scale of the MMPI. After all, there are indeed people who are speaking behind the patient’s back, are plotting against them, and are developing schemes and strategies with opposing lawyers. This reality results in an elevation of the paranoid scale in people who would not have manifested such elevations prior to the onset of the litigation. We see here how adversarial proceedings intensify psychopathology in general (Gardner, 1986), and in this case, paranoid psychopathology especially. The PAS child is less likely to warrant this diagnosis. When the severe level is reached PAS children may warrant the aforementioned Shared Psychotic Disorder diagnosis. On occasion, the diagnosis Schizophrenia, Paranoid Type (295.30) is warranted for the programming parent, but such patients generally exhibited other manifestations of schizophrenia, especially prior to the separation. It goes beyond the purposes of this paper to detail the marital symptoms of schizophrenia which should be investigated if the examiner has reason to believe that this diagnosis may be applicable.

It is important for the examiner to appreciate that there is a continuum from delusional disorder, to paranoid personality disorder, to paranoid schizophrenia. Furthermore, in the course of protracted litigation, a patient may move along the track from the milder to a more severe disorder on this continuum.

comfort zone

https://mkg4583.wordpress.com/2009/07/22/severe-sociopath-behavior-leads-to-parental-alienation/