Written by: Julia Chivu
Edited by: Holly Paik
Paranoid Personality Disorder (PPD), as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is a mental health condition characterized by chronic and extreme distrust of others (Vyas and Khan, 2017). People with PPD are very suspicious of others’ actions and intentions, often thinking that others want to harm them. These suspicions are persistent even when there is no real proof to support these beliefs. PPD can also cause individuals to be very sensitive to what they perceive as rejection (Kellett & Hardy, 2014). As a result, these thoughts can lead to holding grudges, overthinking, and jealousy (Lee, 2017).
Due to the severity of PPD symptoms, individuals with this condition may encounter some unique challenges. For example, they tend to stop working earlier in life compared to those that do not have this disorder (Lee, 2017). In addition, PPD can lead to aggressive behavior, with some individuals having a history of violence and criminal actions (Kellett & Hardy, 2014). While there are varying reports about which conditions often happen together with PPD, it has been commonly noticed that PPD tends to co-occur with agoraphobia or panic disorder (Vyas and Khan, 2017).
Several factors impact the probability of developing PPD. Childhood experiences such as neglect, physical trauma, and abuse have been linked with an increased risk of developing PPD. In addition, it has been observed that factors including low income and belonging to specific racial or ethnic groups, such as Black, Hispanic, or Native American, increase the risk of PPD. There are also findings that show those who have been widowed, separated, never married, or divorced are more likely to develop this disorder (Lee, 2017).
PPD is relatively common among personality disorders (Kellett & Hardy, 2014).
However, despite its prevalence, this disorder has continuously been overlooked and understudied in both research and clinical settings. For instance, epidemiological studies have revealed that women are more likely to have PPD while clinical research studies indicate higher rates of PPD in men (Lee, 2017). It can be challenging to recruit PPD patients for studies, especially when some may not trust medical professionals. Typically, people with PPD will not enroll themselves in any research study or treatment plan. This aid is usually initiated by family members or coworkers (Vyas and Khan, 2017). There is also a lack of funding for research studies related to this condition. Historically, it was thought that this disorder was associated with schizophrenia due to the shared characteristics of mistrust and paranoid thinking. However, the evidence supporting this relationship remains inconclusive. Furthermore, this disorder has also been overlooked because of the resemblances between certain PPD symptoms and those of other personality disorders (Lee, 2017).
As research on this disorder unfortunately remains limited, so do the treatment options. There are no tailored treatment plans or medications currently available for people with PPD. Based on the currently available research findings, the short-term use of antipsychotics or cognitive analytic therapy may be effective treatment methods. Other research suggests that psychodynamic therapy can be beneficial. Psychodynamic therapy is a talk based therapy that allows patients to gain a better understanding of why they think and feel a certain way and how these beliefs impact their actions (Vyas and Khan, 2017). This form of therapy may allow PPD patients to change their view on their suspicions and understand the cause of their problems. Therefore, it is crucial for further studies and funding options to be designed to provide individuals with PPD with the support they need.
References:
El Gassier, M. T. (2018). Person stretching their hands. Retrieved from https://unsplash.com/photos/person-stretching-their-hands-cugryvziO_M
Kellett, S., & Hardy, G. (2014, June 3). Treatment of paranoid personality disorder with cognitive analytic therapy: a mixed methods single case experimental design. Clinical Psychology and Psychotherapy, 21(5), 452-464. https://eprints.whiterose.ac.uk/102728/3/paranoid%20case%20study.pdf
Lee, R. (2017, June). Mistrustful and misunderstood: A review of paranoid personality disorder. Current Behavioral Neuroscience Reports, 4(2), 151-165. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793931/
Vyas, A., & Khan, M. (2017, May 16). Paranoid personality disorder. American Journal of Psychiatry Residents’ Journal. https://psychiatryonline.org/doi/10.1176/appi.ajp-rj.2016.11010
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