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This personality disorder is characterized by pervasive (spread throughout) distrust and suspiciousness of others. These people rarely become close to others or confide in them, often refuse to disclose personal information to anyone, bear grudges, and retain hostile feelings over imagined insults and slights. They devote time to gathering evidence of the malevolence (malicious; having or exhibting ill will) of others and often quesitons the loyalty, fidelity, or intentions of spouses, fmaily members, or others. The condition differs from parnoid schizoprhenia or delusional disorder of the persecutory type in that they include psychotic symptoms such as delusions and hallucinations.
Symptoms:
Suspect, without sufficient basis, that others are exploiting, harming, or deceiving them.
Is preoccupied with unjustified doubts about the loyalty or trustworthiness of family, friends or associates.
Is reluctant to confide in others becaue of unwarranted fear that the information will be used maliciously aginst them.
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 their character or reputation that are not apparent to others and is quick to react angrily or to counter attack.
Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
Treatment Considerations:
We are born with a genetically determined temperament that will continually influence our behaviors throughout life. Understanding of personality disorders and how it affects your life is important -- increased awareness does not lead to radical change but rather to a smoothing of the rough edges and a greater ease of going with their natural flow. To either change or learn how to work with and around personality disorders will require large doses of honesty, hard work, humility, and courage.
Get the story straight and evaluate things as objectively as possible, correcting for your strong tendency to catastrophize.
It requires you to accept that a reasonable degree of uncertainty will always be inevitable -- that you can never be completely sure or completely safe.
Letting down your guard will occasionally get you hurt; but keeping it raised will have you miss out on much that makes life rewarding, comfortable, and fun.
A more ambitious approach would be to try to understand the mechanism of your paranoid thinking -- the things you suspect or hate in others are really a disguised version of your own thoughts and impulses that have been projected onto them.
If you can better understand and accept your own impulses, you won't have the same need to project them onto others -- requiring open-mindedness on your part.
Treatment goals should focus on decreasing resistance to change, goal development, improving social interaction, improving self-esteem, decreasing paranoid thinking, anger management, and decreasing fear with supportive therapeutic relationship.
Information and or Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
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