What Is Paranoid Personality Disorder? - Treatment, Symptoms & Causes

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Paranoid Personality Disorder is an Axis II Personality Disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Key features of Paranoid Personality Disorder include a pervasive pattern of distrust and suspiciousness of others.

We also recommend watching Cluster A Personality Disorders: Paranoid, Schizoid and Schizotypal and Panic Disorder and Agoraphobia: Symptoms, Causes and Treatment

Paranoid Personality Disorder

Paranoid Personality Disorder is an Axis II Cluster A Personality Disorder. All personality disorders display an enduring and inflexible pattern of behavior and experience that is markedly different from the norm. The pattern is clearly seen in multiple areas including cognition (thoughts), affect (feelings), interpersonal functioning (relationships), and impulse control. These behaviors lead to impairment in multiple areas of functioning.

Individuals with Cluster A Personality Disorders appear odd and eccentric. The cause of Paranoid Personality Disorder is not known. As with other Axis II disorders, the development is thought to be a combination of factors including biological, psychological, and social interactions.


There are numerous criteria that need to be met in order to be diagnosed with Paranoid Personality Disorder. The symptoms generally begin in early adulthood and can be seen in a variety of contexts. Symptoms also tend to be seen in males more than females.

People with Paranoid Personality Disorder are suspicious of others and assume that others will harm, deceive and/or exploit them, even if there is no evidence to support this. They have these suspicious feelings and thoughts about others that are not based on any facts at all. They may also feel that they have been deeply injured by another, even though no actions to support this have transpired. They are completely preoccupied about the loyalty and trustworthiness of their friends, and tend to scrutinize every action.

Watching Eye

Any perceived deviation from trustworthiness will serve to support their underlying assumptions. For example, if a friend cancels a date because he or she is ill or stuck in traffic, the person with Paranoid Personality Disorder will view this as an act of betrayal that supports the idea that no one should be trusted.

People with Paranoid Personality Disorder are very reluctant to confide in others or become close to others for fear that any information that they share will be used against them. If they are asked a personal question, even about a seemingly unimportant topic, they will not want to answer. For example, if they were asked what time they wake up in the morning, they may reply with something like it is none of anyone's business. The fear that the information will be used against them prevents them from sharing any personal data.

Those with Paranoid Personality Disorder will put hidden meanings into benign remarks or events. For example, if a cashier gave them change of a $1 bill instead of $10 bill, they would view it as a deliberate attempt to shortchange them and cheat them. If someone at school offers to help them with a project, they view it as a criticism that others believe that they cannot do it on their own.

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