Paranoid Personality Disorder (PPD)

Paranoid Personality Disorder (PPD)


Paranoid personality disorder is a serious mental health condition in which the sufferer has a chronic mistrust of friends, strangers and authority figures.

PPD sufferers often have a heightened sensitivity to the actions and words of others, and often combine confirmation bias with dissociation to form a world view which confirms their belief that they are in imminent danger.

Because of their world view, people who suffer from PPD have a tendency to isolate themselves and may become hostile to people who threaten this isolation, such as family members, partners and friends.

Paranoid Personality Disorder (PPD) - The DSM Criteria

Paranoid Personality Disorder (PPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster A (odd or eccentric) Personality Disorder.

Paranoid Personality Disorder (PPD) is defined as:

a pervasive distrust and suspicion 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 benign remarks or events as threatening or demeaning.
  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.

The traits, behaviors and characteristics:

  1. Do not occur exclusively during the course of a mood disorder accompanied by psychotic features nor other psychotic disorders.
  2. Are not due to the direct physiological effects of a general medical condition.

A formal diagnosis of PPD requires a mental health professional to identify 4 out of the above 7 criteria as positive. Some people with PPD may exhibit all 7. Most will exhibit only a few. 

Nobody’s perfect. Even normal healthy people will experience or exhibit a few of the above criteria from time to time. This does not make a person PPD.

Understanding the clinical criteria for Paranoid Personality Disorder (PPD) is helpful but learning how to cope with having a loved-one who suffers from PPD is quite different.

One of the most effective ways we have found to deal with that is to get support from people who understand what it feels like to be in a relationship or be a family member of someone who suffers from a personality disorder and have learned how to cope. You can find people like that at our Support Forum.

PPD Characteristics & Traits

Alienation - The act of cutting off or interfering with an individual's relationships with others.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Cognitive Dissonance - A psychological term for the discomfort that most people feel when they encounter information which contradicts their existing set of beliefs or values. 

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Dissociation- A psychological term used to describe a mental departure from reality.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Victimization - Casting oneself in the role of a victim.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Triggering -Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

PPD Causes and Treatment

The precise cause of PPD is unknown. PPD has been linked to schizophrenia in some studies which has led to a theory that its causes may be genetic in nature. Some nurturing element has also been associated to PPD.

Because of the nature of the disorder, it is often very difficult to persuade people who suffer from paranoid personality disorder to trust a mental health professional. In general, a combined regime of antidepressant or antipsychotic medication and psychotherapy are prescribed.

Movies Portraying Paranoid Personality Disorder Traits

The Caine Mutiny - The Caine Mutiny is a 1954 World War II drama which portrays the paranoia of a fictitious naval officer Phillip Queeg, played by Humphrey Bogart.

The Treasure of the Sierra Madre - The Treasure of the Sierra Madre tells the story of 3 American prospectors searching for gold in Mexico. One of the prospectors, Fred Dobbs, played by Humphrey Bogart, exhibits paranoid traits.

PPD Support Groups & Links:

Psychforums PPD forum - Psychforums Site.