Personality Disorder Support Community

Personality Disorder Support Community

Paranoid Personality Disorder

Paranoid Personality Disorder is a mental condition that usually appears in early adulthood and seem to be more predominant in men than women. It belongs to a group of conditions under the odd or eccentric personality disorders.

People with Paranoid Personality Disorder tend to:

  • Always believe that they are right.

  • Be wary and suspicious of other people and their motives.

  • Read more than what is intended in the looks/remarks given to them.

  • Be distrustful.

  • Be sensitive to perceived slights, often taking criticism badly.

  • Be hypervigilant.

  • Be isolated and have limited social involvements.

  • Be hostile, unforgiving and/or bear grudges.

In order to be diagnosed with PPD, you will have to meet certain criterion laid out by the DSM IV or the ICD-10.

For the DSM IV, the diagnostic criteria are as follows:

  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.

  2. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition.

Note: If criteria are met prior to the onset of Schizophrenia, add "Premorbid," e.g., "Paranoid Personality Disorder (Premorbid)."

The ICD-10 requires a person to fulfill the general personality disorder criteria first, and lists Paranoid Personality Disorder as follows:

It is characterized by at least three of the following:

  1. Excessive sensitivity to setbacks and rebuffs;

  2. Tendency to bear grudges persistently, i.e. refusal to forgive insults and injuries or slights;

  3. Suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous;

  4. A combative and tenacious sense of personal rights out of keeping with the actual situation;

  5. Recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner;

  6. Tendency to experience excessive self-importance, manifest in a persistent self-referential attitude;

  7. Preoccupation with unsubstantiated "conspiratorial" explanations of events both immediate to the patient and in the world at large.


  • Expansive paranoid, fanatic, querulant and sensitive paranoid personality (disorder).


  • Delusional disorder.

  • Schizophrenia.

Cause of PPD
There is no actual known cause of PPD. However, PPD occurs more commonly in people who have family members or relatives with schizophrenia. There is also evidence of some kind of trauma in childhood that may contribute to the development of PPD.

Diagnosing PPD
If you believe that you may have PPD, you will need to see your gp, who will make a referral to your local mental health unit. Your gp may examine you for any physical symptoms in order to rule out any medical condition.
If you are given an appointment to see a psychologist or a health care professional, you will be need to be assessed in order to be diagnosed with PPD. There will be several sessions at least before a diagnosis is confirmed, if any.

The treatment offered to people with PPD will differ according to severity. Most revolve around providing some kind of relief, or skills that will help the suffers in either managing their symptoms or improving relationships. Some examples of this will be therapies like CBT and psychotherapy.
Sometimes, medication is offered to help with certain symptoms of anxiety or depression.

Millon's Subtypes

This subtype involves behaviours characterised by compulsive and obstinate features. People who fall under this category are not only inflexible, they also often feel that they are always correct. They thrive under rigid, uncomprimising rules, are often highly confident and dislike opposing views.

Sufferers tend to display behaviours where their own importance is greatly inflated. They often have narcissistic tendencies, may be patronising and often talk about greatly exaggerated fantasies.

People who fall into this subcategory often have negativistic features. They are often confrontational and aggressive. They find fault easily, and often display a pessimistic and sullen attitude.

This subtype exhibits avoidant features. They often isolate themselves because they find it difficult to trust the world in general. They tend to be recluses and dislike socialising.

People who fall into this category show sadistic desires and often have cruel tendencies. They tend to feel the need for revenge against those who they perceive, have offended them in some way. They like to dominate and have very little empathy towards others.

© PDChat 2013


Paranoid Personality Disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)

Paranoid Personality Disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)

Millon, Theodore (2006). "Personality Subtypes Summary”. The Official Website for Theodore Millon, Ph.D., D.Sc.. DICANDRIEN, Inc.