Paranoid Personality Disorder

Full description of Paranoid Personality Disorder. Definition, signs, symptoms, causes of Paranoid Personality Disorder.

Full description of Paranoid Personality Disorder (PPD). Definition, signs, symptoms, causes of Paranoid Personality Disorder.

Definition of Paranoid Personality Disorder (PPD)

Simply put, people with Paranoid Personality Disorder do not trust other people and because of the high degree of distrust, PDD is extremely difficult to treat and usually lasts a lifetime.

People with a Paranoid Personality Disorder are usually unable to acknowledge their own negative feelings toward others but do not generally lose touch with reality. They will not confide in people, even if they prove trustworthy, for fear of being exploited or betrayed. They will often misinterpret harmless comments and behavior from others and may build up and harbor unfounded resentment for an unreasonable length of time.

Because they suspect that everyone is out to "get them" and/or exploit them, it often leads to hostility and social isolation. People with Paranoid Personality Disorder do not fit in and they do not make good "team players." Interactions with others are characterized by wariness and hostility. If they marry or become otherwise attached to someone, the relationship is often characterized by pathological jealousy and attempts to control their partner. They often assume their sexual partner is cheating on them. PDD patients can be confrontational, aggressive and argumentative. It is not unusual for them to sue people they feel have wronged them. In addition, patients with PDD are known for their tendency to become violent.

Diagnostic Criteria for Paranoid Personality Disorder (PPD)

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:

  • suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
  • is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
  • is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
  • 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 his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
  • has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

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)."

Causes of Paranoid Personality Disorder (PPD)

The cause of Paranoid Personality Disorder is unknown, although it seems to appear more often in families containing a person with schizophrenia. Paranoid Personality Disorder may also be a result of negative childhood experiences fostered by a threatening domestic atmosphere. It is prompted by extreme and unfounded parental rage and/or condescending parental influence that cultivate profound child insecurities.

For comprehensive information on paranoid personality and other personality disorders, visit the Personality Disorders Community.

Sources: 1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association. 2. Merck Manual, Home Edition for Patients and Caregivers, last revised 2006. 3. NIH, Personality Disorders.

APA Reference
Writer, H. (2009, January 3). Paranoid Personality Disorder, HealthyPlace. Retrieved on 2019, October 18 from

Last Updated: July 5, 2019

Medically reviewed by Harry Croft, MD

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