Paranoid Personality Disorder

Paranoid personality disorder is a personality disorder that consists of a pervasive distrust or suspiciousness of others such that their motives are interpreted as malevolent. It is characterized by a pattern of distrust and suspiciousness of others. Patents with this disorder tend to negatively interpret the actions, words, and intentions of others. They suspect that others intend to harm or deceive them, though there may be little supporting evidence for such concerns. They hold grudges for long periods and are reluctant to confide in others.

Risk Factors
Criterion A

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 4 (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
Criterion B

Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.

Note: If criteria are met prior to the onset of schizophrenia, add “premorbid,” i.e. - “paranoid personality disorder (premorbid).”

Personality Disorder Guidelines

Guideline Location Year PDF Website
World Federation of Societies of Biological Psychiatry (WFSBP) International 2009 - Link