Paranoid Personality disorder
What is personality?
· Characteristic ways a person behaves and thinks. Enduring patterns of thinking and behavior that define the person and distinguish him or her from other people.
Function of personality?
Ways of expressing emotion. Provides with patterns of thinking about ourselves and other people
Abnormal or Disordered Personality?
Enduring patterns of behavior and emotion bring the person into repeated conflicts with others. Prevent the person from maintaining close relationships with others.
What is Paranoid Personality Disorder?
· Paranoid mean suspiciousness, persecutory trends, extremely fearful. Paranoid Personality disorder can be characterized by the pervasive tendency to be inappropriately suspicious of other people’s motives and behaviors.
Sign and Symptoms of Paranoid Disorder
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Paranoid people do not trust anyone
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Trouble maintaining relationships with friends and family members, this symptom is also common in Borderline Personality Disorder.
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This disorder often begins in childhood or early adolescence
·
More common in men than in women
·
Studies estimate that PPD affects between 2.3% and 4.4% of the
general population.
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Doubt the commitment, loyalty, or trustworthiness of others,
believing others are exploiting or deceiving them.
·
Are reluctant to disclose to others or reveal personal information
because they are afraid the information will be used against them.
·
Are unforgiving and hold grudges.
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Are hypersensitive and take criticism poorly.
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Read hidden meanings in the innocent remarks or casual looks of
others.
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Perceive attacks on their character that are not apparent to others;
they generally react with anger and are quick to retaliate.
·
Have persistent suspicions, without reason, that their spouses or
lovers are being unfaithful.
·
Are generally cold and distant in their relationships with others,
and might become controlling and jealous to avoid being betrayed.
·
Cannot see their role in problems or conflicts, believing they are
always right.
·
Have difficulty relaxing.
·
Are hostile, stubborn, and argumentative.
· Tend to develop negative stereotypes of others, especially those from different cultural groups. This disorder must be differentiated from Histrionic Personality Disorder.
Treatment of Paranoid Personality Disorder
·
People with PPD often do not seek treatment on their own because
they do not see themselves as having a problem as the case with Antisocial Personality Disorder.
·
The distrust of others felt by people with PPD also poses a
challenge for health care professionals because trust is an important factor of
psychotherapy
·
When a patient seeks treatment for PPD, psychotherapy is the
treatment of choice.
·
Treatment likely will focus on increasing general coping skills,
especially trust and empathy, as well as on improving social interaction,
communication, and self-esteem.
Case Study of Paranoid Disorder
Nasir Kamal is a 58-year-old Indian man with no prior psychiatric history, He was brought to the
emergency department by police for concerns of psychosis and delusions. Records
stated that the “patient is delusional, in a state of acute psychosis.
Upon initial contact with psychiatrist, the patient reported feeling that
The staff at the hospital were against him.
He reported never having seen a psychiatrist before.
He did not fully cooperate with the interview, was guarded and evasive, and often said, “You don’t need to know.”
His mental status examination was notable for disorganized process and paranoid content.
During the latter part of the assessment, the patient became loud, intrusive, and agitated.
He pounded his
cane on the ground and threw it to the floor in a threatening manner.
He requested discharge but would not elaborate on a safe discharge plan nor allow his family to be contacted.
He declined voluntary inpatient hospitalization and threatened to
sue the emergency department psychiatrist if he were to be involuntarily
committed.
He was then involuntarily admitted to the inpatient unit due to aggressive behavior and risk of harm to others.
He remained at the hospital for 15 days.
During the initial part of his stay, he was easily agitated, displayed verbal aggression, exhibited paranoia, and refused treatment.
He would not engage in conversation with most team members, with the exception of a medical student on the team to whom he reported paranoid ideations about various family members and friends.
He was suspicious and mistrustful of the treatment providers and mostly focused his conversations on legal issues.
He claimed that he was being held in the
hospital illegally and threatened to sue the providers for holding him against
his will.
He reported being estranged from most of his family since his wife’s death.
He stated that his daughters “did not understand him.”
Very reluctantly, he gave permission for one of his daughters to be contacted.
His daughter described him as always being an “eccentric and distrustful person.”
She described incidents in the past in which he had held beliefs about others “being against” him, resulting in isolation from friends and family.
She described him as someone who “often held grudges and for a long time.”
She reported a chronic pattern of behavioral problems, aggression, strained relationships, and suspicious thinking.
She also described his behavior as worsening recently.
The patient’s final diagnosis was psychosis , with underlying paranoid
personality disorder.
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