Paranoid Personality Disorder Paranoid Personality disorder (PPD) can be defined as possessing an inherent trait of high suspiciousness, and a disposition to mistrust people, or perceiving them as purposely malicious with ill intent. There are many instances where individuals sometimes out of instinct may not trust another individual or even become suspicious of a person. It may even often appear that people are a little apprehensive or just simply being cautious before they are receptive and embracing of other individuals.
Some would suggest that the aforementioned are simply just attributed to social norms. However, if an individual is displaying behaviors or verbally expressive in a way that exhibits some deviation from a culture specific behavior, there could be mental disturbances. This means that there is imputed interpersonal dysfunctioning, causing internal distress that dramatically impairs an individual. The Diagnostic and Statistical Manual of Mental Disorders (5th ed. American Psychiatric Association, 2013) presents the following diagnosis and criteria: a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early dulthood 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. . 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.
Does not occur with schizophrenia, or other disorders with psychotic features, and not in-relation to the physiological effect These above criterion of another medical condition. Individuals who have this disorder are disproportionately exaggerated with ideation of people being mistrustful, and often their relationships with others are affected. It is shown that individual with paranoid personality disorder exhibit inordinate sensitivity to perceived or imagined criticisms. In many instances they will take offense to small negligible trivial slights.
They can be effortlessly or easily angered, and will hold a grudge against another when they feel they have been unfairly treated. Individuals with PPD are reluctant to befriend or share information with another because of fear that what was shared will be used against them at some point. They will be in disbelief of the genuine interest in them and the loyalty of acquaintances. Individuals with paranoid personality disorder are sometimes extremely difficult to get along with and often will have problems with their close relationships.
Because they are in-advertly on the look-out for potential threats, they may seem to act in a guarded, secretive, or devious manner and appear to be “cold” and lacking in tender feelings. Their combativeness and suspiciousness can elicit a hostile response in people, which they allow that to confirm their original presumptions. Because individuals with PPD have no trust in others, they portray themselves to be self- ufficient and independent, or possess a strong sense of autonomy.
The reported prevalence of paranoid personality disorder in the general population ranges from 0. 5% to 2. %, and this disorder is more often diagnosed in men than women (APA, 2013). There has been introduced an exuberance of clinical research literature with regard to personality disorders, but there is comparatively no or little information regarding the successful treatment of paranoid personality disorder. Currently, even with the available theoretical research there is no outpour of case chronic rogressive clinical treatment for PPD patients. It is probable that with the nature of personality paranoid disorder that individuals with this disorder will not want to even pursue or history that can suggest treatment.
This may account for the lack of studies referencing the treatment of paranoid personality disorder. Individuals with this disorder, who will need psychological treatment are required to engage in high levels of disclosure about themselves. This would possibly create a level of discomfort for individuals with PPD considering the associative criterion with aladaptive cognitive, affective, and behavioral styles. Additionally, these individuals are unpleasant, and therapist sometimes typically find it difficult to work with them, in having a poor prognosis.
They will be seemingly suspicious of the therapist’s clinical assessment or actions, and motives. In implementing psychological interventions it is suggestive that a cognitive approach may be well suited for individuals with paranoid personality disorder. Williams (1988), states for some PPD clients, cognitive therapy would possibly be a better approach than behavior therapy. The cognitive approach dually addresses the suspiciousness that PPD clients present as an attributable feature. A cognitive intervention will include a behavioral aspect to enable the client to transcribe or decode cognitive changes into more effective behaviors.
Cognitive interventions will assist in accomplishing a reduction in PPD symptomatology and improve the social functioning in many clients. Psychotherapy will provide cognitive implementing that is conducive to change or at least provide a catalyst for a different view or approach. newly developed cognitive intervention. The evidence from the current study of cognitive analytic therapy (CAT) suggests that psychotherapy for PPD requires a cognitive component, within a boundaried and relational therapy, that is able to reflect on paranoid enactments within the therapeutic relationship.
Mindfulness is also a cognitive intervention that holds promising Cognitive analytic therapy is a and useful in current cases as it enabled an attentive awareness of the reality of circumstances, especially of the present moment, and as an antidote to paranoia or paranoid ideation (Kellett and Hardy, 2014). This type of cognitive play is necessary with this type of therapy, to be able to listen and to be aware of PPD clients’ verbal narrative. Also, with observing an individual’s non-verbal cues, this will allow them also to pay attention to their own internal signals, with their thoughts and emotions.
Because of the hypervigilant belief of the harmful intent or mistrust of others, this un-intrusively help them with their internal dialogue. The clinical process helps with identifying a dialogical self, as the client is believed to have developed a therapeutic alliance. When therapists believe the transference relationship has become amicable, they can help clients with gaining awareness of their dysfunctional processes, then distance themselves from the thoughts and adopt new l- positions. This phase also includes helping clients to gather intel about other people’s behaviors and intentions without becoming defensive.
With the client’s gaining awareness of their schemas it is intertwined with the therapist’s efforts to validate their emotional experience and create a shared mental context (Dimaggio et al. , 2006). This conceptualizes the backdrop of Dialogical self-theory (DST), which is when there is interplay een multiple parts that include voices, characters, and positions. The different parts commit an intrusive internal communicative interchange, hence gives the concept of dialogical self. The goal would be to effectively and constructively counteract the voices, characters, and positions.
The research findings are fascinating, with regard to paranoid personality disorder presumably having lasting manifestations over a lifetime, and with their only being successful treatment with the integration of therapy, and in some instances with edication. There is current research that disseminates socioeconomic status and childhood trauma with differences in ethnicity as it relates to paranoid personality disorder. It is significant as research translates intervening variables in the connection between race and PPD symptoms.
There are some research findings that propose that racial differences in PPD clients can or is explained by the problems specifically experienced by African-Americans. It is suggestive that there is a greater frequency of paranoid symptoms when being compared to White/Anglo-Americans. The research is inconclusive and understudied. An additional study found that White/Anglo- American college students were found to have less PPD symptom than that of African-American students. Researchers theorize that when comparing psychotic forms of paranoia, and nonpsychotic forms.
They will be most often presumably include PPD symptoms, and are more intrinsically linked or perhaps strongly suggestive of cultural and environmental adaptations. Specifically, an environment that culminates harbored feelings of victimization, alienation, and lack of control are postulated to ttribute to the arousal of many paranoid symptoms. Evidence depicts that African-Americans are many times more likely than White/Anglo-Americans to be privy to victimization and to recount interpersonal mistrust and cultural mistrust in the dominant White/Anglo culture (lacovino et al. 2014).
Interestingly, the study also showed that when education and income were included comparably with equal measurable reliability/validity, African-American and White/Anglo-American adults did not correlate differences of mistrust. The research findings are significant as there is an interest as a clinician to ork with those individuals in both a current and future clinical setting. However, enthusiastically a venture of specificity would be to work with youth, teenage boys, young adults and older adult males who are of any cultural ethnicity.
But an area of specialty would be that of the male gender, given the attributed dynamics of paranoid personality disorder. Based on the impact of research, and clinical observations there is ground or substantiated evidence that African-American males are associative of not trusting any derivative subset of a perceived White/Anglo-American dominate culture. Iacovino et al. , (2014), states African-American are more likely than White/AngloAmericans to live in poverty and to be victims of socioeconomic and racial discrimination.
These experiences may cause individuals to feel powerless and to perceive the dominant culture as threatening and hostile, leading to suspiciousness, mistrust, and paranoia. As such, low socio-economic status may partly explain elevated symptoms of PPD among AfricanAmericans. This would be one of the populations or an area of concentration that would be of emphasis and warrant undertaking of a clinical framework. In assessing PPD a comprehensive assessment with gathering collective data about early childhood remembrances would be beneficial. Complete a questionnaire about their childhood, school, work and relationships.
In a therapeutic environment give an imagined situation or scenario, then gauge their response or reaction. In having a client complete a Standardized Assessment of Personality – Abbreviated Scale (SAPAS), it’s evaluative for a brief screening of personality disorders. Also screen clients for inappropriate engagement of being distant, hostile, and anxiousness, and having current situational issues, court litigations, and legal battles. Further, attempt to rule out cooccurring disorders, or personality features that are similar to paranoid personality disorder.
Have the client perform a medical evaluation, because persistent substance use, and paranoid traits associated with a physical handicap would need to be distinguished. In remembering cultural differences there would be a need to assess accurately and not mistake guarded or defensive behaviors as PPD, because cultural difference or language barriers could account for mistrust of others (Carroll, 2009). There are additional significant research findings that correlate or compare the role of race, and illicit drug use.
African-Americans are seemingly diagnosed with significantly higher rates of PPD than White/Anglo-Americans in a sampling of substance use treatment seeking individuals. Howeve ver the findings did not conclude that a frequency of drug usage alone was the permeating factor of paranoid personality disorder. A possible theory, relates as cultural paranoia, suggests that African-American individuals have developed a normative, unhealthy, and adaptive response to racism and oppression by a dominant White/Anglo-American culture (Raza et al. , 2014).
