Paranoid personality disorder

Paranoid personality disorder is defined as a personality disorder primarily characterized by paranoid features.

Clinically, it can be identified with a specific set of (highly interrelated) DSM criteria. These include an exaggeration of sensitivity to rejection, resentfulness, and distrust, as well as the inclination to distort experienced events. Neutral and friendly actions of others are often misinterpreted as being hostile or contemptuous. Unfounded suspicions regarding the sexual loyalty of partners and loyalty in general as well as the belief that one's rights are not being recognized is stubbornly and argumentatively insisted upon. Such individuals can possess an excessive self-assurance and a tendency toward an exaggerated self-reference. Pathological jealousy, instinctive aggressive counter-attack, the need to control others, and the gathering of trivial or circumstantial "evidence" to support their jealous beliefs also features. The use of the term paranoia in this context is not meant to refer to the presence of frank delusions or psychosis, but implies the presence of ongoing, unbased suspiciousness and distrust of people.

Paranoia was initially considered (following Sigmund Freud) to arise as an adaptive defense against unconscious impulses. Psychiatrists may still characterize paranoid behaviour in terms of existing constructs such as defense mechanisms (prominently including denial).

Paranoia can also been defined in a less specified manner than the DSM diagnostic characterization of the paranoid personality. For instance, Colby refers to paranoia generally as "the presence of persecutory delusions", an umbrella category that includes distinct somatic, erotic, grandeur, and jealousy delusions. Such delusions may be identified as consistent misinterpretations of events in the paranoid individual's environment.

The term "paranoia" has been widely exported into common usage, where it may describe not the psychiatrically-defined personality condition but simply any behavioural tendencies or attitudes indicating excessive fear.

Diagnostic criteria

Note: The American Psychiatric Association, which publishes the Diagnostic and Statistical Manual of Mental Disorders, forbids the unauthorized reproduction of their diagnostic criteria. A narrative of the DSM-IV-TR criteria follows.