Purpose of Review
Paranoid personality disorder (PPD) has historically been neglected by science out of proportion to its prevalence or its association with negative clinical outcomes. This review provides an update on what is known about PPD regarding its prevalence, demographics, comorbidity, biological mechanism, risk factors, and relationship to psychotic disorders.
PPD has long been the subject of a rich and prescient theoretical literature which has provided a surprisingly coherent account of the psychological mechanism of non-delusional paranoia. Available data indicate that PPD has a close relationship with childhood trauma and social stress. Descriptive data on a sample of 115 individuals with paranoid personality disorder is examined in comparison with a group of individuals with borderline personality disorder. The descriptive data largely confirm previously identified relationships between paranoid personality disorder and childhood trauma, violence, and race. We identify important similarities to and differences from borderline personality disorder.
PPD continues to be an important construct in the clinic and the laboratory. Available data lead to a reconsideration of the disorder as more closely related to trauma than to schizophrenia.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Triebwasser J, Chemerinski E, Roussos P, Siever LJ. Paranoid personality disorder. J Pers Disord [Internet]. 2013;27:795–805. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22928850
Carroll A. Are you looking at me? Understanding and managing paranoid personality disorder. Adv Psychiatr Treat. 2009;15:40–8.
Bernstein D, Useda J. Paranoid personality disorder. In: O’Donohue W, Ka F, So L, editors. Personal. disord. towar. DSM–V. New York: Sage; 2006.
American Psychiatric Association. DSM-IV. Diagnostic stat. man. ment. disord. 4th Ed. TR. 2000.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Am. Psychiatr. Assoc. [Internet]. 2013;991. Available from: http://ajp.psychiatryonline.org/article.aspx?articleID=158714%5Cn, http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:DSM-5#0.
WHO. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Heal. Organ. [Internet]. 1992;1–267. Available from: http://apps.who.int/iris/handle/10665/37958%5Cn, http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:The+ICD-10+Classification+of+Mental+and+Behavioural+Disorders#1.
Mathias JL, Morphett K. Neurobehavioral differences between Alzheimer’s disease and frontotemporal dementia: a meta-analysis. J Clin Exp Neuropsychol. 2010;32:682–98.
Mendez MF. The neuropsychiatric aspects of boxing. Int J Psychiatry Med [Internet]. 1995;25:249–62. Available from: http://ezproxy.newcastle.edu.au/login?url=http://library.newcastle.edu.au/resserv?sid=OVID:medline&id=pmid:8567192&id=&issn=0091-2174&isbn=&volume=25&issue=3&spage=249&pages=249-6
American Psychiatric Association. DSM 5 [Internet]. Am. J. Psychiatry. 2013. Available from: http://ajp.psychiatryonline.org/article.aspx?articleID=158714%5Cn, http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:DSM-5#0
Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, et al. Research Domain Criteria (RDoC): toward a new classification framework for research on mental disorders. Am. J. Psychiatry. 2010. p. 748–51.
Gore WL, Widiger TA. The DSM-5 dimensional trait model and five-factor models of general personality. J Abnorm Psychol [Internet]. 2013;122:816–21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23815395
Grant BF, Hasin DS, Stinson FS, Dawson DA, Chou SP, Ruan WJ, et al. Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2004;65:948–58.
Loranger AW, Janca A, Sarotius N. Assessment and diagnosis of personality disorders: the ICD-10 international personality disorder examination (IPDE). J Chem Inf Model. 2007.
Birkeland SF. Paranoid personality disorder and sociodemography: a 25-year study of first admissions to a Danish general psychiatric hospital. Nord Psychol. 2011;63:40–9.
Berman ME, Fallon AE, Coccaro EF. The relationship between personality psychopathology and aggressive behavior in research volunteers. J Abnorm Psychol. 1998;107:651–8.
Esbec E, Echeburúa E. Violence and personality disorders: clinical and forensic implications. Actas Esp Psiquiatr. 2010;38:249–61.
Mullen PE. Jealousy and violence. Hong Kong J Psychiatry. 1995;5:18–24.
Mullen PE, Lester G. Vexatious litigants and unusually persistent complainants and petitioners: from querulous paranoia to querulous behaviour. Behav Sci Law. 2006;24:333–49.
Bone S, Oldham JM. Paranoia: historical considerations. In: Oldham JM, Bone S, editors. Paranoia new psychoanal. perspect. Madison: International Universities Press; 1994. p. 3–15.
Karterud S, Pedersen G, Bjordal E, Brabrand J, Friis S, Haaseth O, et al. Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network. J Personal Disord. 2003;17:243–62.
Pompili M, Girardi P, Ruberto A, Tatarelli R. Suicide in borderline personality disorder: a meta-analysis. Nord. J Psychiatry [Internet]. 2005;59:319–24. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16757458
Jackson HJ, Burgess PM. Personality disorders in the community: a report from the Australian National Survey of Mental Health and Wellbeing. Soc Psychiatry Psychiatr Epidemiol [Internet]. 2000;35:531–8. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11213842
Torgersen S, Kringlen E, Cramer V. The prevalence of personality disorders in a community sample. Arch Gen Psychiatry. 2001;58:590–6.
Raza GT, DeMarce JM, Lash SJ, Parker JD. Paranoid personality disorder in the United States: the role of race, illicit drug use, and income. J Ethn Subst Abuse [Internet]. 2014;13:247–57. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25176118
• Iacovino JM, Jackson JJ, Oltmanns TF. The relative impact of socioeconomic status and childhood trauma on Black-White differences in paranoid personality disorder symptoms. J. Abnorm. Psychol. [Internet]. 2014;123:225–30. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370342/. This report replicates findings that PPD is more common in African American but is able to demonstrate that this is likely due to higher levels of socioeconomic stress.
Combs DR. Perceived racism as a predictor of paranoia among African Americans. J Black Psychol. 2006;32:87–104.
Wong KK, Freeman D, Hughes C. Suspicious young minds: paranoia and mistrust in 8- to 14-year-olds in the UK and Hong Kong. Br J Psychiatry. 2014;205:221–9.
Kraepelin E. Manic depressive insanity and paranoia. New York: Arno Press; 1921.
Bleuler E. Affectivitat, suggestibilitat, paranoia. Marhold: Halle; 1906.
Meyer A. The problem of mental reaction types, mental causes, and diseases. Psychol Bull. 1908;5:245–61.
Schneider K. Psychopathic personalities. Hamilton M, Anderson E, Thomas C, editors. Springfield: Springfield; 1950.
American Psychiatric Association. Mental disorders, diagnostic and statistical Manual. Acad Med [Internet]. 1952;27:365. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00001888-195209000-00035
Fleiss J, Levin B, Cho Paik M. Statistical methods for rates and proportions. Wiley. 2003.
Mellsop G, Varghese F, Joshua S, Hicks A. The reliability of axis II of DSM-III. Am J Psychiatry. 1982;139:1360–1.
Zanarini MC, Skodol AE, Bender D, Dolan R, Sanislow C, Schaefer E, et al. The collaborative longitudinal personality disorders study: reliability of axis I and II diagnoses. J Personal Disord. 2000;14:291–9.
Pilkonis P, Heape C, Proietti J, Clark S, McDavid J, Pitts T. The reliability and validity of two structured diagnostic interviews for personality disorders. Arch Gen Psychiatry. 1995;52:1025–33.
Jane JS, Pagan JL, Turkheimer E, Fiedler ER, Oltmanns TF. The interrater reliability of the structured interview for DSM-IV personality. Compr Psychiatry [Internet]. 2006;47:368–75. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-33746878425&partnerID=40&md5=d8a65112f84465e9b260f9e73f671f75
Lobbestael J, Leurgans M, Arntz A. Inter-rater reliability of the structured clinical interview for DSM-IV axis I disorders (SCID I) and axis II disorders (SCID II). Clin. Psychol. Psychother. 2011;18:75–9.
Westen D, Shedler J, Durrett C, Glass S, Martens A. Personality diagnoses in adolescence: DSM-IV axis II diagnoses and an empirically derived alternative. Am J Psychiatry. 2003;160:952–66.
Edens JF, Marcus DK, Morey LC. Paranoid personality has a dimensional latent structure: taxometric analyses of community and clinical samples. J Abnorm Psychol. 2009;118:545–53.
Lyoo IK, Youn T, Ha TH, Park HS, Kwon JS. Classification of frequency distributions of diagnostic criteria scores in twelve personality disorders by the curve fitting method. Psychiatry Clin Neurosci. 2003;57:417–23.
Falkum E, Pedersen G, Karterud S. Diagnostic and statistical manual of mental disorders, fourth edition, paranoid personality disorder diagnosis: a unitary or a two-dimensional construct? Compr Psychiatry. 2009;50:533–41.
Costa PT, McCrae RR. Personality disorders and the five-factor model of personality. J. Pers. Disord. [Internet]. 1990;4:362–71. Available from: http://guilfordjournals.com/doi/abs/10.1521/pedi.1922.214.171.1242
Saulsman LM, Page AC. The five-factor model and personality disorder empirical literature: a meta-analytic review. Clin Psychol Rev. 2004. p. 1055–85.
Trull TJ. DSM-III-R personality disorders and the five-factor model of personality: an empirical comparison. J Abnorm Psychol. 1992;101:553–60.
Poulton R, Caspi A, Moffitt TE, Cannon M, Murray RM, Harrington H. Children’s self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Arch Gen Psychiatry. 2000;57:1053–8.
Freeman D, Garety PA, Bebbington PE, Smith B, Rollinson R, Fowler D, et al. Psychological investigation of the structure of paranoia in a non-clinical population. Br J Psychiatry [Internet]. 2005;186:427–35. Available from: http://bjp.rcpsych.org/content/186/5/427.abstract
Freeman D, McManus S, Brugha T, Meltzer H, Jenkins R, Bebbington P. Concomitants of paranoia in the general population. Psychol. Med. [Internet]. Cambridge, UK: Cambridge University Press; 2011;41:923–36. Available from: https://www.cambridge.org/core/article/div-class-title-concomitants-of-paranoia-in-the-general-population-div/04E44B35F9EF830DE6D6BED01A759ED9.
Bebbington PE, McBride O, Steel C, Kuipers E, Radovanovic M, Brugha T, et al. The structure of paranoia in the general population. Br J Psychiatry. 2013;202:419–27.
Kendler KS. Kraepelin and the diagnostic concept of paranoia. Compr Psychiatry. 1988;29:4–11.
Combs DR, Penn DL, Wicher M, Waldheter E. The Ambiguous Intentions Hostility Questionnaire (AIHQ): a new measure for evaluating hostile social-cognitive biases in paranoia. Cogn Neuropsychiatry. 2007;12:128–43.
Peters ER, Moritz S, Schwannauer M, Wiseman Z, Greenwood KE, Scott J, et al. Cognitive biases questionnaire for psychosis. Schizophr Bull. 2014;40:300–13.
Jeon IH, Kim KR, Kim HH, Park JY, Lee M, Jo HH, et al. Attributional style in healthy persons: its association with ‘theory of mind’ skills. Psychiatry Investig. 2013;10:34–40.
Johnson JG, Cohen P, Kasen S, Skodol AE, Hamagami F, Brook JS. Age-related change in personality disorder trait levels between early adolescence and adulthood: a community-based longitudinal investigation. Acta Psychiatr Scand. 2000;102:265–75.
Skodol AE. Longitudinal course and outcome of personality disorders. Psychiatr. Clin. North Am. 2008. p. 495–503.
Fulton M, Winokur G. A comparative study of paranoid and schizoid personality disorders. Am J Psychiatry. 1993;150:1363–7.
Widiger TA, Trull TJ. Performance characteristics of the DSM-III-R personality disorder criteria sets. In: Widiger TA, Frances AJ, Pincus HA, Ross R, First MB, Davis WW, editors. DSM-IV Sourceb, vol. 4. Washington DC: American Psychological Association; 1998. p. 357–73.
Gore WL, Widiger TA. The DSM-5 dimensional trait model and five-factor models of general personality. J Abnorm Psychol. 2013;122:816–21.
Morey LC. Personality disorders in DSM-III and DSM-III-R: convergence, coverage, and internal consistency. Am J Psychiatry. 1988;145:573–7.
Blackburn R, Coid JW. Empirical clusters of DSM-III personality disorders in violent offenders. J Pers Disord [Internet]. 1999;13:18–34. Available from: http://search.proquest.com.proxy1.library.mcgill.ca/docview/195236761?accountid=12339
Ramklint M, von Knorring A-L, von Knorring L, Ekselius L. Child and adolescent psychiatric disorders predicting adult personality disorder: a follow-up study. Nord J Psychiatry. 2003;57:23–8.
Reich J, Braginsky Y. Paranoid personality traits in a panic disorder population: a pilot study. Compr Psychiatry. 1994;35:260–4.
Johnson JG, Smailes EM, Cohen P, Brown J, Bernstein DP. Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: findings of a community-based longitudinal study. J. Pers. Disord. [Internet]. 2000;14:171–87. Available from: http://guilfordjournals.com/doi/abs/10.1521/pedi.2000.14.2.171
Golier JA, Yehuda R, Bierer LM, Mitropoulou V, Antonia New MS, Schmeidler J, et al. The relationship of borderline personality disorder to posttraumatic stress disorder and traumatic events. Am J Psychiatry [Internet]. 2013;160:2018–24. Available from: http://ajp.psychiatryonline.org
Bierer LM, Yehuda R, Schmeidler J, Mitropoulou V, New AS, Silverman JM, et al. Abuse and neglect in childhood: relationship to personality disorder diagnoses. CNS Spectr. 2003;8:737–54.
Grover KE, Carpenter LL, Price LH, Gagne GG, Mello AF, Mello MF, et al. The relationship between childhood abuse and adult personality disorder symptoms. J Personal Disord. 2007;21:442–7.
Tyrka AR, Wyche MC, Kelly MM, Price LH, Carpenter LL. Childhood maltreatment and adult personality disorder symptoms: influence of maltreatment type. Psychiatry Res. 2009;165:281–7.
Thomas CR, Russell W, Robert RS, Holzer CE, Blakeney P, Meyer WJ. Personality disorders in young adult survivors of pediatric burn injury. J Personal Disord. 2012;26:255–66.
Munro A. Delusional (paranoid) disorders: etiologic and taxonomic considerations. I. The possible significance of organic brain factors in etiology of delusional disorders. Can J Psychiatry. 1988;33:171–4.
Hibbard MR, Uysal S, Kepler K, Bogdany J, Silver J. Axis I psychopathology in individuals with traumatic brain injury. J Head Trauma Rehabil. 1998;13:24–39.
Koponen S, Taiminen T, Portin R, Himanen L, Isoniemi H, Heinonen H, et al. Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow-up study. Am J Psychiatry. 2002;159:1315–21.
Zimbardo PG, Andersen SM, Kabat LG. Induced hearing deficit generates experimental paranoia. Science (80- ) [Internet]. 1981;212:1529–31. Available from: http://www.sciencemag.org/cgi/reprint/212/4502/1529.pdf
Freud S. Pscyho-analytic notes upon an autobiographical account of a case of paranoia (dementia paranoides). Stand. Ed. London: Hogarth Press; 1911. p. 3–79.
Shapiro D. Paranoia from a characterological standpoint. In: Oldham JM, Bone S, editors. Paranoia new psychoanal. perspect. Madison: International Universities Press; 1994. p. 49–57.
Auchincloss E, Weiss RW. Paranoid character and the intolerance of indifference. In: Oldham JM, Bone S, editors. Paranoia new psychoanal. perspect. Madison: International Universities Press; 1994.
Kernberg OF. A psychoanalytic classification of character pathology. J Am Psychoanal Assoc. 1970;18:800–22.
Klein M. Notes on some schizoid mechanisms. Int J Psychoanal [Internet]. 1946;27:99–110. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3330415&tool=pmcentrez&rendertype=abstract
Westen D. Towards a revised theory of borderline object relations: contributions of empirical research. Int J Psychoanal [Internet]. 1990;71(Pt 4):661–93. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2074152
Cooper AM. Paranoia: a part of every analysis. In: Oldham JM, Bone S, editors. Paranoia new psychoanal. perspect. Madison: International Universities Press; 1994. p. 133–50.
Bentall R, David AS, Cutting J. Cognitive biases and abnormal beliefs: towards a model of persecutory delusions. Neuropsychol. Schizophr. 1994. p. 337–60.
Garety PA, Freeman D. Cognitive approaches to delusions: a critical review of theories and evidence. Br J Clin Psychol. 1999;38(Pt 2):113–54.
Combs DR, Penn DL. The role of subclinical paranoia on social perception and behavior. Schizophr Res. 2004;69:93–104.
Johnson J, Jones C, Lin A, Wood S, Heinze K, Jackson C. Shame amplifies the association between stressful life events and paranoia amongst young adults using mental health services: implications for understanding risk and psychological resilience. Psychiatry Res. 2014;220:217–25.
Beck AT, Butler AC, Brown GK, Dahlsgaard KK, Newman CF, Beck JS. Dysfunctional beliefs discriminate personality disorders. Behav Res Ther. 2001;39:1213–25.
Gracie A, Freeman D, Green S, Garety PA, Kuipers E, Hardy A, et al. The association between traumatic experience, paranoia and hallucinations: a test of the predictions of psychological models. Acta Psychiatr Scand [Internet] Blackwell Publishing Ltd. 2007;116:280–9. doi:10.1111/j.1600-0447.2007.01011.x.
Turkat ID, Banks DS. Paranoid personality and its disorder. J Psychopathol Behav Assess. 1987;9:295–304.
McReynolds P, Collins B, Acker M. Delusional thinking and cognitive organization in schizophrenia. J Abnorm Soc Psychol. 1964;69:210–2.
Abroms G, Taintor Z, Lhamon W. Percept assimilation and paranoid severity. Arch Gen Psychiatry [Internet]. 1966;14:491–6. doi:10.1001/archpsyc.1966.01730110043006.
Thompson-Pope SK, Turkat ID. Reactions to ambiguous stimuli among paranoid personalities. J Psychopathol Behav Assess. 1988;10:21–32.
Freeman D. Suspicious minds: the psychology of persecutory delusions. Clin Psychol Rev. 2007;27:425–57.
Beyer F, Münte TF, Göttlich M, Krämer UM. Orbitofrontal cortex reactivity to angry facial expression in a social interaction correlates with aggressive behavior. Cereb Cortex. 2014:3057–63.
Freeman D, Evans N, Lister R, Antley A, Dunn G, Slater M. Height, social comparison, and paranoia: an immersive virtual reality experimental study. Psychiatry Res. 2014;218:348–52.
Schiffman J, Lam CW, Jiwatram T, Ekstrom M, Sorensen H, Mednick S. Perspective-taking deficits in people with schizophrenia spectrum disorders: a prospective investigation. Psychol Med. 2004;34:1581–6.
Kinderman P, Dunbar R, Bentall RP. Theory-of-mind deficits and causal attributions. Br J Psychol. 1998;89:191–204.
Colby KM. Modeling a paranoid mind. Behav Brain Sci [Internet]. 1981;4:515–60. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc2&NEWS=N&AN=1982-22376-001
Wadenberg ML. Conditioned avoidance response in the development of new antipsychotics. Curr Pharm Des. 2010;16:358–70.
Moutoussis M, Williams J, Dayan P, Bentall RP. Persecutory delusions and the conditioned avoidance paradigm: towards an integration of the psychology and biology of paranoia. Cogn Neuropsychiatry [Internet]. 2007;12:495–510. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17978936
Liu Y, Shen X, Zhu Y, Xu Y, Cai W, Shen M, et al. Mismatch negativity in paranoid, schizotypal, and antisocial personality disorders. Neurophysiol Clin. 2007;37:89–96.
•• Lee RJ, Gollan J, Kasckow J, Geracioti T, Coccaro EF. CSF corticotropin-releasing factor in personality disorder: relationship with self-reported parental care. Neuropsychopharmacology. 2006;31:2289–95. This report included data on a subset of subjects who met PPD criteria and had high levels of corticotropin-releasing factor
Strome EM, GHT W, Higley JD, Loriaux DL, Suomi SJ, Doudet DJ. Intracerebroventricular corticotropin-releasing factor increases limbic glucose metabolism and has social context-dependent behavioral effects in nonhuman primates. Proc Natl Acad Sci U S A [Internet]. 2002;99:15749–54. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=137787&tool=pmcentrez&rendertype=abstract%5Cn, http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=137787%5C&tool=pmcentrez%5C&rendertype=abstract%5Cnfile:///Users/eharoon/Dropbox/Papers2/Artic
Europe PMC Funders Group. Biological insights from 108 schizophrenia-associated genetic loci. Nature. 2014;511:421–7.
Tidey JW, Miczek KA. Social defeat stress selectively alters mesocorticolimbic dopamine release: an in vivo microdialysis study. Brain Res. 1996;721:140–9.
Webb CT, Levinson DF. Schizotypal and paranoid personality disorder in the relatives of patients with schizophrenia and affective disorders: a review. Schizophr Res. 1993;11:81–92.
Kendler KS, McGuire M, Gruenberg AM, O’Hare A, Spellman M, Walsh D. The Roscommon Family Study. III. Schizophrenia-related personality disorders in relatives. Arch Gen Psychiatry [Internet]. 1993;50:781–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8215802
Maier W, Lichtermann D, Minges J, Heun R. Personality disorders among the relatives of schizophrenia patients. Schizophr Bull. 1994;20:481–93.
Winokur G. Familial psychopathology in delusional disorder. Compr Psychiatry. 1985;26:241–8.
Kendler KS, Masterson CC, Davis KL. Psychiatric illness in first-degree relatives of patients with paranoid psychosis, schizophrenia and medical illness. Br J Psychiatry. 1985;147:524–31.
Hans SL, Auerbach JG, Styr B, Marcus J. Offspring of parents with schizophrenia: mental disorders during childhood and adolescence. Schizophr Bull [Internet]. 2004;30:303–15. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed6&NEWS=N&AN=2004274065%5Cn, http://www.scopus.com/inward/record.url?eid=2-s2.0-3042664377&partnerID=40&md5=438ee5241b24a7a88f10ae36ad22addb
Tienari P, Wynne LC, Läksy K, Moring J, Nieminen P, Sorri A, et al. Genetic boundaries of the schizophrenia spectrum: evidence from the Finnish adoptive family study of schizophrenia. Am J Psychiatry. 2003;160:1587–94.
Stoffers J, Völlm BA, Rücker G, Timmer A, Huband N, Lieb K. Pharmacological interventions for borderline personality disorder. Cochrane Database Syst. Rev. [Internet]. 2010;CD005653. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20556762.
Nosè M, Cipriani A, Biancosino B, Grassi L, Barbui C. Efficacy of pharmacotherapy against core traits of borderline personality disorder: meta-analysis of randomized controlled trials. Int Clin Psychopharmacol. 2006;21:345–53.
Hollander E, Allen A, Lopez RP, Bienstock CA, Grossman R, Siever LJ, et al. A preliminary double-blind, placebo-controlled trial of divalproex sodium in borderline personality disorder. J Clin Psychiatry [Internet]. 2001;62:199–203. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11305707
Oldham JM, Skodol A. Do patients with paranoid personality disorder seek psychoanalysis? Paranoia New Psychoanal. Perspect. 1994. p. 151–66.
Doering S, Hörz S, Rentrop M, Fischer-Kern M, Schuster P, Benecke C, et al. Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. Br J Psychiatry. 2010;196:389–95.
Nicolo G, Centerno E, Nobile S, Porcari F. Paranoid personality disorder: a single case intervention. Ric Psicoter. 2003;5:89–107.
Kellett S, Hardy G. Treatment of paranoid personality disorder with cognitive analytic therapy: a mixed methods single case experimental design. Clin Psychol Psychother. 2014;21:452–64.
Westermann S, Kesting ML, Lincoln TM. Being deluded after being excluded? How emotion regulation deficits in paranoia-prone individuals affect state paranoia during experimentally induced social stress. Behav Ther. 2012;43:329–40.
Colby KM. Modeling a paranoid mind. Behav Brain Sci. 1981;4:515–60.
Bateman A, Fonagy P. Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. Am J Psychiatry. 2009;166:1355–64.
Kvarstein EH, Karterud S. Large variations of global functioning over five years in treated patients with personality traits and disorders. J Pers Disord [Internet] Guilford Publications Inc. 2012;26:141–61. doi:10.1521/pedi.2012.26.2.141.
Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2008;69:533–45.
Raza GT, DeMarce JM, Lash SJ, Parker JD. Paranoid personality disorder in the United States: the role of race, illicit drug use, and income. J Ethn Subst Abus. 2014;13:247–57.
Handelsman L, Holloway K, Kahn RS, Sturiano C, Rinaldi PJ, Bernstein DP, et al. Hostility is associated with a low prolactin response to meta-chlorophenylpiperazine in abstinent alcoholics. Alcohol Clin Exp Res [Internet]. 1996;20:824–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8865955
Davis MH. A multidimensional approach to individual differences in empahty. Cat Sel Doc Psychol [Internet]. 1980;40:3480. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1981-50664-001&site=ehost-live%5CnValidierung-Empathie
Jeung H, Herpertz SC. Impairments of interpersonal functioning: Empathy and intimacy in borderline personality disorder. Psychopathology. 2014. p. 220–34.
The research was partially funded by 1R21MH083309 (PI: Royce Lee). The descriptive data come from subjects recruited for research studies by Royce Lee, M.D., and Emil F. Coccaro, M.D.
All subjects provided written, informed consent with consent forms approved by the IRB of The University of Chicago.
Conflict of Interest
Dr. Royce Lee declares that he has no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
This article is part of the Topical Collection on Personality and Impulse Control Disorders
About this article
Cite this article
Lee, R.J. Mistrustful and Misunderstood: a Review of Paranoid Personality Disorder. Curr Behav Neurosci Rep 4, 151–165 (2017). https://doi.org/10.1007/s40473-017-0116-7
- Paranoid personality disorder
- Borderline personality disorder
- Childhood trauma
- Corticotropin-releasing hormone
- Personality disorder