Paranoid Personality Disorder (PPD):
« Back to Glossary IndexParanoid personality disorder (PPD) is condition characterized by a pervasive and unwarranted distrust and suspicion of others, where a person believes without evidence others are trying to harm, deceive, or exploit them. It’s classified in DSM-5 as a Cluster A (“odd or eccentric”) personality disorder (PD). Unlike schizophrenia, these suspicions are non-delusional — they don’t lose touch with reality or experience hallucinations, but their beliefs are fixed and out of proportion to actual threats. They’re constantly on guard, hypervigilant for signs of betrayal or threat, can be cold and hostile — which interferes with having close relationships. Other symptoms include reluctance to confide in others (fear of exploitation), distrust of partner’s fidelity, misinterpreting innocent remarks (as threatening), holding grudges, and reacting angrily to perceived attacks on their character. Risk factors include a family history of schizophrenia and childhood trauma. Treatment is often difficult as those with PPD may not recognize their behavior as a problem or trust healthcare professionals. Cognitive behavioral therapy (CBT) is the main approach to help change thought patterns and improve coping skills.
