Paranoid personality disorder( paranoia) - Causes, symptoms and treatment. MF.

Paranoid personality disorder or, according to traditional domestic terminology, paranoid personality disorder "is characterized by distrust and suspicious attitude towards other people."However, the belief in one's own ideas and abilities can be excessive.

The main manifestations of this type of psychopathy is the special propensity of patients to the appearance of supervalued formations, combined with rigidity of the mind, suspicion and, as a rule, overestimated self-esteem.

Stages of becoming a paranoid personality disorder

Since childhood these individuals are prone to unilateral interests, addictions, stubbornness, straightforward judgments. Increased activity and reassessment of one's own abilities determines the desire for leadership, self-affirmation, quite often, despite the resistance of others. They are extremely sensitive and vindictive, extremely sensitive to disagreement with their opinion. At the same time, they do not forgive anyone for even the most insignificant offenses. To other people, paranoid psychopaths are usually treated with disregard, patronizing. Typical signs of overvalued ideas and paranoid reactions are formed in such subjects by 20-25 years.

As they mature, features of their character increase. Patients become inert, conservative, rigid.

Symptoms of Paranoid Personality Disorder

Paranoid psychopaths are almost incapable of supporting everyday everyday relationships in the family and community. This is hampered by the inability to compromise, the desire to act in all cases, only in accordance with its own opinion. Their judgments are distinctly cautious, self-confident, categorical.

Special meaning and significance for the paranoid gets everything that is somehow connected with his own personality, affects his interests. To phenomena outside the sphere of "attraction" of their "I" they are deeply indifferent, simply, excluding them from the field of active attention."Everything that does not have a close relationship to his" I ", seems paranoid is not very worthy of attention."

In this aspect, it is necessary to emphasize one more feature of paranoids, hardly noticeable in everyday life, but distinctly acting in the conditions of a somatic hospital is the egotism with respect to one's own corporal sphere. Psychopathic personalities of this circle are not only indifferent to a number of events of external life, but also to the problems of their somatic state. The news of a severe physical illness often leaves them indifferent - does not entail anxiety, fears of the harmful effects of the disease, the fear of death, and the reduction of mood. Often this leads to neglect of medical recommendations, refusal to take medication, the patient can continue to perform life-threatening exercises and physical activities.

Constant opposition to oneself around, perception of the world as a phenomenon of the opposite and even hostile is manifested in paranoia by such features as "super-vigilance"( constant search for a threat from the outside, readiness to respond to any alarm) and distrust of people. Often in the foreground are fears of encroachment on their rights, their property, their spouse or sexual partner. Such distrust of the intentions of others easily passes from paranoid personalities to suspicion. There are thoughts that people around them treat them unfairly, without due respect, envy or even want to humiliate, insult;under them "undermine", infringe on their authority. An incorrect, one-sided interpretation of the words and actions of others leads the paranoiac to an unreasonable and for the most part devoid of even the slightest suspicion of suspicion. Any trifle that does not have a direct relationship to them can be interpreted as a manifestation of bad intentions, negative( or even hostile) attitudes of others( more often relatives and co-workers).

The most typical, according to P. B. Gannushkin, property of paranoiacs is the propensity to form supervalued ideas, in the power of which they later turn out to be. Supervalued ideas subordinate to themselves the whole personality, determine the behavior of the individual;Not a paranoid personality governs one's thoughts, but thoughts govern it.

Depending on the subject of overvalued ideas, several types of paranoid personalities are distinguished:

• jealousy,
• inventors,
• querulants,
• fanatics.

However, a systematics based only on the content of overvalued entities can not reflect the structure of psychopathy as a whole.

There are two polar variants of paranoid psychopathy:

1. expansive( stronger, active, provocative, angry, ardent),
2. sensitive( weak, passive, secretive, touchy).

Expansive paranoid personalities - pathological jealousy, hysteria, people prone to conflict, truth-seeking and reform. Since childhood they have been deceitful, vindictive, often slander and complain, notice the shortcomings of others, but do not recognize them in themselves. As pointed out by VF Chizh( 1902), they are always happy with themselves, their failures do not confuse. We are convinced that only they are proficient in this specialty, only they understand everything perfectly. They do not want to obey, they confine themselves to a modest role, they usually struggle with their personal enemies, and not for a common cause. Fighting opponents and asserting their worth fill their lives. As a rule, these are stenic and even exalted people with an accelerated pace of mental activity and a constantly elevated background of mood. They are energetic, mobile, occasionally fussy, do not know what fatigue is, do not feel the need for rest. To the expansive paranoid personalities is a group of fanatics. Fanatics are people who dedicate all their interests, activity, time, and ultimately their whole life with exceptional passion to one cause, one idea. The strength of their obsession is that they are capable of capturing, even temporarily, other people with their idea. It should be emphasized that this refers to blind faith( for example, religious fanaticism) that does not require a logical justification. Although fanatics, in contrast to other paranoid personalities, do not bring themselves to the forefront, they are far from true altruism, are deprived of immediate love for their neighbor, soulless, and often cruel.

is characterized by a combination of contrasting personality traits: asthenic, sensitive( self-inferiority, vulnerability, false modesty) and sthenic( ambition, increased self-esteem) characteristic of the sensitive variant of paranoid psychopathy. These people are timid, shy, timid and at the same time suspicious and irritable, prone to self-analysis, self-criticism and even to self-suicide. They are distinguished by a heightened sense of humiliating insolvency for them in relation to standards( professional, everyday, etc.), which they established for themselves.

Causes of Paranoid Personality Disorder

1. The psychodynamic concept as a cause of development of a paranoid nature considers violations in the early development of a child. In the formation of this disorder, the role is played by early relationships with demanding parents, especially a detached, cruel father and an overly caring but rejecting mother. As a result of increased demand, the child develops an unfriendly and distrustful attitude toward all those around him with an accumulation of negative feelings( irritation, anger) and projection of them on others.
2. Others believe that paranoid disorder is of genetic origin.
3. Developers of evolutionary psychology believe that paranoid psychopathy is characterized by a pattern of general distrust and suspicion of the surrounding and unreasonable assumption that other people will exploit, deceive or harm. Such subjects harbor grievances and quickly strike back or even attack the imaginary enemy in advance. This behavior pattern is often demonstrated by animals that have low status in hierarchical groups. Vigilance and aggression can also be adaptive qualities when the threat comes from neighboring groups. Thinking like "our and others", which exaggerates insignificant differences and creates negative stereotypes, manifests itself in paranoid psychopaths in extreme forms.

For paranoid psychopathy, the main criteria for personality disorders( according to ICD-10) are:

1. Persistent stereotypes of behavior and perception differ from accepted cultural norms.
2. Behavior is not flexible( disadaptive).
3. Having your own subjective suffering, negative effects on the environment are clearly associated with behavior.
4. Deviations are stable and come from childhood and adolescence, the deviations are not associated with adult disorders.

Paranoid( paranoid) personality disorder( ICD-10 criteria):

1. excessive sensitivity to failures and failures;
2. the tendency to constantly be dissatisfied with someone, that is, the refusal to forgive insults, causing damage and the attitude of patronizing;
3. suspicion and a general tendency to distort the facts by misinterpreting the neutral or friendly actions of others as hostile or contemptuous;
4. is a militantly scrupulous attitude to issues related to the rights of the individual, which does not correspond to the actual situation;
5. renewed unjustifiable suspicions regarding the sexual fidelity of a spouse or sexual partner;
6. the tendency to experience its increased importance, which is manifested by the permanent attribution of what is happening to one's own account;
7. coverage of nonessential "conspiratorial" interpretations of events occurring with this person or, in the large, in the world.

Included:

• is a fanatical disorder;
• is a fanatical person;
• expansive-paranoid disorder;
• is an expansive-paranoid personality;
• is a sensitive-paranoid disorder;
• is a sensitive-paranoid personality;
• is a paranoid personality;
• is a paranoid personality disorder;
• is a paranoid personality;
• is a touchy-paranoid person;
• is a disorder of personality disorder.

Excluded:

• schizophrenia( F20.-);
• delusional disorder( F22.0x);
• paranoia( F22.01);
• paranoia is a curved( F22.88);
• paranoid psychosis( F22.08);
• paranoid schizophrenia( F20.0xx);
• paranoid state( F22.08);
• organic delusional disorder( F06.2x);
• paranoids caused by the use of psychoactive substances, including alcoholic delirium of jealousy, alcoholic paranoids( F10);
• F19).

Treatment of paranoid personality disorder

Drug therapy is usually ineffective.

Among the methods of psychotherapy, one can single out the theory of psychodynamics of object relations( in this case the doctor tries to explain to the patient what is behind his anger, and works on the hidden desires of the person to have satisfactory relations) and behavioral and cognitive psychotherapy that are aimed at arranging assistance to such people in controlling anxietyand improving the skills of resolving interpersonal problems. Patients are helped to more realistically interpret the actions and intentions of other people and better understand the point of view of others.