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by Dr Andrew Carroll
and Dr Clare
Last updated: July 2020
The focus of this module is paranoid
personality disorder (PPD), a condition in which mistrust of others
is the cardinal feature. PPD is a somewhat neglected topic, and is
often the subject of diagnostic confusion and therapeutic
pessimism. The research base on the disorder remains sparse,
however an understanding of underlying psychological processes
can assist with its assessment and treatment.
Although a certain degree of mistrust with respect to the
intentions of others is normal, particularly in certain social
situations, suspiciousness may become maladaptive. Clinically
significant paranoid features are found in a variety of contexts:
in previously healthy individuals subjected to abnormal stress; in
mental illness; and in those with personality disorders.
This module presents a summary of the key
diagnostic issues relating to PPD and describes the various
psychological and social processes mooted to be central to the
genesis of paranoid thinking and behaviours. The evidence relating
to PPD and violence risk is then summarised and clinically useful
guidance for the safe treatment of sufferers is outlined.
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