Paranoid Personality Disorder (PPD)

Ever find yourself being overly cautious in certain situations? Paranoid thoughts happen when we worry about what others think of us, particularly when we are caught in vulnerable and stressful situations.

Most people, when paranoid, understand that their thoughts are extreme and dismiss them eventually. However, when an individual finds that his or her paranoid feelings happen all the time without reason and are interfering with his or her way of life, this could indicate the presence of a disorder. This disorder is known as Paranoid Personality Disorder (PPD).

The key characteristic of PPD is mistrust and suspicion of others without a valid reason. As individuals believe that others harbour bad motives and will harm them, they are highly vigilant to physical, verbal, or social attacks. These ungrounded beliefs interfere with their daily functioning, hindering their ability to form close relationships due to the absence of trust.

PPD often begins in early adulthood and is more frequently diagnosed in males than females. The prevalence of PPD is estimated to be between 2.3% and 4.4% of the general population. 



  • Suspicion without sufficient basis that others are exploiting or deceiving him or her
  • Preoccupation with unjustified doubts about the loyalty of friends or associates 
  • Reluctance to confide in others because of an unwarranted fear that the information will be used maliciously against him or her

The underlying issue in PPD focuses on the absence of justification for paranoia. For an individual to be diagnosed with PPD, he or she should present symptoms of mistrust or suspiciousness since early adulthood and in a variety of contexts. Additionally, the symptoms should not occur exclusively during another psychotic disorder and are not due to direct physiological effects of a general medical condition.



While the causes of PPD are not yet fully established, it is believed to be contributed by a combination of biological and psychological factors. 

✽   Biological Factors

  • This includes individuals with a family history of schizophrenia or persecutory type delusional disorders.

✽   Psychological Factors



Persons with PPD are initially reluctant to seek psychological help due to their suspicion about mental health professionals. However, when treatment is sought, Cognitive Behavioural Therapy (CBT) is generally implemented. 

✽   Cognitive Behavioural Therapy (CBT)

  • This can be effective in altering maladaptive beliefs and improving communication and self-esteem in persons with PPD. This intervention equips them with skills to cope and function in their daily lives. 

✽   Medication

  • Although medication is not mainly used, antidepressants may be prescribed if symptoms are extreme.