CASE I:

Joe lived with three siblings, mom, and dad. When he was 11, his grandmother came to live with
them because she could not take care of herself. In school, Joe did exceptionally well getting the
highest grades possible, and even correcting his teachers. Although Joe did well in school, he
was rude. Joe made fun of those who could not get an A in a class, and when he corrected his
teachers, he would laugh and mock them. Joe was considered very arrogant, and always thought
he was better than everyone else was. Joe had troubles with relationships in his life because he
felt like they were taking his ideas, and could not form a trust with anyone.
His poor peer relationships ended him become an underachiever in university. Therefore, he
avoided crowds of people. Despite his struggles with people Joe eventually got a girlfriend, but
she later left him, and this made Joe seek revenge. Later in life, Joe met Rania who eventually
became his wife. In this relationship, Joe got his first job. He was employed at a drug company.
While working Joe showed such hostility and argumentativeness towards his coworkers that, he
was asked to resign. His second job Joe would work at a university, but got fired because he
accused the school of trying to kill him with radiation in the laboratory. During this event, Joe
thought his wife was out to steal his finances, and they divorced. They also had one daughter.
Later on Joe started getting panic attacks, and he went to his doctor who directed him to a
psychiatrist. “The treatment did not work because Joe didn't believe he had a problem.” These
panic attacks continued, and Joe got his third job as a taxi driver. 15 years down the road Joe still
believes that his wife betrayed him, and he never went back to a psychiatrist to get more
treatment.  

TIPS: narcissism – he was young anw

The early behavior could have been mistaken for npd, but he was too young to diagnosed with that,
and later on it became clear that he has ppd. (he meets 3 of the minimum 5 out of 9 – arrogance –
sense of self-importance- lacks empathy)

They believe they are superior, special, and unique and expect others to recognize them as such.

 made fun of those who could not get an A in a class

 rude
 would laugh and mock them
 very arrogant, and always thought he was better than everyone else was.

LATER IN LIFE: PPD

Criteria 6
 Suspects, without sufficient basis, that others are, harming him ex: accused the school of
trying to kill him with radiation in the laboratory (delusions)

 Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends

or associates. Ex:, he doesn’t trust his friends with his thoughts , and at work with
 coworkers , because As we can see he left several jobs, PPD people form nothing but tension
in their work place because they keep accusing other people because of their trust issues.
 Is reluctant to confide in others because of unwarranted fear that the information
will be used against him . Ex: troubles with relationships in his life because he felt like
they were taking his ideas, and could not form a trust with anyone
 Persistently bear grudges) ex: gf she later left him, and this made Joe seek revenge., 15
years down the road Joe still believes that his wife betrayed him,
 Perceives attacks on his character or reputation that are not apparent to others
and is quick to react angrily or to counterattack. Ex showed hostility and
argumentativeness towards his coworkers
 . Has recurrent suspicions, without justification, regarding fidelity Ex: Joe thought his
wife was out to steal his finances

 avoided crowds of people

Joe started getting panic attacks
 The treatment did not work because Joe didn't believe he had a problem.” - Those with
this disorder rarely seek treatment; when referred to treatment by someone, and in his
case the doctor referred him, plus to that they can often pull themselves together and
appear unstressed.
 As we can see he left several jobs, PPD people form nothing but tension in their work place
because they keep accusing other people and in joe’s case it was present

Paranoid Personality Disorder CLUSTER A -the “odd” or “eccentric”

4 out of 7 criteria should meet

. It is important to remember that oftentimes, a person can be diagnosed with more than just one
personality disorder. In general, about half the people diagnosed with any one of the personality
disorders will meet the criteria for at least one additional personality disorder

They hold grudges, and they cut people off leading them to become socially isolated and in his case it
was mentioned (during university).

Epidemiology:

The prevalence has been reported to be 2% in general population and more common in males.

The most common co-occurring personality disorders appear to be schizoid, schizotypal, narcissistic,
borderline, and in his case we saw a bit of narcissistic symptoms.

Causes of Paranoid Personality Disorder:

 biological contributions
  Psychological contributions are pointed in the maladaptive way to view the world. - mainly their
basic mistaken assumptions about others - “People are deceptive”
 Social and environmental factors

Listen rule oit the physical vondition , look for the sigs and syptoms

Differential Diagnosis :

 differentiated from Delusional disorder by the absence of fixed delusions.

 differentiated from Paranoid Schizophrenia by the lack of hallucinations.
 from borderline personality disorder is that patients with paranoid personality are rarely
capable of overly involved relationships with others

Treatment of Paranoid Personality Disorder: Paranoid personality disorder is life-long; in some, it is an

indication of schizophrenia.

( well-guarded) prognosis

People with such a disorder tend to be mistrustful of everyone including mental health professionals,
when they do seek therapy, the trigger is usually some crisis in their lives not their personality disorder.

 cognitive therapy to try to counter the person’s mistaken assumptions about others

these individuals would not continue long enough to be helped, and in joe’s case he left.

 Pharmacotherapy is useful in dealing with anxiety and agitation. In most cases, an anxiolytic
such as valium is sufficient. But at times, it may necessary to use an antipsychotic, in small doses
to manage severe agitation.

Axis I provided information about clinical disorders: /

Axis II provided information about personality disorders: PPD
Axis III provided information about any medical conditions: None
Axis V was a rating scale called the Global Assessment of Functioning :/

Defense mechanism: project, they project their own unacknowledged feelings to others. Confrontation
guarantees a lasing enemy and an early termination of the therapy.