Paranoid personality disorder: a synthesis of developmental, dynamic, and descriptive features.
Suspiciousness, feeling persecuted, and grandiosity constitute the classical triad associated with paranoid personality. However, a more important feature appears to be the discrepancy between the outer persona and the inner world of such individuals. The split is pervasive and involves self-concept, object-relations, affects, morality, sexuality, and cognitive style. Outwardly, paranoid individuals are demanding, arrogant, mistrustful, driven, unromantic, moralistic, and acutely vigilant towards the external environment. Internally, however, they are frightened, timid, self-doubting, gullible, inconsiderate, vulnerable to erotomania, and cognitively unable to grasp the totality of actual events. This way of conceptualizing the paranoid symptomatology is superior to ordinary check-list methods since it (1) links the phenomenological and psychostructural aspects of the condition, (2) helps in a more meaningful differential diagnosis of paranoid from other personality disorders, and most importantly, (3) hints at areas that require exploration in the psychotherapeutic management or psychoanalysis of such individuals.
Akhtar
S
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Jefferson Medical College, Philadelphia, PA.
D003937:Diagnosis, Differential; D006801:Humans; D010260:Paranoid Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D010553:Personality Development; D010554:Personality Disorders / Q000523:psychology*; D011574:Psychoanalytic Theory