What Triggers Paranoid Personality Disorder?

August 21, 2020

Teenagers with paranoid personality disorder suffer from paranoia and an unrelenting mistrust and suspicion of others. These feelings occur even though there is no reason to be suspicious, or nothing has been done to provoke a lack of trust. Those with paranoid personality disorder tend to have significant difficulty maintaining or fostering relationships with family, friends, and coworkers.

Paranoid personality disorder is one of a group of conditions called eccentric personality disorders. It is one of the most common personality disorders as experts believe this disorder may affect up to four and a half percent of the population. People who struggle with paranoid personality disorder feel threatened by others, so they are usually reluctant to seek medical attention or mental health treatment. Consequently, many primary care providers and mental health providers have minimal experience in diagnosing and treating paranoid personality disorder. Additionally, there are no clinical studies or treatment guidelines available to guide in diagnosis and treatment and very limited real life experiences to look to.

What is Paranoid Personality Disorder?

A teen with a paranoid personality disorder may experience sensitivity to criticism, emotional rigidity, and increased alertness. This disorder often begins in childhood or early adolescence. It also appears to be more common in men than in women. Paranoid personality disorder has been part of the Diagnostic and Statistical Manual of Mental Disorders since its third edition was published in 1980.

While paranoid personality disorder can occur as a standalone mental illness, it is also not uncommon for people with some other common mental health conditions to show paranoid personality disorder symptoms. Some of the most common illnesses where this occurs include schizophrenia, Alzheimer’s disease, brain injuries, and schizoaffective and psychotic states of bipolar disorder.

Unfortunately, there is little else available in terms of knowledge around paranoid personality disorder. Due to their intense distrust of other people and feelings of paranoia, people with paranoid personality disorder tend to be very reluctant to volunteer for clinical studies.

What are the Symptoms of Paranoid Personality Disorder?

Teenagers with paranoid personality disorder are always on guard. They have an unfounded belief that others are continually trying to demean, harm, or threaten them. As previously noted, they are consistently distrusting or suspicious of others. This disorder prevents teens from confiding in others and having close, meaningful relationships and friendships. There are several additional signs and symptoms of paranoid personality disorder that your teen may exhibit, and you should be on the lookout for.

Some symptoms such as hypersensitivity and difficulty taking criticism could be mistaken for typical teen behavior; however, teens with a paranoid personality disorder will preset these symptoms in an exacerbated way. You may also find that they are unforgiving and hold grudges and begin to read hidden meanings into innocent remarks or casual glances from other people. They have persistent suspicions that their friends or even significant others are being unfaithful, and they are generally cold and distant in their relationships with others to avoid being betrayed. A teen with a paranoid personality disorder will have difficulty seeing their role in a problem or conflict because they believe that they’re always right. You may also notice that they are becoming increasingly hostile, stubborn, and argumentative and that they tend to develop negative stereotypes of others, especially those from different cultural or socioeconomic groups. You may also begin to notice signs of substance use or addictive behavior in your teen. Despite the minimal research available on paranoid personality disorder, it has been found that substance misuse problems and addiction are common among people with this illness.

What Triggers Paranoid Personality Disorder?

Most studies investigating the cause of different psychological disorders tend to group all of the personality disorders together. Thus, it can be challenging to identify the cause of one particular personality disorder, such as paranoid personality disorder. Also, paranoid personality disorder’s exact cause remains unknown, adding to the difficulty in determining a trigger or cause for the illness. However, some research points to a few potential causes.

A 2017 review showed that several studies have consistently pointed to childhood trauma as a risk factor for paranoid personality disorder. In addition, a paranoid personality disorder is found to be more common in people who have close relatives with schizophrenia and delusional disorder. This suggests the potential of a genetic link between the two disorders and indicates that heredity may play a role.

Researchers have also identified a few other factors that may predict paranoid personality disorder syndrome in teens and young children. These include emotional neglect, physical neglect, parental neglect, experiencing extreme or unfounded parental rage, or, again, being the victim of or witness to a traumatic event. To adequately determine triggers or causes for paranoid personality disorder, further research is necessary into the illness. However, this remains challenging as it is challenging to find participants with paranoid personality disorder who are willing to participate in a clinical study.

How is Paranoid Personality Disorder Diagnosed?

There are no lab tests or other conclusive tests used in the diagnosis of paranoid personality disorder. If your teen is experiencing symptoms, their primary care provider will assess them to see whether they satisfy paranoid personality disorder criteria, as indicated in the Diagnostic and Statistical Manual for Mental Disorders (5th edition). They will also use various diagnostic tests to rule out physical illnesses as the cause of your teen’s symptoms.

For example, in some cases, difficulty hearing or long-lasting substance abuse may be confused with a paranoid personality disorder. If your primary care provider finds no physical reason for the symptoms, they will refer your teen to a mental health provider or a treatment facility like Hillcrest in Los Angeles, CA. Hillcrest’s mental health professionals are specially trained to diagnose and treat mental illnesses such as paranoid personality disorder.

It valuable to note that some of the diagnostic criteria for paranoid personality disorder overlap with other mental health conditions, including bipolar disorder, schizophrenia, a depressive disorder with psychotic features, or other psychotic disorders. For this reason, your teen’s mental health provider must conduct a thorough assessment to ensure an accurate diagnosis and the proper course of treatment.

How is Paranoid Personality Disorder Treated?

Due to the limited amount of information regarding paranoid personality disorder, the doctors are only beginning to understand the best treatment methods. Also, people with a paranoid personality disorder often do not seek treatment on their own because they do not see themselves as having a problem. Doctors may sometimes consider treatment options, including medications and psychotherapy. Still, even these pose a challenge because trust, a challenging emotion for those with a paranoid personality disorder, is an essential psychotherapy element. Consequently, many people with paranoid personality disorder do not follow their treatment plan and may even question the therapist’s motives. For this reason, outpatient treatment programs may not be suitable if your teen has a paranoid personality disorder.


To date, the Food and Drug Administration has not approved any drug treatments for paranoid personality disorder. There has been some suggestion that treating paranoid personality disorder with the same drugs used to treat borderline personality disorder may be beneficial. The premise behind this thought is that the two conditions share similar diagnostics features, such as hostility and aggression towards others. Mental health professionals may also prescribe antipsychotics, mood stabilizers, and anti-depressants to help reduce aggressive symptoms. If your teen is diagnosed with a co-occurring mental health disorder such as anxiety or depression, the medications prescribed to alleviate the associated symptoms may also reduce the symptoms related to a paranoid personality disorder.


Like medication therapy, medical providers do not know much about psychotherapy’s effectiveness for paranoid personality disorder. However, many therapists believe that cognitive-behavioral therapy may help alleviate symptoms, and there are a limited number of case studies that support its use. The overall goal of therapy sessions is to encourage your teen to become more trusting of others and stop them from reacting to perceived insults with anger and hostility. In addition, therapy helps prevent your teen from questioning family and close friends’ loyalty and viewing benign or even positive comments as threats.

A paranoid personality disorder is a significant cause of disability in the United States. Its associated symptoms can manifest in oppression and violence towards others. Consequently, teens with a paranoid personality disorder may find themselves socially isolated and depressed, resulting in a lower quality of life. These difficulties may also extend to the lives of their family, friends, and other loved ones as they struggled to maintain or forge positive relationships. Paranoid personality disorder often occurs alongside other disorders, which have an association with an increased risk of suicide. However, it remains unclear whether suicide rates are higher among people, specifically with a paranoid personality disorder. Sadly, paranoid personality disorder has been included in the Diagnostic and Statistical Manual of Mental Disorders for over 40 years. Yet, many doctors and mental health professionals are still entirely unfamiliar with this condition.

While it is not possible to prevent paranoid personality disorder, treatment can sometimes allow your teen who may be prone to this disorder to learn more productive ways of dealing with emotions and situations. If you suspect your teen struggles with a paranoid personality disorder, reach out to your primary care provider to discuss their symptoms and consider asking for a referral to a specialized treatment center like Hillcrest. Here at Hillcrest, our skilled team of treatment providers understands the difficulties your teen and your family may be facing at this time.

Therapist Session - Paranoid Personality Disorder - Hillcrest

There is indeed significant confusion and fear involved when you are concerned about the health of your child. At Hillcrest, our treatment programs are designed to meet your teen and your family’s individual needs. We understand the decision to send your teen to treatment away from home is likely one of the most difficult as a parent you will ever have to make. It is vital to keep in mind that paranoid personality disorder symptoms often limit the success of outpatient treatment programs.

Therefore, a residential treatment program like Hillcrest will provide your teen with the most significant opportunity for success. If you have questions about how our treatment programs may be able to help your teen and your family, call Hillcrest Adolescent Treatment Center today.

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