Diagnostic criteria
Personality disorders are persistent and dominant patterns of thought, perception, and behavior violating lifestyle of a person, leading to maladjustment and interpersonal conflicts. The DSM-5 includes 10 personality disorders, which, depending on the similarity of symptoms, are divided into three clusters (A, B, and C). Paranoid disorder, along with schizoid and schizotypal, is included in class A. A characteristic feature of all these psychopathologies is unusual, “eccentric” behavior.
Cluster A personality disorders meet in 3.6% of people. The prevalence of paranoid disorder is 2.4%.
BPD is diagnosed when four or more of the following are present.
The psyche of paranoid personalities called “stuck” because they have overvalued ideas that become the epicenter of thinking, emotions and actions. Overvalued ideas occupy a dominant position in the mind, which encourages a person to fight for their implementation, to achieve them by any means.
Stuck mentality and other symptoms of BPD can begin as early as childhood. If you notice the problem in time and focus the “tenacious” attention of the child on study or sports, he can achieve tremendous success. People with BPD are highly goal-oriented, hard-working, and future-oriented.
In the absence of a positive goal, the psyche of the paranoid “gets stuck” on something negative. Stuck on resentment transforms him into an avenger, on betrayal – into a pathological jealous, focusing on money and power – into a money-grubber or a criminal.
BPD is rarely the only mental illness, its frequent companions are anxiety and phobic disorders, PTSD, schizophrenia, and alcohol dependence. Also it can be combined with other personality disorders – schizotypal, narcissistic, borderline or avoidant.
Genetics and traumatic childhood experiences
BPD, like other personality disorders, is caused by genetics and environmental factors. Study with 122 twins showed heritability of BPD in 50%. According to other versions, the heritability of the disease varies from 21 to 66%.
Modern genomic technologies have made it possible to find out which genetic variants contribute to the development of personality disorders. many genes contain variable regions of DNA (polymorphic loci), the structure of which may be different. Some variants of polymorphism correlate with certain psychopathologies. For example, such variants include the Val158Met polymorphism of the COMT gene.
This gene codes for an enzyme involved in the metabolism of important neurotransmitters, dopamine and norepinephrine. Carriers of the Val158Met polymorphism have a low level of dopamine and a pronounced predisposition to alcoholism and drug addiction. They also have an increased risk of developing paranoid and schizotypal disorders.
The external factors provoking paranoid disorder primarily include psychological childhood trauma.
BPD is much more common than other personality disorders correlates with childhood abuse. In this case, we are talking not only about physical and sexual violence, but also about emotional.
Russian scientists tested 319 schoolchildren to assess the frequency of paranoid, schizoid and hysterical disorders among children who did not seek psychiatric help. Half of the respondents studied at a regular general education school, half at a school with a physics and mathematics specialization.
Obvious signs of paranoid disorder were detected in 12.6% of students in a school with a physical and mathematical bias and in 4.2% of children from a regular school. In the families of a third of schoolchildren with signs of BPD, competition among children was observed. In the families of schoolchildren from the general sample, this phenomenon occurred 13 times less frequently.
Many children with paranoid personality traits pointed to problems such as lack of equality in the family, formal relationships with parents, family conflicts. The key aspects of education were unquestioning obedience to adults and lack of initiative. At the same time, in the families of schoolchildren from the general sample, emphasis was placed on the development and promotion of independence.
In schoolchildren from the BPD group, much more often than in children from the general sample, the following were observed:
Gadgetmania. 76% of children preferred virtual communication to real communication and spent most of their free time in social networks. Many had formal or conflicting relationships with peers. There were half as many gadget addicts in the total sample. anxiety disorders. Pathological anxiety associated with various events was present in 92% of adolescents from the BPD group, and a third had signs of generalized anxiety disorder. Explosive (emotionally unstable) disorder, which is characterized by severe affective outbursts. With a combination of BPD and an atmosphere of competition in the family, the probability of developing this psychopathology is 50%.
The researchers found no correlation between paranoid disorder and suicidal behavior. The latter is widespread among children with signs of a hysterical (theatrical) disorder, which is characterized by excessive emotionality and an increased need for attention. 28.6% of the “theatre-goers” had a positive attitude towards suicide as a way out of a traumatic situation.
Destructive supervalues and criminal behavior of paranoids
Paranoid individuals whose psyche is stuck on jealousy, revenge or personal dislike often become criminals. Criminalist R.A. Sevostyanov studied the behavior of 311 paranoids convicted of murder, fraud, robbery, robbery and other crimes, and highlighted their key features.
When committing intentional crimes, paranoids are characterized by special aggressiveness and cruelty, which is associated with the need to get rid of accumulated resentment and anger. At the same time, crimes are distinguished by careful preparation and consistent execution. Often their motives are pathological jealousy and revenge:
Citizen R. during a quarrel learned from his pregnant cohabitant that she was expecting a child not from him. After the woman said that her confession was a cruel joke. However, this did not calm the roommate: he suffered from resentment and jealousy, did not sleep at night and hatched a plan of cruel revenge.
One day, citizen R. noticed how a cohabitant was communicating with someone over the Internet, and this was the last straw of his patience. He invited the woman to take a walk in the forest, where he hid the sledgehammer in advance. In the forest, a man tied his victim to a tree and inflicted at least a dozen blows to her head, from which the woman died.
As a rule, the acquisitive crimes of paranoids are quite simple and driven by the desire to satisfy basic needs.
However, if money acquires the status of supervalue, crimes become inventive and large-scale.
Some paranoids are ready to completely turn their life around to achieve their goal, even if it is comfortable and successful:
Citizen S. (father of three children and an accomplished businessman) was fond of watching crime films in which the characters deftly pulled off thefts and scams. One day, while visiting a bank, he noticed that there was a large sum of money in the cash register. From that moment on, money became an overvalued value for him. The thought began to dominate his mind that he, like the gangsters in the movies, could live a carefree life of crime.
Driven by a fanatical idea, citizen S. quickly transformed from a businessman into the leader of a gang that robbed banks. All crimes were carefully planned, special attention was paid to camouflage: to hide their appearance, the bandits used balaclavas, respirators, dressed as construction workers. The criminals spent the stolen money on luxury cars, travel, luxury goods.
Paranoids are not characterized by a sense of guilt: only a few repent of their deeds. Typically, perpetrators with BPD place the blame on the victim or external circumstances. They even equate their crimes against the person with self-defense.
Paranoid individuals adapt to places of isolation much longer than other convicts. They have chronic stress, apathy, depression. After a period of adaptation, they are looking for an activity in which they can immerse themselves. With pleasure they perform routine work that requires mental labor.
Treatment and prevention
Paranoid personalities are rare apply for psychiatric help: they consider themselves absolutely healthy and blame others for all their suffering. If, nevertheless, a person with this disease gets to a psychiatrist, then his personal characteristics become an obstacle to successful treatment.
The paranoid transfers his suspicions to psychiatrists, distrusts treatment and sabotages any recommendations. The fear of being humiliated and offended makes it difficult to share your thoughts, feelings and experiences with a specialist. Establishing a trusting relationship between a doctor and a patient with a paranoid disorder is the most difficult step in treatment.
The main treatment for BPD is cognitive behavioral therapy. If necessary, antidepressants and atypical antipsychotics may be prescribed.
There are no specific methods for preventing the disease, but since physical and emotional abuse and an authoritarian parenting style contribute to its development, it is logical to assume that the elimination of these factors will reduce the risk of developing BPD.
Exists “prevention” of the formation of criminogenic features of the paranoid. Parents of a child with BPD symptoms are advised to:
To captivate the child with activities that are interesting for him (sports, study, creativity). Make sure that the child does not have a lack of communication. The “stuck” of the psyche, characteristic of the paranoid, provokes social phobia, which, in turn, contributes to the chronicity of BPD. To diversify the child’s life with bright and positive impressions, which will reduce the risk of dwelling on negative aspects.
2023-08-15 11:32:41
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