Internet Mental Health

PARANOID PERSONALITY DISORDER





Diagnostic Features of Paranoid Personality Disorder

SYMPTOM DEFINITION SELF-DESCRIPTION
ANTAGONISM (Harming Others)
Suspiciousness Mistrusting others; excessively suspicious about the motives of others "I'm always on my guard for someone trying to trick or harm me."
Bearing Grudges Having persistent resentment; not forgiving an insult or injury; seeking revenge "I have held grudges against people for years."
Feeling Victimized Feeling that one has received cruel or unjust treatment "It seems like I'm always getting a “raw deal” from others."

Core Features of Personality Disorders:

The general requirements for the diagnosis of a personality disorder are:

  • a pervasive pattern of maladaptive traits and behaviours

  • beginning in early adult life

    • it usually has its first manifestations in childhood and is clearly evident in adolescence

    • it is not diagnosed before early adult life because these maladaptive traits are very common in childhood and adolescence, but most individuals age-out of these traits before early adulthood

  • leading to substantial personal distress and/or social dysfunction, and disruption to others

  • is of long duration, typically lasting at least several years

Severity Rating Scale For Personality Disorders:

Severity rating scale for personality disorders in the International Classification of Diseases (ICD)-11:

  • Mild Personality Disorder: There are notable problems in many interpersonal relationships and the performance of expected occupational and social roles, but some relationships are maintained and/or some roles carried out. Mild personality disorder is typically not associated with substantial harm to self or others .

  • Moderate Personality Disorder: There are marked problems in most interpersonal relationships and in the performance of expected occupational and social roles across a wide range of situations that are sufficiently extensive that most are compromised to some degree. Moderate personality disorder often is associated with a past history and future expectation of harm to self or others, but not to a degree that causes long-term damage or has endangered life .

  • Severe Personality Disorder: There are severe problems in interpersonal functioning affecting all areas of life. The individual's general social dysfunction is profound and the ability and/or willingness to perform expected occupational and social roles is absent or severely compromised. Severe personality disorder usually is associated with a past history and future expectation of severe harm to self or others that has caused long-term damage or has endangered life .

Onset:

Paranoid Personality Disorder occurs in 4.4% of the U.S. population. Typical features of paranoid personality disorder are distrust and suspiciousness such that others' motives are interpreted as malevolent.

For this diagnosis to be given, the individual must be at least in early adulthood. This disorder is only diagnosed when these behaviors become persistent and very disabling or harmful to others.

This disorder does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.

Treatment:

There is insufficient (randomized controlled trial) evidence to prove the effectiveness of any psychological intervention or medication for adults with this disorder. Lacking such evidence, it would be prudent to only offer crisis intervention or short-term psychotherapy, rather than long-term psychotherapy.

Prognosis:

Paranoid Personality Disorder can persist for a lifetime. Individuals with this disorder are generally difficult to get along with and often have problems with close relationships because of their excessive suspiciousness and hostility. They usually are unable to collaborate well with others at work. They may have a need to have a high degree of control over those around them. Their combative and suspicious nature may elicit a hostile response in others, which then serves to confirm their original expectations. They are often rigid, and critical of others, although they have great difficulty accepting criticism themselves.

SAPAS Personality Screening Test

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

Most of the time and in most situations:

      In general, do you have difficulty making and keeping friends?
      Would you normally describe yourself as a loner?
      In general, do you trust other people? (No)
      Do you normally lose your temper easily?
      Are you normally an impulsive sort of person?
      Are you normally a worrier?
      In general, do you depend on others a lot?
      In general, are you a perfectionist?

Answer "Yes" or "No" to each of these 8 questions.


7-Question Well-Being Screening Test (By P. W. Long MD, 2020

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

      Agreeableness: I was kind and honest. (Instead had suspiciousness, felt victimized or insulted and was quick to react angrily or to counterattack, bore grudges)
      Conscientiousness: I was diligent and self-disciplined.
      Openness/Intellect: I showed good problem-solving and curiosity.
      Sociality: I was gregarious, enthusiastic, and assertive.
      Emotional Stability: I was emotionally stable and calm.
      Physical Health: I was physically healthy.
      Role Functioning: I functioned well socially and at school/work.

How often in the past week did you do each of these 7 behaviors:


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Diagnose Paranoid Personality Disorder

Diagnose All Personality Disorders

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment Of President Trump

Paranoid Personality Disorder 301.0

This diagnosis is based on the following findings:

  • Suspiciousness or paranoid ideation (still present)

  • Has unjustified doubts about the loyalty or trustworthiness of friends or associates (still present)

  • Reads hidden, demeaning, or threatening meanings into benign remarks or events (still present)

  • Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights) (still present)

  • Is quick to counterattack and react with anger to misperceived insults (still present)

  • This disorder did not exclusively occur during the course of a psychotic mental disorder

  • This disorder is not due to the direct physiological effects of a general medical condition

Treatment Goals:

  • Goal: be more trusting of others.
    If this problem persists: He will continue to assume that other people will exploit, harm, or deceive him, even when there is no evidence to support these suspicions. He will continue to feel that he has been deeply hurt by another person even when there is no evidence for this.

  • Goal: stop questioning friends' loyalty.
    If this problem persists: He will continue to be preoccupied with unjustified doubts about the loyalty or trustworthiness of his friends and associates, and continue to minutely scrutinize their behavior for evidence of betrayal or hostile intentions.

  • Goal: stop reading hidden, demeaning, or threatening meanings into benign events.
    If this problem persists: He will continue to misread honest mistakes made by others as deliberate attempts to harm him. He may also continue to misinterpret compliments as criticisms of him. Likewise, he may view an offer of help as a criticism that he is not doing well enough on his own.

  • Goal: be more forgiving of others.
    If this problem persists: He will continue to bear grudges and be unwilling to forgive the slights that he thinks he has received. Minor slights will continue to arouse major hostility.

  • Goal: don't react with anger to perceived insults.
    If this problem persists: He will continue to be quick to counterattack and react with anger to perceived insults.




Read This Before Diagnosing President Trump


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Diagnostic Features

"Paranoid personality disorder is characterized by excessive sensitivity to setbacks, unforgiveness of insults; suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner; and a combative and tenacious sense of personal rights. There may be excessive self-importance, and there is often excessive self-reference" (ICD10). It is "a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts" (DSM-5).

In terms of the "Big-6" Dimensions of Mental Health this disorder is characterized by detachment (suspiciousness, bearing grudges, feeling victimized). This leads to substantial personal distress and/or social dysfunction, and disruption to others. This is not diagnosed before early adult life because these maladaptive traits are very common in childhood and adolescence, but most individuals age-out of these traits before early adulthood. This disorder is of long duration, typically lasting at least several years.

The diagnosis of Paranoid Personality Disorder requires four (or more) of the following:

  • Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.

  • Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.

  • Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.

  • Reads hidden demeaning or threatening meanings into benign remarks or events.

  • Persistently bears grudges, (i.e., is unforgiving of insults, injuries, or slights).

  • Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.

  • Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

This disorder should not be diagnosed if its symptoms occur exclusively during the course of a Psychotic Disorder, or if it is attributable to Substance Use Disorder or another medical condition.

Individuals with Paranoid Personality Disorder falsely believe that they are being victimized by others. They are highly critical of others, yet hypersensitive to criticism of themselves. They bear grudges and are unwilling to forgive the insults that they think they have received. Minor slights arouse major hostility, and the hostile feelings persist for a long time. Their combative and suspicious nature may elicit a hostile response in others, which then serves to confirm their original expectations. They may be pathologically jealous.

Like all personality disorders, Paranoid Personality Disorder is a deeply ingrained and enduring behavior pattern, manifesting as an inflexible response to a broad range of personal and social situations. This behavior represents an extreme or significant deviation from the way in which the average individual in a given culture relates to others. This behavior pattern tends to be stable.

Course

Paranoid Personality Disorder may be first apparent in childhood and adolescence with solitariness, poor peer relationships, social anxiety, underachievement in school, hypersensitivity, and peculiar thoughts and language. These children may appear to be odd or eccentric and attract teasing. The course of this disorder is chronic.

Complications

Individuals with Paranoid Personality Disorder are generally difficult to get along with and often have problems with close relationships because of their excessive suspiciousness and hostility. They usually are unable to collaborate well with others at work. They may have a need to have a high degree of control over those around them. They are reluctant to confide in or become close to others because they fear that the information they share will be used against them. They may be litigious and frequently become involved in legal disputes.

Their combative and suspicious nature may elicit a hostile response in others, which then serves to confirm their original expectations. They are often rigid, and critical of others, although they have great difficulty accepting criticism themselves. They may exhibit thinly hidden, unrealistic grandiose fantasies, are often attuned to issues of power and rank, and tend to develop negative stereotypes of others, particularly those from population groups distinct from their own. More severely affected individuals with Paranoid Personality Disorder may be perceived by others as fanatics and form tightly knit cults or groups with others who share their paranoid beliefs.

A Political Warning From Forensic Psychiatry:

The combination of Narcissistic, Antisocial, and Paranoid Personality Disorders is very dangerous. Historically, this particular combination of three personality disorders was seen in all of history's worst tyrants (e.g., Hitler, Stalin etc.). These tyrants lust for wealth, fame and power, and callously destroy everyone that opposes them. As they gain more power, they become more grandiose, power-hungry, and paranoid. If unopposed, these tyrants initiate wars, which result in the mass slaughter of innocent civilians. The tragedy is that the public is easily seduced by these tyrant's grandiose fantasies of national "greatness", and their paranoid hatred of some scapegoated minority (e.g., Jews, Muslims, immigrants, or refugees). These tyrants know that is easier to mobilize people by teaching them hatred and paranoia, than by teaching them love and forgiveness.

Comorbidity

Some other disorders frequently occur with this disorder:

    Non-Personality Disorders

            Schizophrenia Spectrum and Other Psychotic Disorders:
      • This disorder may be a premorbid antecendent of a psychotic disorder. In response to stress, individuals with this disorder may experience very brief psychotic episodes (lasting minutes to hours). If the psychotic episode lasts longer, this disorder may actually develop into delusional disorder or schizophrenia.
            Depressive Disorders:
      • Major depressive disorder
            Anxiety Disorders:
      • Agoraphobia
            Obsessive-Compulsive and Related Disorders:
      • Obsessive-compulsive disorder
            Substance-Related and Addictive Disorders:
      • Alcohol and other substance use disorder frequently occur

    Personality Disorders

            Negative Emotion Cluster:
      • Avoidant personality disorder
            Detachment Cluster:
      • Schizoid and schizotypal personality disorders
        Note: Paranoid, schizoid, and schizotypal personality disorders are all closely related since they all share the same core feature of detachment. If an individual has one of these detached personality disorders, they are very likely to have another.
            Antagonism Cluster:
      • Narcissistic, borderline personality disorders

Associated Laboratory Findings

No laboratory test has been found to be diagnostic of this disorder.

Prevalence

The prevalence of Paranoid Personality Disorder is 2.3%-4.4% of the general population. It occurs more commonly in males.

Outcome

Paranoid Personality Disorder is chronic.

Familial Pattern

Paranoid Personality Disorder is more common among first-degree biological relatives of those with Schizophrenia and Delusional Disorder, Persecutory Type.

Controlled Clinical Trials Of Therapy

Click here for a list of all the controlled clinical trials of therapy for this disorder.

Psychotherapy

There is insufficient evidence to justify using any psychological intervention for adults with this disorder. Lacking such evidence, it would be prudent to only offer crisis intervention or short-term psychotherapy, rather than long-term psychotherapy. Individuals with this disorder seldom voluntarily present for treatment. Most therapists believe that Paranoid Personality Disorder is very difficult to treat.

Pharmacotherapy

There are currently no medications approved by the FDA to treat this disorder. Vitamins and dietary supplements are ineffective for all Personality Disorders.

Trustworthy Research (PubMed.gov)


A Dangerous Cult: Videos


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Videos

Stories

Rating Scales

Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder

Research has shown that genetic, environmental, and prenatal factors all play important roles in the development of personality disorder. Research has also shown that low parental affection and harsh parenting increase the risk of a child later developing a personality disorder.

"Low affection" was defined as: low parental affection, low parental time spent with the child, poor parental communication with the child, poor home maintenance, low educational aspirations for the child, poor parental supervision, low paternal assistance to the child's mother, and poor paternal role fulfillment. "Harsh parenting" was defined as: harsh punishment, inconsistent maternal enforcement of rules, frequent loud arguments between the parents, difficulty controlling anger toward the child, possessiveness, use of guilt to control the child, and verbal abuse.


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(USE SLIDER ON RIGHT SIDE OF THE ABOVE PAGE TO SEE FULL CHECKLIST)



This disorder is characterized by pathological personality traits in the following domain:

  • Antagonism , characterized by:

    • Suspiciousness:
      Expectations of — and heightened sensitivity to — signs of interpersonal ill-intent or harm; doubts about loyalty and fidelity of others; feelings of persecution.
      Question:"Do you believe most people are fair and honest with you?" (No)

      • "Suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous." (ICD-10)

      • "Preoccupation with unsubstantiated "conspiratorial" explanations of events around the subject or in the world at large. " (ICD-10)

      • "Recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner." (ICD-10 and DSM-5)

      • "Persistent self-referential attitude, associated particularly with excessive self-importance." (ICD-10)

      • "Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her." (DSM-5)

      • "Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates." (DSM-5)

      • "Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her." (DSM-5)

      • "Reads hidden demeaning or threatening meanings into benign remarks or events." (DSM-5)

    • Bearing Grudges:
      Having persistent resentment; not forgiving an insult or injury; seeking revenge.
      Question:"Have you held grudges against people for years?" (Yes)

      • "Tendency to bear grudges persistently, e.g. unforgiveness of insults, injuries or slights." (ICD-10)

      • "Persistently bears grudges, (i.e., is unforgiving of insults, injuries, or slights)." (DSM-5)

    • Feeling Victimized:
      Feeling that one has received cruel or unjust treatment
      Question:"Do you fight for your rights even when it annoys people?" (Yes)

      • "Excessive sensitivity to setbacks and rebuffs." (ICD-10)

      • "A combative and tenacious sense of personal rights out of keeping with the actual situation." (ICD-10)

      • "Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack. " (DSM-5)


(Note: Recovery = symptomatic remission + full-time gainful employment + weekly contact with friends)


Paranoid Personality Disorder F60.0 - ICD10 Description, World Health Organization

Paranoid personality disorder is characterized by excessive sensitivity to setbacks, unforgiveness of insults; suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner; and a combative and tenacious sense of personal rights. There may be excessive self-importance, and there is often excessive self-reference.

ICD-10 International Personality Disorder Examination Screening Questions

  • I don't react well when someone offends me.

  • Most people are fair and honest with me (False).

  • I've held grudges against people for years.

  • People often make fun of me behind my back.

  • I fight for my rights even when it annoys people.

  • I think my spouse (or lover) may be unfaithful to me.

  • I'm convinced there's a conspiracy behind many things in the world.

ICD-10 Diagnostic Criteria (For Research)

A. The general criteria of personality disorder must be met:

  • Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range (or 'norm').

  • The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e. not being limited to one specific 'triggering' stimulus or situation).

  • There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior.

  • There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.

  • The deviation cannot be explained as a manifestation or consequence of other adult mental disorders.

  • Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation.

(Ask yourself if President Trump meets the following diagnostic criteria:)

B. At least four of the following must be present:

  • Excessive sensitivity to setbacks and rebuffs:
      (E.g., "If someone tries to push me around, I push back as hard as I can so that they never try that again.")

  • Tendency to bear grudges persistently, e.g. unforgiveness of insults, injuries or slights.
      (E.g., "I've held grudges against people for years.")

  • Suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous.
      (E.g., "I don't believe most people are fair and honest with me.")

  • A combative and tenacious sense of personal rights out of keeping with the actual situation.
      (E.g., "I fight for my rights even when it annoys people.")

  • Recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner.
      (E.g., "I think my spouse (or lover) is unfaithful to me.")

  • Persistent self-referential attitude, associated particularly with excessive self-importance.
      (E.g., "People often make fun of me behind my back.")<

  • Preoccupation with unsubstantiated "conspiratorial" explanations of events around the subject or in the world at large.
      (E.g., "I'm convinced there is a conspiracy behind many things that happen in the world.")

Paranoid Personality Disorder - Diagnostic Criteria, American Psychiatric Association

A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by 4 (or more) of the following:

  • Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.

  • Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.

  • Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.

  • Reads hidden demeaning or threatening meanings into benign remarks or events.

  • Persistently bears grudges, (i.e., is unforgiving of insults, injuries, or slights).

  • Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.

  • Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

  • Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects effects of another medical condition.

  • This enduring pattern of inner experience and behavior must deviate markedly from the expectations of the individual's culture.

  • This enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

  • This enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • Empirically Derived Taxonomy for Personality Diagnosis: Paranoid Personality Disorder

    (This section uses an alternative classification system to that of the American Psychiatric Association)

    These individuals:

    • Are chronically suspicious, expecting that others will harm, deceive, conspire against, or betray them.

    • Blame others for their own failures or shortcomings, and believe their problems are caused by external factors. Rather than recognizing their own role in interpersonal conflicts, they tend to feel misunderstood, mistreated, or victimized.

    • Are angry or hostile and prone to rage episodes.

    • See their own unacceptable feelings or impulses in other people instead of in themselves (i.e., "projection"). Thus they misattribute their hostility to other people.

    • Are controlling, oppositional, contrary, or quick to disagree, and to hold grudges. They often get into power struggles.

    • Tend to be self-righteous or moralistic, and often elicit dislike or animosity in others. They often lack close friendships and relationships.

    • May become irrational when strong emotions are stirred up, to the point of seeming delusional. They may “catastrophize,” seeing problems as disastrous or unsolvable.

    A Paranoid Life

    Paranoid Personality Disorder Examples
    Excessive sensitivity to setbacks and rebuffs "I don't react well when someone offends me."
    Tendency to bear grudges persistently, e.g. unforgiveness of insults, injuries or slights "I've held grudges against people for years."
    Suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous "I don't believe most people are fair and honest with me."
    A combative and tenacious sense of personal rights out of keeping with the actual situation "I fight for my rights even when it annoys people."
    Recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner "I think my spouse (or lover) is unfaithful to me."
    Persistent self-referential attitude, associated particularly with excessive self-importance "People often make fun of me behind my back."
    Preoccupation with unsubstantiated "conspiratorial" explanations of events around the subject or in the world at large "I'm convinced there is a conspiracy behind many things that happen in the world."

    A Good Life (The Opposite of Paranoid Personality Disorder)

    How does one live a good life?

    One approach to answering this question is to study the behavior of individuals who live troubled lives. Could the opposite of their maladaptive personality traits define how to live a good life?

    Research has shown that individuals with Paranoid Personality Disorder have a significantly increased risk of vocational, economic, marital and social failure.

    Could the opposite of the personality traits seen in Paranoid Personality Disorder be a clue as to how to live a good life? If so, the right side of the following table would define a good life. (This table uses DSM-5 diagnostic criteria.)

    Paranoid Personality Disorder The Opposite Of Paranoid Personality Disorder
    Suspiciousness: Altruism, Trust:
    Suspects, without sufficient basis, that others are exploiting, harming, or deceiving her Does not suspect, without sufficient basis, that others are exploiting, harming, or deceiving him or her
    Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates Is not preoccupied with unjustified doubts about the loyalty or trustworthiness of her friends or associates
    Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her Confides in others without unwarranted fear that the information will be used maliciously against her
    Reads hidden demeaning or threatening meanings into benign remarks or events Does not read hidden demeaning or threatening meanings into benign remarks or events
    Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner Does not doubt, without justification, the fidelity of her spouse or sexual partner
    Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack Does not perceive attacks on her character or reputation that are not apparent to others
    Lack Of Forgiveness: Forgiveness:
    Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights Does not bear grudges, i.e., is forgiving of insults, injuries, or slights

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    Treatment

    Setting Goals In Therapy

      Questions To Ask When Setting Goals

      In The Past Week:
      • WHO: was your problem?

      • EVENT: what did he/she do?

      • RESPONSE: how did you respond to that event?

      • OUTCOME: did your response help?

      • TRIGGER: what did you do that could have triggered this problem?

      • GOAL: what life skill(s) do you have to work on? (from checklist)

      Example Of Setting Goals In Interviewing A Person With Paranoid Personality Disorder

      In The Past Week:
      • WHO: was your problem?
        "My friend."

      • EVENT: what did he/she do?
        "My friend hasn't called me in weeks. I think she's mad at me."

      • RESPONSE: how did you respond to that event?
        "I decided that, if she didn't call me, I wouldn't call her."

      • OUTCOME: did your response help?
        "No. she still hasn't called."

      • TRIGGER: what did you do that could have triggered this problem?
        "We had an argument, and she said some things that really hurt me. Ever since then I stopped calling her."

      • GOAL: what life skill(s) do you have to work on? (from checklist)
        "I want to work on: (1) Forgiveness ("forgiving other peoples' mistakes; not bearing grudges or seeking revenge"), and (2) Sociality ("being friendly; interested in social contacts and activities")."

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    Self-Help Resources

    Monitoring Your Progress

    NOTE: When each of the following presentations finish; you must exit by manually closing its window in order to return to this webpage.

    The Healthy Social Behavior Scale lists social behaviors that research has found to be associated with healthy social relationships. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    The Mental Health Scale lists behaviors and symptoms that research has found to be associated with mental health (or disorder). You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    The Life Satisfaction Scale lists the survey questions often used to measure overall satisfaction with life. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    Life Satisfaction Scale (5-Minute Video)

    The "Big 6" Dimensions of Mental Health

    Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders.

    This website uses these 5 major dimensions of human behavior (i.e., Agreeableness, Conscientiousness, Openness/Intellect, Extraversion/Sociability, and Emotional Stability) to describe all mental disorders. This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.

    The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].



    Desiderata (5-Minute Video)



    The following "Morning Meditation" allows you to plan your day using these "Big 6" dimensions of mental health.



    The following "Evening Meditation" allows you to review your progress on these "Big 6" dimensions of mental health.




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      "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

      Lord Kelvin (1824 – 1907)


    • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

    • Economist in grim battle against deceptive scholarship

    • List of Predatory Journals and Publishers

    • The power of asking "what if?"

    • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

    • Criteria For High Quality Research Studies

    • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

      • Randomized Controlled Trial:
        Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

      • Representative Sample:
        Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

      • Single Blind Trial:
        Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

      • Double Blind Trial (Better Than Single Blind Trial):
        Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

      • Baseline Comparability:
        Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

      • Confounding Factors:
        Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

      • Intervention Integrity:
        Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

      • Statistical analysis:
        Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

        Ask: Are the results both statistically significant and clinically significant? Many medical research findings are statistically significant (with a p-value <0.05), but they are not clinically significant because the difference between the experimental and control groups is too small to be clinically relevant.

        For example, the effect of a new drug may be found to be 2% better than placebo. Statistically (if the sample size was large enough) this 2% difference could be statistically significant (with a p-value <0.05). However, clinicians would say that this 2% difference is not clinically significant (i.e., that it was too small to really make any difference).

        Statistically, the best way to test for clinical significance is to test for effect size (i.e., the size of the difference between two groups rather than confounding this with statistical probability).

        When the outcome of interest is a dichotomous variable, the commonly used measures of effect size include the odds ratio (OR), the relative risk (RR), and the risk difference (RD).

        When the outcome is a continuous variable, then the effect size is commonly represented as either the mean difference (MD) or the standardised mean difference (SMD) .

        The MD is the difference in the means of the treatment group and the control group, while the SMD is the MD divided by the standard deviation (SD), derived from either or both of the groups. Depending on how this SD is calculated, the SMD has several versions such, as Cohen's d, Glass's Δ, and Hedges' g.

          Clinical Significance: With Standard Mean Difference, the general rule of thumb is that a score of 0 to 0.25 indicates small to no effect, 0.25-0.50 a mild benefit, 0.5-1 a moderate to large benefit, and above 1.0 a huge benefit. It is a convention that a SMD of 0.5 or larger is a standard threshold for clinically meaningful benefit.

        The statistical summary should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention).

        In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

          Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

          Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

          Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

        Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

      • Completeness of follow-up data:
        Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

      • Handling of missing data:
        Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

      • Replication of Findings:
        Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

      • Fraud:
        Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size ( n ), mean ( M ) and standard deviation ( SD ) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

        • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean ( M ) is defined as "the sum ( Sum ) of the values of each observation divided by the total number ( n ) of observations". So: M = Sum / n . Thus: ( Sum ) = ( M ) multiplied by ( n ). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate ( M ) multiplied by ( n ). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean ( M ) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value , and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

        • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible.

        • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

        • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

        • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

        • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

        • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

        • If the research study's data contradicts the study's own conclusions - surprisingly, this often occurs.

    • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

    • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

    • Not All Scientific Studies Are Created Equal - video

    • The efficacy of psychological, educational, and behavioral treatment

    • Estimating the reproducibility of psychological science

    • Psychologists grapple with validity of research

    • Industry sponsorship and research outcome (Review) - Cochrane Library

    • 'We've been deceived': Many clinical trial results are never published - (text and video)

    • Junk science misleading doctors and researchers

    • Junk science under spotlight after controversial firm buys Canadian journals

    • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

    • When Evidence Says No, But Doctors Say Yes


    • Cochrane Collaboration - the best evidence-based, standardized reviews available

    Research Topics

    Paranoid Personality Disorder - Core Clinical Journals

    Paranoid Personality - All Journals

    Paranoid Personality - Review Articles - Core Clinical Journals

    Paranoid Personality - Review Articles - All Journals

    Paranoid Personality Disorder - Treatment - Core Clinical Journals

    Paranoid Personality Disorder - Treatment - All Journals

    Recommended Free Full Text Articles


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    Normal Distribution Of Human Attributes

    Regression to the Mean (Or Why Scientific Experiments Require A Control Group)

    The "Big 6" Dimensions of Mental Health

    Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Five Factor Model of Personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

    This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.)

    The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].

    Which "Big 6" Dimensions of Mental Health are Impaired in Paranoid Personality Disorder?

    THE POSITIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THE NEGATIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THIS DISORDER
    Agreeableness
    Being kind and honest.
    Antagonism
    Being unkind or dishonest.
          Antagonism
    Conscientiousness
    Being diligent and self-disciplined.
    Disinhibition
    Being distractible, impulsive, or undisciplined.
    Openness/Intellect
    Showing good creativity, problem-solving, and learning ability
    Impaired Intellect
    Showing decreased creativity, problem-solving, or learning ability.
    Extraversion
    Being gregarious, assertive and enthusiastic.
    Detachment
    Being detached, unassertive, or unenthusiastic.
    Emotional Stability
    Being emotionally stable and calm.
    Emotional Distress
    Being emotionally unstable/distressed.
    Physical Health
    Being physically fit and healthy.
    Physical Symptoms
    Being physically unfit or ill.

    The Following Will Only Discuss The Dimensions of Mental Illness That Are Abnormal In This Disorder

    The problems that are characteristic of this disorder are highlighted with this pink background color.


    AGREEABLENESS VS. ANTAGONISM

    AGREEABLENESS (Helping Others)
    Description: Agreeableness is synonymous with compassion and politeness. Compassion reflects empathy, sympathy, and caring for others. Politeness reflects respect for others. Individuals with high Agreeableness do not hold grudges, are lenient in judging others, are willing to compromise and cooperate with others, and can easily control their temper. The Agreeableness dimension measures the behaviors that are central to the concept of JUSTICE and equality (fair, honest, and helpful behavior - living in harmony with others, neither harming nor allowing harm). Basic human rights are enshrined in the UN Universal Declaration of Human Rights. Individuals with high Agreeableness avoid manipulating others for personal gain, feel little temptation to break rules, are uninterested in lavish wealth and luxuries, and feel no special entitlement to elevated social status. High Agreeableness is associated with better: longevity, helping others, giving to charity, job [team] performance, and marital success. (This dimension appears to measure the behaviors that differentiate friend from foe.)
    Descriptors: Honest, humble, compassionate, polite, cooperative, nonaggressive.
    • Compassion:
      • Forgiving nature
      • Considerate and kind
      • Feel other's emotions
      • Inquire about others’ well-being
      • Sympathize with others’ feelings
      • Take an interest in other people’s lives
      • Like to do things for others
    • Politeness:
      • Seldom rude
      • Respect authority
      • Hate to seem pushy
      • Avoid imposing my will on others
      • Rarely put people under pressure
    • From International Personality Item Pool:
      • Would never cheat on taxes
      • Sympathize with the homeless
      • Trust others
      • Make people feel welcome
      • Am easy to satisfy
      • Dislike being the center of attention
    Chimpanzees: The Agreeableness-Antagonism dimension of human behavior can be traced back to our chimpanzee ancestory. Chimpanzee communities, like every social species, organize themselves according to status (video). In such status hierarchies, the dominant members actively protect their privileged status within the community by using domineering, antagonistic behavior towards subordinate members. This antagonistic, competitive behavior by high-status dominant members of the community is in contrast to the agreeable, cooperative behavior of the low-status, subordinant members. In humans, this same antagonistic behavior is used by those seeking to dominate others.
    Evolution: The brains of social species evolved to allow cooperation and altruism which require coordinating one’s goals with those of others. The core features of Agreeableness are empathy and fairness. In more intelligent species, there appears to be an almost instinctual sense of empathy and fairness (video).
    Language Characteristics: Pleasure talk, agreement, compliments, empathy, few personal attacks, few commands or global rejections, many self-references, few negations, few swear words, few threats, many insight words.
    Research: Higher scores on Agreeableness are associated with deeper relationships. Are you a giver or taker? (video). *MRI research found that Agreeableness was associated with increased volume in regions that process information about the intentions and mental states of other individuals.
    "I am helpful and unselfish with others."
    "I have a forgiving nature."
    "I am generally trusting."
    "I am considerate and kind to almost everyone."
    "I like to cooperate with others."
    "I don't find fault with others."
    "I don't start quarrels with others."
    "I am not cold and aloof."
    "I am not rude to others."
    "I feel other's emotions."
    "I inquire about others' well-being."
    "I sympathize with others' feelings."
    "I take an interest in other people's lives."
    "I like to do things for others."
    "I respect authority."
    "I hate to seem pushy."
    "I avoid imposing my will on others."
    "I rarely put people under pressure."
    ANTAGONISM (Harming Others)
    Description: Antagonism is synonymous with being very self-centered and lacking empathy. They find it hard to forgive, are critical of others' shortcomings, are stubborn in defending their point of view, and readily feel anger when provoked.
    Language Characteristics: Problem talk, dissatisfaction, little empathy, many personal attacks, many commands or global rejections, few self-references, many negations, many swear words, many threats, little politeness, few insight words.
    * Suspiciousness:
    "It seems like I'm always getting a “raw deal” from others."
    "I suspect that even my so-called 'friends' betray me a lot."
    "Others would take advantage of me if they could."
    "Plenty of people are out to get me."
    "I'm always on my guard for someone trying to trick or harm me."
    ("Agreeableness vs. Antagonism" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five) [More Information]
    *MRI Research:
    Testing predictions from personality neuroscience. Brain structure and the big five.



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    Ancient Wisdom Relevant To Paranoid Personality Disorder

    Buddhism (Gautama Buddha 623–543 BCE)

    • "What you think, you become. What you feel, you attract. What you imagine, you create."

    • "Health, contentment, and trust are your greatest possessions."

    • "Do not believe in anything simply because you heard it... But after observation and analysis, when you find that anything agrees with reason and is conducive to the good and benefit of one and all, then accept it and live up to it."

    Judaism, The Bible, Islam

    • These religions don't specifically deal with the issue of suspiciousness. They simply tell believers to trust in God, for example: "Trust in the Lord with all thine heart; and lean not unto thine own understanding." (Proverbs 3:5)


    Comment by Phillip Long MD (Psychiatrist and Editor):


    It's A Wonder We're Still Alive

    The Man Who Saved The World

    The world barely avoided being annihilated in 1983. On 26 September 1983, the nuclear early warning system of the Soviet Union erroneously reported an incoming attack against Russia by American intercontinental missiles. Russia has a "launch on warning" policy whereby it launches its missiles against America on the first warning of an incoming American missile attack.

    Fortunately this missile attack warning was correctly identified as a false alarm by Stanislav Petrov, lieutenant colonel of the Soviet Air Defence Forces. Petrov's decision to disregard the erroneous radar warnings is credited with having prevented a retaliatory nuclear attack on the United States and its NATO allies that could have resulted in large-scale nuclear war.

    Stanislav Petrov had the courage to disobey his military orders (to "launch on warning") because of his personal knowledge and convictions. He knew that launching a large-scale nuclear war would annihilate humanity, and he knew that the Russian early warning system could not be trusted.

    9 Times the World Was at the Brink of Nuclear War — and Pulled Back

    Due to human error, there have been nine times that the world was at the brink of nuclear war — but pulled back. Accidental false alerts which could trigger a nuclear war are not a rare occurrence. Given how incompetent our nuclear "launch on warning" system is - it is a miracle that we haven't already annihilated all life on earth.



    The 2 Men Who Could End The World

    America and Russia possess 93% of the world's nuclear weapons. Thus Valdimir Putin and President Trump are the only two people on earth who could single-handedly start a nuclear World War III and thus annihilate all life on our planet.

    The problem now is that the leaders of Russia and America have severe personality flaws that make them incapable of appreciating the enormity of harm that they may cause.

    Both Vladimir Putin and President Trump have Antisocial, Narcissistic, and Paranoid Personality Disorders.

    Why is the mental health of Vladimir Putin or President Trump important?

    The world's fate is now in the hands of two leaders who have the following severe personality flaws:

    Antisocial Personality Disorder

    Narcissistic Personality Disorder

    • Arrogance:
      Being boastful or excessively proud; offensive display of superiority or self-importance.

    • Manipulation:
      Exploiting, conning, or taking unfair advantage of others.

    • Callousness:
      Lack of guilt or remorse about causing others harm; indifference to the suffering of others.

    • Attention Seeking:
      Trying to be the center of attention; being overly dramatic or flamboyant.

    Paranoid Personality Disorder

    • Suspiciousness:
      Suspecting, without sufficient basis, that others are harming or deceiving him.

    • Bearing grudges:
      Blaming others; seeking revenge

    • Being Hot-Headed:
      Easily angered; quick to take offense; unable to take criticism, blame or rejection.


    Tony Schwartz wrote "The Art of the Deal" for Donald Trump, and spent 18 months in Donald Trump's office observing him in order to write this Donald Trump biography. In 2016, immediately before the presidential election, Tony Schwartz gave a scathing lecture entitled "The Truth About Trump" at Oxford University. Every American who voted for President Trump should watch this Oxford lecture video.

    Jan. 29, 2017: Alexandre Bissonnette, a white, 27-year-old, French-Canadian male far right extremist shot 25 Muslims in the back while they were at prayer in their mosque in Quebec City, Canada. Six were killed, 5 were hospitalized in critical condition, and the other wounded required only brief hospitalization. All of Canada mourned this barbaric act of senseless hatred against Muslims. Canadians are now asking how can the flood of far right anti-Muslim hatred coming into Canada from other countries be stopped? Take a good look at where the far right anti-Muslim hatred is taking us. [Racism can be untaught: How getting beat up taught a new Canadian not to be racist]

    P.S. In the past 2 years, Canada has accepted more than 40,000 Syrian refugees. Not one of these Syrian refugees has attempted a terrorist attack in Canada or America.

    A Counterargument To President Trump's Xenophobia:
    (Interview with Jack Ma, a Chinese businessman worth US$ 35 billion) "In the past 30 years, America has had 13 wars spending US$ 14.2 trillion . What if they spent a fraction of that money building up [America's] infrastructure, and helping white collar and blue collar workers? ... You are supposed to spend money on your own people. The money has gone to Wall Street. And what happened? In 2008, the financial crisis wiped out US$ 19.2 trillion in USA alone, and destroyed 34 million jobs globally . What if that money wasn't spent on Wall Street? What if that money was spent on middle America and the rest of the United States developing the industry there? So it's not the other countries stealing jobs from America, it is your strategy [over-spending on war and on Wall Street]. You did not distribute your money in the proper way."


    How The Rich Neglect The Poor

    Having Money Makes You Ruder And Less Empathetic

    Certain individuals have amassed great power and wealth. These fabulously rich individuals totally neglect the poor and the starving, and care only about accumulating more wealth, fame and power - even if it means oppressing half of humanity. They, and the corporations they control, do everything in their power to avoid paying their fair share of taxes. Although they may give millions to charity, many of their corporations avoid paying billions in taxes every year.





    The 62 Richest People Are As Wealthy As The Poorest Half Of The World

    The richest 1% now own a staggering portion of the world's wealth

    Half of England is owned by less than 1% of the population

    The top 0.1% of American households hold the same amount of wealth as the bottom 90%

    What the 1% Don't Want You to Know

    All the ways billionaires like Jeff Bezos and Mark Zuckerberg spend their billions — from lavish real estate to vintage car collections

    Jeff Bezos got so rich in 2018 that he now makes more per minute than most people do in a year

    The wealth of these 8 men equals the bottom 50% of the entire world

    How Amazon gets away with not paying taxes



    The "Five Factor Model of Personality" as Shown In Dogs

    All animals have personalities - that is, consistent individual differences in behavior. Within virtually any population, some individuals are consistently more active, more aggressive, or are more willing to engage in risk-taking behavior. Thus the same "Big 5 Factors" of personality found in humans can be found in dogs.



    AGREEABLENESS VS. ANTAGONISM
    Agreeableness ("Friend")
    Dog is friendly towards unfamiliar people.
    Dog is friendly towards other dogs.
    When off leash, dog comes immediately when called.
    Dog willingly shares toys with other dogs.
    Dog leaves food or objects alone when told to do so.
    Antagonism ("Foe")
    Dog is dominant over other dogs.
    Dog is assertive with other dogs (e.g., if in a home with other dogs, when greeting).
    Dog behaves aggressively towards unfamiliar people.
    Dog shows aggression when nervous or fearful.
    Dog aggressively guards coveted items (e.g., stolen item, treats, food bowl).
    Dog is quick to sneak out through open doors, gates.

    CONSCIENTIOUSNESS VS. DISINHIBITION
    Conscientiousness ("Self-Controlled")
    Dog works at tasks (e.g., getting treats out of a dispenser, shredding toys) until entirely finished.
    Dog works hard all day herding or pulling a sleigh (if a "working dog" on the farm or in the snow). *
    Dog is curious.
    Disinhibition ("Disinhibited")
    Dog is boisterous.
    Dog seeks constant activity.
    Dog is very excitable around other dogs.

    OPEN-MINDEDNESS / INTELLECT VS. CLOSED-MINDEDNESS / IMPAIRED INTELLECT
    Intellect
    Dog is able to focus on a task in a distracting situation (e.g., loud or busy places, around other dogs).
    Impaired Intellect
    Dog is slow to respond to corrections.
    Dog ignores commands.
    Dog is slow to learn new tricks or tasks.

    EXTRAVERSION VS. DETACHMENT
    Sociality ("Approach")
    Dog is attention seeking (e.g., nuzzling, pawing or jumping up on family members looking for attention and physical contact).*
    Dog seeks companionship from people.
    Dog is affectionate.
    Detachment ("Avoidance")
    Dog is aloof.
    Dog gets bored in play quickly.
    Dog is lethargic.

    EMOTIONAL STABILITY VS. EMOTIONAL DISTRESS
    Emotional Stability ("Safety")
    Dog tends to be calm.
    Dog is relaxed when greeting people.
    Dog is confident.
    Dog adapts easily to new situations and environments.
    Emotional Distress ("Danger")
    Dog is anxious.
    Dog is shy.
    Dog behaves fearfully towards unfamiliar people.
    Dog exhibits fearful behaviors when restrained.
    Dog avoids other dogs.
    Dog behaves fearfully towards other dogs.
    Dog behaves submissively (e.g., rolls over, avoids eye contact, licks lips) when greeting other dogs.
    Modified from Jones, A. C. (2009). Development and validation of a dog personality questionnaire. Ph.D. Thesis. University of Texas, Austin.

    * New items added by Phillip W. Long MD

    The "Five Factor Model of Personality" In A Social Species

    The behaviors of the "Five Factor Model of Personality" serve adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociality" ], (4) decide whether to proceed in a self-controlled or disinhibited manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness to Experience" ].

    Spider Personalities

    All animals have personalities (defined as consistent behavioral differences among individuals). Animals can consistently differ on: (1) Antagonism (e.g., aggression), (2) Disinhibition (e.g., risk taking), (3) Intellect (e.g., inventiveness), (4) Extraversion (e.g., assertiveness), and (5) Emotional Stability (e.g., calmness).

    Some social spiders live in colonies of up to several hundred individuals, and exhibit cooperative behaviours such as prey capture and maternal care. Researchers have found that spider personalities differ in aggressiveness:
    • Aggressive spiders are more likely to attack their mirror image than are shy spiders who are more likely to run away.
    • In a spider colony, individual spiders differ in degree of boldness (aggression) vs. shyness (nonaggression). [Aggressive spiders show shorter latencies to attack prey and to resume movement after a disturbance.] Hunting prey for these social spiders is a collective effort. The presence of a bold spider causes the shy spiders to become bolder which increases the effectiveness of their collective hunting effort. A positive feedback loop is established whereby hunting success increases spider boldness which increases future collective hunting success. However, when researchers removed these bold "leader" spiders, the collective hunting by the remaining spiders became less successful. The bold "leader" spiders thus were shown to have a disproportionately large impact on the group, and so were named "keystone individuals". Because of their special personality characteristic (boldness) the "leader" spiders performed a vital function (making the shy spiders bolder) which fascilitated collective social action.

      This research made the very important finding that the spiders modified each other's personalities. The bold spiders became bolder because of their hunting success. However their hunting success was entirely dependent upon gaining the collective support of the shy spiders. Likewise, the shy spiders owed their hunting success to being made bolder by association with the bold spider. Thus for more successful collective action, the bold "leader" spider needed to have followers, and the shy "follower" spiders needed to have a "leader". To make their collective social action more successful, the different spider personalities had to bring out the "best" in each other.

    The "Five Factor Model of Personality" and Personality Disorders

    The following diagram shows the relationship between the "Five Factor Model of Personality" and personality disorders. This diagram is based on the research of Sam Gosling, Jason Rentfrow, and Bill Swann, Gerard Saucier, Colin G. DeYoung, and Douglas Samuel and Thomas Widiger.


    Enlarge Image



    3D Models of How the Personality Disorders Are Correlated



    The DSM-IV personality disorders in the National Comorbidity Survey Replication study determined how personality disorders statistically correlated with each other. The above 3D model was created (by P.W. Long MD) from this correlational data.

    This statistical model shows that all of the personality disorders are highly correlated - they are overlapping entities that blend into each other with no clear boundaries. This 3D model groups personality disorders into two highly interrelated large clusters (named "greed" and "fear" by PWL).

    The fact that these personality disorders are so highly interrelated suggests that it is common for individuals to have multiple personality disorders.



    Section III of the DSM-5 presents an alternative model for personality disorders. Based on research findings, this model drops four personality disorders: Schizoid, Paranoid, Dependent, and Histrionic.

    The above 3D model shows the statistical correlations between personality disorders in this alternative DSM-5 model.

      Note: Borderline Personality Disorder plays a central role in this model. It is correlated to all of the other major personality disorders (except Schizotypal Personality Disorder). It could be argued that Borderline Personality Disorder may not be a true personality disorder. Instead, it may more represent chaotic instability - an advanced stage in which a previous stable personality disorder becomes unstable and goes from order into chaos. This would explain why Borderline Personality Disorder is usually diagnosed in combination with another personality disorder.

      Thus, it is argued, instead of diagnosing someone as having both "Paranoid and Borderline Personality Disorders"; it would be more correct to diagnose "Paranoid Personality Disorder with Emotionally Unstable Traits".

      Chaos theory states that balanced systems under stress can be pushed into instability. Specifically, as stress on a stable system is increased, a "tipping point" is reached wherein the system quickly goes from stability to instability. The following animated graphs illustrate this mathematical principle. The vertical (y) axis represents the stress level. As the stress level increases, a tipping point is reached whereafter the system becomes more unstable. (These animations recycle.)

      Logistic map animation.gif
      By Snaily CC BY-SA 3.0, The "tipping point" between stability and instability



      According to chaos theory, these animations could represent what happens when a personality disorder is under increasing stress. Initially, the personality disorder remains stable; then under increasing stress a tipping point is reached wherein the previously stable personality disorder becomes chaotic. Any further stress makes the personality disorder even more unstable.

      Thus the emotional instability, chaotic social functioning, and self-harming behavior of Borderline Personality Disorder could represent a chaotic, unstable state of a previously stable personality disorder.


    Primate Evolution

    There appears to be three different ways in which primates have evolved socially:

    • The chimpanzees have evolved to be socially antagonistic, competitive, callous, and manipulative. Chimpanzees are the only primates (apart from humans) that wage organized war. Thus chimpanzee social behavior most closely mirrors the antagonistic behavior of the antisocial-paranoid-narcissistic-histrionic-borderline cluster of personality disorders.

    • In contrast, the bonobos have evolved to be socially anxious, peaceful, cooperative, and loving. Thus bonobo social behavior most closely mirrors the emotional distress (anxious) behavior of the avoidant-dependent cluster of personality disorders.

    • Another separate evolutionary path was followed by the orangutans. They evolved to become solitary hermits. Thus orangutan social behavior most closely mirrors the detached behavior of the schizoid-schizotypal cluster of personality disorders.


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