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Paranoid and relationships

The DSM-IV notes that individuals with PPD are generally difficult to get along with and have consistent trouble within relationships. They are distrustful and hostile; their interpersonal behavior may involve overt argumentativeness, complaining, or aloofness. They can be guarded, secretive, or devious; they appear to lack tender feelings and engage in stubborn and sarcastic exchanges with others. It can be difficult to elicit the behaviors suggestive of PPD from individuals in treatment. PPD characteristics tend to be manifested in interpersonal conflicts with close or significant others, e.g. spouses, supervisors, colleagues, and relatives.

Individuals with PPD tend to provoke hostility in others. They engage in "hair-trigger" responses to trivial behavior from others. These individuals repeatedly enact guarded and domineering interpersonal patterns. They are distrustful, secretive, and isolative; for they will direct hate and rage at those who betray or disappoint them. They are concerned with the issues of power and powerlessness and fear domination. They are inordinately quick to take offense, slow to forgive, and ever willing to counterattack. However, the range of dysfunction within the diagnosis of paranoid personality disorder is sufficient to allow many of these individuals to be sufficiently interpersonally functional to preserve relatively cohesive relationships.

Even so, there have been documented accounts of individuals with PPD whose symptoms manifest at a level of subtlety that allows them to function within a marriage and maintain adequate work relationships. This is further reinforced as individuals with PPD can often develop enough trust to work successfully within the therapeutic process with therapists.