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Author Topic: DIFFERENCES|COMORBIDITY: Borderline and Paranoid Personality Disorder  (Read 6207 times)
Alastor
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« on: November 25, 2009, 04:41:10 AM »

I have a hard time separating BPD from Paranoid Personality Disorder (PPD). BPD definitely receives more press and attention from researchers. However, that underlying "fear of abandonment" coupled with "perception of real or imaging attacks on his or her character" and "vigorous counterattacks" almost sounds like the basics of BPD.

"According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), a patient must fit at least four of the following criteria in order to be diagnosed with PPD:

    * unfounded suspicion that others are exploiting, harming, or deceiving him or her
    * preoccupation with unjustified doubts about the loyalty of friends or associates
    * reluctance to confide in others because of unwarranted fear that the information will be used against him or her
    * finds hidden demeaning or threatening meanings in benign remarks or events
    * persistently bears grudges and is unforgiving
    * frequently perceives attacks on his or her character and is quick to react angrily or to counterattack
    * unjustified suspicions regarding fidelity of spouse or sexual partner"

They belong in different groups, so I'm not sure if they are comorbid / exist at the same time in one individual. Is this just part of the confusion about this greater spectrum of personality disorders? Or that the two share some common traits? What is the difference exactly?

Any insights on this?

Thanks.
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Randi Kreger
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« Reply #1 on: November 26, 2009, 12:55:15 PM »

I have a hard time separating BPD from Paranoid Personality Disorder (PPD). BPD definitely receives more press and attention from researchers. However, that underlying "fear of abandonment" coupled with "perception of real or imaging attacks on his or her character" and "vigorous counterattacks" almost sounds like the basics of BPD.

"According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), a patient must fit at least four of the following criteria in order to be diagnosed with PPD:

    * unfounded suspicion that others are exploiting, harming, or deceiving him or her
    * preoccupation with unjustified doubts about the loyalty of friends or associates
    * reluctance to confide in others because of unwarranted fear that the information will be used against him or her
    * finds hidden demeaning or threatening meanings in benign remarks or events
    * persistently bears grudges and is unforgiving
    * frequently perceives attacks on his or her character and is quick to react angrily or to counterattack
    * unjustified suspicions regarding fidelity of spouse or sexual partner"

They belong in different groups, so I'm not sure if they are comorbid / exist at the same time in one individual. Is this just part of the confusion about this greater spectrum of personality disorders? Or that the two share some common traits? What is the difference exactly?

Any insights on this?

Thanks.

I will give you another example.

The DSM definition of BPD includes a high degree of emotional instability. This is a defining trait. It also includes fear of abandonment, rage, and splitting, etc.

Bipolar, depression, and a host of other disorders also have mood components. But they DON'T have fear of abandonment, rage, or splitting.

In just this way, under great stress BPs may have paranoid-like thinking. But people with a paranoia disorder don't have fear of abandonment, rages, and splitting.

Randi Kreger
 
Author, "The Essential Family Guide to Borderline Personality Disorder "
 

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Author, The Essential Family Guide to Borderline Personality Disorder, Stop Walking on Eggshells, and the SWOE Workbook. Coauthor, Splitting: Protecting Yourself While Divorcing Someone with Borderline or Narcissistic Personality Disorder.
Randi Kreger
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« Reply #2 on: November 26, 2009, 12:58:00 PM »

I'd be willing to bet that somewhere out these there is someone with BPD and comorbid paranoia. But it's surely not common and not listed in the Axis l disorders most commonly found with BPD, which include substance abuse, eating disorders, depresion, bipolar, narcissistic PD, and ADD. (Offhand from memory here.)

Randi Kreger
 
Author, "The Essential Family Guide to Borderline Personality Disorder "
 
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Author, The Essential Family Guide to Borderline Personality Disorder, Stop Walking on Eggshells, and the SWOE Workbook. Coauthor, Splitting: Protecting Yourself While Divorcing Someone with Borderline or Narcissistic Personality Disorder.


GENERAL ANNOUNCEMENT

This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question.

Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board.

You will find indepth information provided by our senior members in our workshop board discussions (click here).

Alastor
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"Haters gonna hate."


« Reply #3 on: November 26, 2009, 02:29:39 PM »

Randi, excellent clarification, thanks. I was struggling with this when evaluating my BPD mother. The psychiatrist told me BPD at first, but then I read on PPD and thought jeeze, that also fits her behaviour. However, she definitely splits, fears abandonment, and rages in addition to the other stuff.

As for PPD, she is convinced people (especially me) are spreading rumours about her, uses the term "disloyal" a lot, all her romantic relationships ended in accusations of infidelity, and is certain we are all using her somehow. She is also a hermit, completely isolated from the family with no close friends. But, like you said, pure PPD does NOT include the rages, splitting etc.

I saw one study that estimates up to 4% of the population has PPD, so it's in in the range of BPD in terms of sufferers. However, there is not nearly as much out there on PPD in terms of literature, studies, support groups, etc, maybe because PPD isn't quite so explosive or destructive as BPD. Thank God there is increasing awareness of BPD! More interest = more research = better understanding towards treatment.

Thanks
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dados76
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« Reply #4 on: November 26, 2009, 03:32:44 PM »

my partner as both.. bpd and ppd.. there is a big difference.. he says its like different 'disorders' get to drive his brian for a while.. bpd shows up a lot in him as self doubt and anxiety about people.. he also has social anxiety disorder.. his self image is a lot.. bpd.. and ppd.. is a lot more of his view of the world.. he also has some delusions that go with it.. probably more than he will admit to..

if paranoid is driving his brain.. he will have a 'logical' answer for everything.. and goes way into over analyzing things.. if borderline his driving his brain.. everything is emotional.. fun is when both are fighting over the wheel.. and talking to him logically gets a emotional response.. and talking emotion gets a cold logical response.. he does sometimes go way off the deep end.. to the point of accusing people of lying about who they are.. that they're really two people posing as each other.. obviously.. other people take that kind of hard.. and when they get upset.. he just answers 'see thats exactly what somebody who is lying and doesnt want to be caught would say' .. borderline.. i have a lot more tools to deal with.. and he responds really well to validating and in therapy.. paranoia is a whole other thing.. most reading i find about it says its really hard to treat.. i believe that.. paranoid side is really hard to live with

also.. i think that w/bpd there can be some psychotic feature.. when they get pushed really far.. emotional instability and some psychotic reactions w/dissociation from bpd + paranoia and delusions.. you get something that looks kind of like schizoaffective.. but doesnt respond w/medications..

one of my partners best friends is schizoaffective.. they trade workbooks back and forth.. b/c the paranoia stuff overlaps so much..
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« Reply #5 on: December 15, 2011, 01:27:30 PM »

DIFFERENCES|COMORBIDITY: Overview of Comorbidity

Additional discussions...

Personality Disorders
Borderline and Paranoid Personality Disorder
Borderline and Schzoid/Schizotypal Personality Disorder
Borderline and Antisocial Personality Disorder
Borderline and Histrionic Personality Disorder
Borderline and Narcissistic Personality Disorder
Borderline and Avoidant Personality Disorder
Borderline and Dependent Personality Disorder
Borderline and Obsessive Compulsive Personality Disorder
Borderline and Depressive Personality Disorder
Borderline and Passive Aggressive Personality Disorder
Borderline and Sadistic Personality Disorder
Borderline and Self Defeating Personality Disorder

Other
Borderline PD and Alcohol Dependence
Borderline PD and Aspergers
Borderline PD and Attention Deficit Hyperactivity Disorder
Borderline PD and BiPolar Disorder
Borderline PD and Dissociative Identity Disorder
Borderline PD and P.T.S.D.
Borderline PD and Reactive Attachment Disorder (RAD)
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