COMPARISON: Paranoid Personality Disorder vs BPD

[BPDFamily.com]

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.

[Alastor]

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.

[Randi Kreger]

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 "

[Randi Kreger]

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 "

[Alastor]

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

[dados76]

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...

[BPDFamily]

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)