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Paranoid Personality Disorder (301.0) in the DSM-IV

PARANOID PERSONALITY DISORDER (301.0) IN THE DSM-IV

Introduction

There are valid grounds for the Christian objection to much of modern psychology. For modern psychology differs greatly from the Bible with a different structure and treatment of behavior problems. Obviously, modern psychology is not based upon an inductive study of what the Bible says on behavior problems. But if one looks at the so-called bible of psychiatry, the DSM-IV (recently with revised commentary as the DSM-IV-TR), one finds quite a list of behaviors that are deemed undesirable not only by psychologists, but also by persons in general, and by Christians.

Modern psychology has given much thought to what behavioral patterns are undesirable. Since the existence of those behavioral patterns is accepted by many persons, even Christians do well to think about them critically and consider what the Bible may say about those patterns. As a Christian does this, he is mindful that it is possible that patterns have been wrongly defined or classified. But if one examines those patterns or traits, at least often one will probably come to the conclusion that modern psychology is on to something.

For example, a person who bursts into rooms and draws a great amount of attention to himself (for no reason except a vain attempt to glorify himself) is obnoxious. Psychology would likely diagnose such a person as having Histrionic Personality Disorder. The Bible would call such a person a fool.

As another example, a person who is prone to misjudge the conduct of others and assign blame where none is due would likely be diagnosed as having Paranoid Personality Disorder (PPD). The Bible condemns such behavior as “judging.”

A Christian does well to look at the various behaviors which psychology has identified and ask whether or not he has such behavior patterns and what the Bible says about them. The Christian may also be comforted by the knowledge that psychology gives a general excuse from disorder diagnosis if a behavior is acceptable in someone’s culture (which should include his religion). There is a general Biblical principle of not giving offence. Thus if one’s behavior offends, one should consider whether or not that behavior is a necessary offence (like proclamation of the gospel) or is in fact a behavior that the Bible objects to.

Since PPD is classified as a “Personality Disorder,” the DSM-IV groups it with the other personality disorder as “Axis II.” Axis I is another group of disorders called “clinical disorders,” which includes more serious disorders of behavior and thought, such as Delusional Disorder and Paranoid Schizophrenia (called “psychoses”). As these three disorders are compared, PPD is a lesser disorder than Delusional Disorder, which is a lesser disorder than Paranoid Schizophrenia. These three are the three illusional/delusional disorders. PPD is defined as characterized by illusions, misbeliefs held with a lower strength of belief, suspicions being lower in intensity than convictions. A PPD person might suspect that his neighbor is trying to hurt him. On the other hand, a person with Delusional Disorder (or Paranoid Schizophrenia) would be more certain that the neighbor wants to hurt him.


The third (and most severe) delusional/illusional disorder is Paranoid Schizophrenia, concerning which one may overgeneralize as follows: In Delusional Disorder the person’s delusion could theoretically be true; his neighbor could try to hurt him. But with Paranoid Schizophrenia, the person is certain of a bizarre, impossible delusion. He may be certain that little green men from Mars want to hurt him, which is utterly impossible.

In real life there may be no boundaries between these disorders, with a continuum of illusion/delusion from the weakest suspicion to the strongest and most bizarre delusion. And there is nothing unbiblical about recognizing that persons hold false beliefs or delusions.