Psychiatric Assessment and Fundamentals Q 37
A long-term goal for a paranoid male client who has unjustifiably accused his wife of having many extramarital affairs would be to help the client develop:
A. Insight into his behavior
B. Better self-control
C. Feeling of self-worth
D. Faith in his wife
Correct Answer: C. Feeling of self-worth
Helping the client to develop a feeling of self-worth would reduce the client’s need to use pathologic defenses. Paranoid personality disorder (PPD) is one of a group of conditions called Cluster A or eccentric personality disorders. People with these disorders often appear odd or peculiar. The essential characteristic of people with PPD is paranoia, a relentless mistrust and suspicion of others without adequate reason to be suspicious. This disorder often begins in childhood or early adolescence and appears to be more common in men than in women. Studies estimate that PPD affects between 2.3% and 4.4% of the general population.
Option A: People with PPD are always on guard, believing that others are constantly trying to demean, harm, or threaten them. These generally unfounded beliefs, as well as their habits of blame and distrust, interfere with their ability to form close or even workable relationships.
Option B: Patients with paranoid personality disorder distrust others and assume that others intend to harm or deceive them, even when they have no or insufficient justification for these feelings. From 2.3 to 4.4% of the general US population are estimated to have paranoid personality disorder. It is thought to be more common among men. Patients with paranoid personality disorder suspect that others are planning to exploit, deceive, or harm them. They feel that they may be attacked at any time and without reason. Even though there is little or no evidence, they persist in maintaining their suspicions and thoughts.
Option D: Often, these patients think that others have greatly and irreversibly injured them. They are hypervigilant for potential insults, slights, threats, and disloyalty and look for hidden meanings in remarks and actions. They closely scrutinize others for evidence to support their suspicions. For example, they may misinterpret an offer of help as implication that they are unable to do the task on their own. If they think that they have been insulted or injured in any way, they do not forgive the person who injured them. They tend to counterattack or to become angry in response to these perceived injuries. Because they distrust others, they feel a need to be autonomous and in control.