Paranoid individuals have a strong tendency to blame others for interpersonal problems, usually can cite many experiences which seem to justify their convictions about others, are quick to deny or minimize their own problems, and often have little recognition of the ways in which their behavior contributes to their problems. Thus, when an assessment is based on the client’s self-report, it can easily appear that the client’s suspicions are justified or that the problems are due to inappropriate actions by others. In addition, because the characteristics of paranoia are understood to some extent by most laymen, paranoid individuals are likely to recognize that others consider them to be paranoid, and to realize that it is prudent to keep their thoughts to themselves. When this is the case, indications of paranoia tend to emerge only gradually over the course of therapy and may easily be missed.

Often it is easiest to identify paranoid individuals by watching for characteristics other than blatantly unrealistic suspicions. Table 6.2 presents a number of possible signs of a paranoid personality style which may be early indications of PPD. Individuals with PPD are typically quite vigilant, tend to interpret ambiguous situations as threatening, and are quick to take precautions against perceived threats. They frequently are perceived by others as argumentative, stubborn, defensive, and unwilling to compromise. They also may manifest some of the characteristics they perceive in others, being seen by others as devious, deceptive, disloyal, hostile, and malicious.