Paranoid personality disorder (PPD) is a severe condition, lacking specialized and empirically supported treatment. To provide the clinician with insights into how to treat this condition, we present a case study of a 61-year-old man with severe PPD who presented with ideas of persecution, emotionally charged hostility, and comorbid antisocial personality disorder. The client was treated with 6 months of Metacognitive Interpersonal Therapy, which included: creating a shared formulation of his paranoid attitudes; trying to change his inner self-image of self-as-inadequate and his interpersonal schemas where he saw the others as threatening. Guided imagery and rescripting techniques, coupled with behavioral experiments, were used to promote a change. At the end of the therapy the client reported a reliable change in general symptomatology and, specifically, in interpersonal sensitivity, hostility, and paranoid ideation; he could no longer be diagnosed as PPD and only some paranoid and antisocial characteristics remained.

中文翻译：

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元认知人际关系疗法治疗严重偏执型人格障碍患者的案例研究

偏执型人格障碍 (PPD) 是一种严重的疾病，缺乏专业和经验支持的治疗。为了让临床医生深入了解如何治疗这种情况，我们提供了一个 61 岁患有严重 PPD 的男性的案例研究，他提出了迫害、充满情感的敌意和共存的反社会人格障碍的想法。来访者接受了为期 6 个月的元认知人际关系治疗，其中包括：创建他偏执态度的共享公式；试图改变他内在的自我形象，以及他认为他人具有威胁性的人际模式。引导图像和重写技术，加上行为实验，被用来促进改变。在治疗结束时，客户报告了一般症状的可靠变化，并且，具体而言，在人际敏感性、敌意和偏执观念方面；他不再被诊断为 PPD，只剩下一些偏执和反社会的特征。