Paranoia Symptoms Test: Identifying If You Have Paranoia

Paranoia is the sense that people or external forces want to cause you harm despite a lack of evidence to support this belief. Mild to moderate paranoia might be common. Not only is the symptom associated with multiple mental illnesses, but people can experience temporary paranoia in daily life. 

Paranoid thoughts often seem to be true to the person thinking them. As a result, some people may struggle to identify whether their thoughts are accurate or paranoid. While there is no universal paranoia symptoms test, there are multiple strategies and inventories people have developed over the years to identify paranoia symptoms. Below, explore a few tools to help individuals identify paranoia and some of the most commonly used paranoia-related tests and inventories.

Wondering if your suspicious thoughts are paranoia?

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Could you have paranoia?

Up to 20% of the general public experience paranoid thoughts regularly. Paranoia is the thought that others want to cause you harm despite a lack of evidence. If you believe others want to cause you harm, you may have paranoia. However, discerning whether you are experiencing paranoia can be difficult if your paranoid thoughts seem true to you. You might not pick up on any deviations from reality. For this reason, determining whether evidence supports your belief can be a way to understand whether you’re experiencing paranoia. 

Some experts believe that paranoia falls on a scale ranging from mild to severe. Some people may be quick to worry, slow to trust others, and tend to hold grudges but not be profoundly impacted by this paranoia. Others may have paranoid thoughts frequently, impacting functioning due to their mistrust of others. Those with severe paranoia are more likely to hold delusions, sometimes bizarre in nature, that involve believing they're being persecuted, harassed, or oppressed despite no objective evidence. To gain awareness of one's own paranoia, a self-awareness of thoughts and feelings and an objective assessment of their accuracy can be helpful. 

Gaining self-awareness

Talking with people you can trust

Talking with people you trust may provide discernment when navigating paranoia. You can share thoughts about which you're concerned and ask those you trust if the thoughts seem accurate. Others can help you determine whether you're assuming the worst of others, experiencing worry, or if your sense that certain people are out to get you reflects your reality. Therapists are equipped to help people with paranoia, but sometimes those who have paranoia, especially in more severe forms, struggle to trust therapists and others providing professional support.

Paranoia inventories used by researchers 

There is no single paranoia test that will determine whether you have paranoia. However, different researchers have developed inventories designed to assess paranoia among participants. Below are some of the most popular paranoia interventions. 

The Paranoia Scale: Mental health and paranoid symptoms 

One systematic review and meta-analysis found that the Paranoia Scale was the paranoia inventory most widely used in 20 reviewed studies. Published by Fenigstein and Vanable in 1992, the Paranoia Scale is a self-reported scale in which people read statements and indicate which ones apply to them. However, the study authors who found the scale to be most widely used also noted that it may not adequately identify clinical levels of paranoia. The Paranoia Scale is sometimes also called the General Paranoia Scale (GPS).

The General Paranoia Scale (GPS) revised

According to experts, the General Paranoia Scale "was devised to assess paranoid ideation in the general population." However, because the scale did not capture all facets of paranoia, some researchers created a revised version in 2015. In addition to having statements about general paranoia, the revised version contains statements about distrust, persecutory ideas, and self-deprecation. An example of a statement related to distrust is, "I often wonder what hidden reason another person may have for doing something nice for me."

The Paranoid Thoughts Scale

A systematic review of self-reported paranoia measures concluded that the Paranoid Thoughts Scale by Green et al. "had the strongest evidence for its measurement properties and is, therefore, recommended as the most reliable and valid self-report assessment of paranoia currently available." The Paranoid Thoughts Scale is another self-reported inventory in which people identify how much each statement applies to them. Many studies have used this scale.

A Revised Green et al. Paranoid Thoughts Scale (R-GPTS) is available for free download from the University of Oxford. The revised Paranoid Thoughts Scale includes a total of 18 statements. For each statement, a person gives a rating from zero to four, indicating whether they've had those thought in the past month, ranging from "not at all" to "totally." These statements primarily measure general paranoia. For example, two statements included are, "I have been thinking a lot about people avoiding me" and "Certain individuals have had it in for me."

The Paranoia Checklist

Like the Paranoid Thoughts Scale, the Paranoid Checklist contains 18 statements. People taking the self-reported inventory identify how frequently they've had each thought listed. Example thoughts include, "I need to be on my guard against others" and "There might be negative comments being circulated about me."

Paranoid personality disorder test

The previously mentioned paranoia inventories are often used in research settings, not clinical healthcare settings. When a person with paranoia meets with a doctor, psychiatrist, or therapist, the practitioner may do an evaluation for paranoid personality disorder (PPD) and other personality disorders. To identify paranoid personality disorder, a practitioner gives a diagnosis according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 

Paranoid personality disorder symptoms and diagnostic criteria

To be diagnosed with paranoid personality disorder, a person must have "a persistent distrust and suspiciousness of others." This symptom and others must have been present since early adulthood. In addition to this distrust and suspiciousness, four or more of the following symptoms must be present:

• Unjustified suspicion that other people are exploiting, injuring, or deceiving them
• Preoccupation with unjustified doubts about the reliability of their friends and coworkers
• Reluctance to confide in others lest the information be used against them
• Misinterpretation of benign remarks or events as having hidden belittling, hostile, or threatening meaning
• Holding of grudges for insults, injuries, or slights
• Readiness to think that their character or reputation has been attacked and quickness to react angrily or to counterattack
• Recurrent, unjustified suspicions that their spouse or partner is unfaithful

Other mental health symptoms tests

A mental health professional may administer other tests when a person has paranoia. Other mental illnesses that sometimes involve paranoia include borderline personality disorder (BPD) and psychotic disorders. In each case, a practitioner can administer the tests designed to diagnose these conditions. In addition to administering tests, diagnosing these disorders may involve taking a person's detailed history and ruling out other disorders.

Paranoia mental health symptoms

The diagnostic criteria related to paranoia differ depending on the mental health condition. In addition to paranoid personality disorder, borderline personality disorder, schizophrenia, and delusional disorder all contain symptoms of paranoia. Below are the diagnostic criteria for paranoia related to different mental health conditions. 

Borderline personality disorder

Borderline personality disorder is a cluster B personality disorder in the DSM-5. To be diagnosed with borderline personality disorder, a person must have five of nine symptoms. One of those nine symptoms is "transient, stress-related paranoid ideation or severe dissociative symptoms." Since borderline personality disorder generally involves a deep-seated fear of abandonment, paranoid thoughts are often related to relationships and stem from this fear. When fear about a relationship passes, the paranoid thoughts may also pass.

Schizophrenia

To be diagnosed with schizophrenia, a person must have delusions, hallucinations, or disorganized speech, among other symptoms, for at least a month. Delusions are persistent beliefs that are not reflected in reality. Those who have delusions as part of schizophrenia might have paranoid delusions. Often, these thoughts are implausible. For example, a person might believe that the president is planning to kill them.

Delusional disorder

In delusional disorder, a person holds a delusion for at least a month. Various types of delusions are possible, but the most common is the persecutory type. When a person holds persecutory delusions, they believe others are out to get them. Although unfounded, these beliefs are often more plausible than those found in schizophrenia and have to do with people the person actually knows, like friends, neighbors, or coworkers.

Wondering if your suspicious thoughts are paranoia?

Talk to a therapist

Therapy for paranoia

If you're trying to figure out if you have paranoia, talking with a therapist may help. Therapists are trained in identifying paranoia and other mental health symptoms. They can provide a safe space in which you can talk about thoughts and feelings that may cause you stress or discomfort. 

Remote therapy might be useful for people with paranoia, allowing clients to attend therapy from location in which they are most comfortable. Through an online therapy platform like BetterHelp, you can choose between phone, video, or live chat sessions and receive support anonymously under any name you want, which can be helpful if you experience some paranoia about talking to a therapist. 

Treatment aimed at anxiety may be helpful for people who have paranoia but not a more serious mental illness causing it, like paranoid personality disorder or schizophrenia. A research study of 30 college students found that ten weekly sessions of anxiety-focused cognitive-behavioral therapy (CBT) reduced paranoia and improved overall function. This study builds on another that also found targeting anxiety reduced paranoia.