Paranoid anxiety is a term used in object relations theory, particularity in discussions about the Paranoid-schizoid and depressive positions. The term was frequently used by Melanie Klein, especially to refer to a pre-depressive and persecutory sense of anxiety characterised by the psychological splitting of objects.
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Further developments
Donald Meltzer saw paranoid anxiety as linked not only to a loss of trust in the goodness of objects, but also to a confusion between feeling and thought.
For the extreme forms of such anxiety, he coined the term 'terror', to convey something of the qualitatively different intensity of their nature.
Defensive functions
Idealisation (as in the transference) can be used as a defence against deeper paranoid anxieties about the actual presence of a destructive, denigrating object.
Conversely, paranoid fears, especially when systematised, may themselves serve as a defence against a deeper, chaotic disintegration of the personality.
Persecutory anxiety state (panic attack) and persecutory delusion
Paranoid anxiety may reach the level of a persecutory anxiety state (a form of panic attack), including various levels of persecutory delusions (the preferred term to paranoid delusions).
Heavy drinking is said to sometimes precipitate acute paranoid panic - the protagonist's unconscious hostile impulses being projected onto all those around.
Literary examples
Hamm in Endgame by Samuel Beckett has been singled out as a character driven by paranoid anxiety.