For there to be a diagnosis of PPD, four or more of seven diagnostic criteria must be present plus the general criteria for personality disorder must be met. The DSM-IV/-5 diagnostic criteria for Paranoid Personality Disorder (PPD) includes:
- (1) Perceives hidden insulting or threatening messages into benign remarks or events.
- (2) Recurrently holds grudges, i.e., is unforgiving of insults, injuries, or slights.
- (3) suspiciousness, without justification, regarding fidelity of spouse or sexual partner.
- (4) Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.
- (5) Preoccupation with unjustified doubts about the loyalty or trustworthiness of friends or associates.
- (6) Perceives attacks on their character or reputation that are not apparent to others, and they are quick to react angrily or to counterattack.
- (7) Reluctance to confide in others because of unwarranted fear that the information will be used maliciously against him or her.