interpreted as a criticism for selfishness; a compliment on an accomplishment is misinter-
preted as an attempt to coerce more and better performance). They may view an offer of
help as a criticism that they ar e not doing well enough on their own.
Individuals with this disorder persistently bear grudges and are unwilling to forgive
the insults, injuries, or slights that they th ink they have received (Criterion A5). Minor
slights arouse major hostility, and the hostile f eelings persist for a long time. Because they
are constantly vigilant to the harmful intentions of others, they very often feel that their
character or reputation has been attacked or that they have been slighted in some other
way. They are quick to counterattack and react with anger to perceived insults (Criterion
A6). Individuals with this disorder may be pathologically jealous, often suspecting that
their spouse or sexual partner is unfaithful without any adequate ju stification (Criterion
A7). They may gather trivial and circumstantial  “evidence” to support  their jealous beliefs.
They want to maintain complete control of intimate relationships to avoid being betrayed
and may constantly question and challenge th e whereabouts, actions, intentions, and fi-
delity of their spouse or partner.
Paranoid personality disorder should not be diagnosed if the pattern of behavior oc-
curs exclusively during the course of schizo phrenia, a bipolar disorder or depressive dis-
order with psychotic features, or another psychoti c disorder, or if it is attributable to the
physiological effects of a neurological (e.g., temporal lobe epilepsy) or another medical
condition (Criterion B).
Associated Features Supporting Diagnosis
Individuals with paranoid personality disorder are generally difficult to get along with
and often have problems with close relationsh ips. Their excessive suspiciousness and hos-