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  • A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
    • suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
    • is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
    • is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
    • reads hidden demeaning or threatening meanings into benign remarks or events
    • persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
    • perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
    • has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner
  • Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition.

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