A pervasive distrust and suspiciousness of other people such that their motives are interpreted as malevolent, and it start 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