Four of seven specific issues must be present, which include different types of suspicions or doubt (such as of being exploited, or that remarks have a subtle threatening meaning), in some cases regarding others in general or specifically friends or partners, and in some cases referring to a response of holding grudges or reacting angrily.PPD is characterized by 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. To qualify for a diagnosis, the patient must meet at least four out of the following criteria:
Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them. 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 them. 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 their 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.The DSM-5 lists paranoid personality disorder essentially unchanged from the DSM-IV-TR version and lists associated features that describe it in a more quotidian way. These features include suspiciousness, intimacy avoidance, hostility and unusual beliefs/experiences. Other
Various researchers and clinicians may propose varieties and subsets or dimensions of personality related to the official diagnoses.
This kind of insecurity leads to overcompensation: compulsive formality, strict social observances and exaggerated displays of assurance.In 1950, Kurt Schneider described the "fanatic psychopaths" and divided them into two categories: the combative type that is very insistent about his false notions and actively quarrelsome, and the eccentric type that is passive, secretive, vulnerable to esoteric sects but nonetheless suspicious about others.The descriptions of Leonhard and Sheperd from the sixties describe paranoid people as overvaluing their abilities and attributing their failure to the ill-will of others; they also mention that their interpersonal relations are disturbed and they are in constant conflict with others.In 1975, Polatin described the paranoid personality as rigid, suspicious, watchful, self-centered and selfish, inwardly hypersensitive but emotionally undemonstrative. However, when there is a difference of opinion, the underlying mistrust, authoritarianism and rage burst through.In the 1980s, paranoid personality disorder received little attention, and when it did receive it, the focus was on its 
potential relationship to paranoid schizophrenia. The most significant contribution of this decade comes from Theodore Millon who divided the features of paranoid personality disorder to four categories:1) behavioral characteristics of vigilance, abrasive irritability and counterattack,
2) complaints indicating oversensitivity, social isolation and mistrust,
3) the dynamics of denying personal insecurities, attributing these to others and self-inflation through grandiose fantasies
4) coping style of detesting dependence and hostile distancing of oneself from others. Controversy
Due to repeated concerns of the validity of PPD and poor empirical evidence, it has been suggested that PPD be removed from the DSM.