Healthy levels of suspicion can help us question the intentions behind unexpected communications, such as texts. However, excessive suspicion may escalate into paranoia, where individuals hold unwarranted beliefs about harm or deceit from others. For example, a grandfather's irrational distrust towards his caring grandson illustrates how paranoia manifests. The DSM-5 TR outlines diagnostic criteria for paranoid personality disorder, including unjustified doubts about loyalty, interpreting benign actions negatively, and persistent grudges. Important to diagnosis is the exclusion of symptoms present during psychotic episodes related to other psychological disorders.
To rise to the level of psychiatric concern, symptoms must be out of proportion to any evidence; e.g., a grandfather suspects his 33-year-old grandson Eric asking questions about family generations.
According to the DSM-5 TR, criteria for paranoid personality disorder includes elements of cognition and behavior that reach back to one's early adulthood and are present in various contexts.
Symptoms of paranoid personality disorder include unjustified doubts about loyalty, reluctance to confide, reading benign actions as threatening, and persistent grudges.
Diagnosis of paranoid personality disorder must exclude symptoms occurring during schizophrenia, bipolar or depressive episodes with psychotic features.
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