5.06 Cluster A Personality Disorders Psychiatry review for the USMLE Step 1 Exam. The cluster A personality disorders include paranoid, schizoid, and schizotypal. These disorders are characterized by individuals who are perceived as weird, awkward, and quiet. Personality disorders differ from normal personality quirks based on their negative impact on daily life, lack of awareness of the problem, and deviation from cultural expectations. Paranoid Personality Disorder: Patients are chronically suspicious and distrustful of others, without persistent fixed delusions. Key characteristics include unwarranted suspicions, doubts about loyalty, reluctance to confide, reading hidden meanings, holding grudges, perceiving attacks on reputation, and suspicion of infidelity. Schizoid Personality Disorder: Individuals prefer isolation and have difficulty forming relationships. Criteria for diagnosis include a lack of interest in close relationships, solitary activities, indifference to praise or criticism, emotional coldness, and flattened affectivity. Schizotypal Personality Disorder: Considered a less severe form of schizophrenia, with odd behavior, speech, thinking, and mild perceptual experiences. Notable features include social isolation, "magical" beliefs, mild paranoia, constricted affect, and social anxiety.