Differential diagnosis means making precise and differentiated assessments or decisions. It must be clear why a particular circumstance, such as a diagnosed disease, applies (and another does not), because the symptoms that have occurred exclude it. For the construct of manipulation, both the construct validity within the internal structure in the relationships of the feature facets and to other selected personality traits must be demonstrated. This also includes bizarre or peculiar character images that have been widespread and known since Theophrastus in antiquity. As far as possible, correlative relationships to suitable objective criteria should also be found and statistically verified.