Learning Objectives
Show We’ve learned about paranoid personality disorder, now let’s take a look at another Cluster A disorder: schizoid personality disorder. Persons with schizoid personality disorder are considered classic loners. Table 1. DSM-5 Personality Disorders
Schizoid Personality DisorderFigure 1. Schizoid personality disorder is characterized by a solitary lifestyle and detachment from others. Schizoid personality disorder (often abbreviated as SPD or SzPD) is a personality disorder characterized by a lack of interest in social relationships, a tendency toward a solitary or sheltered lifestyle, secretiveness, emotional coldness, detachment, and apathy. Affected individuals may be unable to form intimate attachments to others and simultaneously possess a rich and elaborate but exclusively internal fantasy world. Other associated features include stilted speech, a lack of deriving enjoyment from most activities, feeling as though one is an observer rather than a participant in life, an inability to tolerate emotional expectations of others, apparent indifference when praised or criticized, a degree of asexuality, and idiosyncratic moral or political beliefs. Symptoms typically start in late childhood or adolescence. Schizoid personality disorder (SPD) is described as a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. Beginning by early adulthood and present in a variety of contexts, as indicated by at least four of the following:
Those with schizoid personality disorder (SPD) may often be unable to, or will rarely, express aggressiveness or hostility, even when provoked directly. These individuals can seem vague or drifting about their goals and their lives may appear directionless. ComorbiditySchizoid personality disorder is often found to occur with at least one of several disorders or pathologies. Sometimes, a person with SPD may meet criteria for an additional personality disorder; when this happens, it is most often avoidant, schizotypal, or paranoid personality disorder. Alexithymia (the inability to identify and describe emotions) is often present in SPD. While SPD shares several symptoms with other mental disorders, there are some important differentiating features:
PrevalenceStudies suggest that SPD disorder has a prevalence of less than 1%. There is no difference observed in the frequency between males and females. EtiologyAlthough not much is definitively known regarding the etiology of schizoid personality disorder, it is assumed that genetics significantly contributes to the disorder. Twin studies using self-report questionnaires have estimated heritability rates for schizoid personality disorder to be about 30%. TreatmentPeople with schizoid personality disorder rarely seek treatment for their condition. This is an issue found in many personality disorders, which prevents many people who are afflicted with these conditions from coming forward for treatment: they tend to view their condition as not conflicting with their self-image and their abnormal perceptions and behaviors as rational and appropriate. Case StUdy: Schizoid Personality DisorderEdgar is a 26-year-old man. Despite extraordinary intelligence, Edgar was not able to complete or participate in any educational programs. He wanted to have a normal life with family and friends, but thought that he was rootless and he felt that other people thought that he was peculiar or odd. He felt that he was an outsider. As a child, he went to various schools because his parents moved around. He was thought of as a lonely wolf and did not participate in the social life, games, or sports with his peers. During class, he was often absent-minded, being absorbed in his own thoughts and fantasies. From around the age of thirteen, he became interested in computers and was quite advanced in his understanding of mathematics. Edgar became exceedingly isolated with his computer as his sole companion and remains detached from people to this day. He has never been in a relationship and expressed no desire to be in one. Edgar is diagnosed with schizoid personality disorder because of his pervasive pattern of detachment from social relationships, his emotional flatness, his lack of desire for relationships, and his preference for solitary activities. Figure 2. Some schizoid individuals can form relationships based on occupational activities. The vignette above illustrates the difficulties for those with schizoid personality disorder in establishing stable relationships with significant others like peers and family. Often it is regarded as unusual that a person with schizoid personality disorders complains that they feel isolated. Many schizoid patients, on the contrary, claim to be quite satisfied with their loneliness and it is quite unusual that they wish to have a family. Also, schizoid persons usually accept their situation or even deny any desire for closer relationships. People who have SPD tend to be happiest when in relationships in which their partner places few emotional or intimate demands on them and does not expect phatic or social niceties. It is not necessarily people they want to avoid, but negative or positive emotional expectations, emotional intimacy, and self-disclosure. Therefore, it is possible for individuals with SPD to form relationships with others based on intellectual, physical, familial, occupational, or recreational activities, as long as there is no need for emotional intimacy. Donald Winnicott explains this is because schizoid individuals “prefer to make relationships on their own terms and not in terms of the impulses of other people.” Failing to attain that, they prefer isolation. In general, friendship among schizoids is usually limited to one person, often also schizoid, forming what has been called a union of two eccentrics. Key Takeaways: schizoid personality disorderWatch ITThis video provides a brief overview of schizoid personality disorder. You can view the transcript for “Schizoid Personality Disorder in a Minute” here (opens in new window). Try ItGlossaryalexithymia: the inability to identify and describe emotions schizoid personality disorder: a personality disorder characterized by a lack of interest in social relationships, a solitary lifestyle, and detachment from others What are the two hallmark features of schizoid personality disorder?According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the essential feature of schizoid personality disorder is a persistent detachment from social relationships and limited emotional expression in social settings.
What is the criteria for schizoid personality disorder?Schizoid personality disorder is characterized by a pervasive pattern of detachment from and general disinterest in social relationships and a limited range of emotions in interpersonal relationships. Diagnosis is by clinical criteria. Treatment is with cognitive-behavioral therapy.
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