Schizoid Personality Disorder: DSM-5 EPPP Lecture Video

The video below is the section for Schizoid Personality Disorder from Part 7 of TSM’s lecture series on DSM-5 and the EPPP, followed by a transcript. This lecture series aims to equip those preparing for the EPPP with everything you need to know about the impact DSM-5 will be having on the EPPP. To watch all of Part 7, click HERE. To watch earlier lectures in this series, or register for our webinar series on DSM-5 and the EPPP, click HERE.

Transcript of DSM-5 EPPP Lecture Video: Schizoid Personality Disorder

NARRATIVE DEFINITION:

Schizoid Personality Disorder is a Cluster A Personality Disorder characterized by detachment from social relationships and restricted affect in interpersonal settings. Others tend to view individuals with Schizoid Personality Disorder as emotionally distant, cold, and aloof. People with this disorder are often classified as loners, observing rather than participating in the world around them. They appear unresponsive to criticism and praise and neither enjoy nor seek out close relationships.

Interpersonal interactions may be limited to close relatives, as individuals with this disorder rarely have friends or romantic partners and are indifferent to physical as well as emotional intimacy. There is little, if any, desire to engage in sexual relationships with others. If given a choice, individuals with this disorder prefer solitary activities and hobbies, which are often mechanical or abstract in nature (e.g., computer or mathematical games). There are very few activities from which these individuals derive pleasure, as they appear to have a limited capacity for enjoying sensory, bodily, or interpersonal experiences.

Individuals with Schizoid Personality Disorder often may fail to reciprocate subtle social signals such as smiling or nodding, and they don’t display emotional reactivity in social interactions. They respond to major life events, both positive and negative, with a flattened affect. Even when directly provoked, these individuals rarely express anger and tend to be passive in most responses, which may lead to a lack of direction in life. They may experience occupational impairment when their jobs require social interaction, although they may function well in more solitary positions. In the rare instance when such individuals may partially reveal themselves, they may admit to painful feelings, particularly regarding social interactions.

As children or adolescents, these individuals are likely to have experienced poor peer relationships, academic underachievement, and teasing. Individuals with Schizoid Personality Disorder may be at risk for developing Major Depressive Disorder or becoming homeless, possibly due to the lack of a social support network (Hersen, 2007). Individuals who have family members with Schizophrenia or Schizotypal Personality Disorder are at an increased risk of developing Schizoid Personality Disorder. In some cases, Schizoid Personality Disorder may be a precursor to Delusional Disorder or Schizophrenia. Schizotypal, Paranoid, and Antisocial Personality Disorders often co-occur with this disorder.

Schizoid Personality Disorder can be differentiated from Avoidant Personality Disorder chiefly by the lack of apparent desire for close relationships in the former. In contrast, individuals with Avoidant Personality Disorder are quite eager for contact, but their heightened sensitivity to rejection or ridicule prevents them from seeking relationships. It can be difficult to differentiate from milder forms of Austism Spectrum Disorder, but severely impaired social interaction stereotyped behavior are suggestive of a more severe form of Autism.

Schizoid Personality Disorder is rare in clinical settings; as is the case with many personality disorders, these individuals rarely seek treatment. When they do, however, it is usually because they are experiencing increased life stress or pressure. Overall, slightly more men than women receive this diagnosis. Psychotherapy will generally be solution-focused, addressing immediate concerns rather than underlying personality issues, because individuals with Schizoid Personality Disorder have difficulty forming the sort of close, trusting relationships necessary for engaged, sustained treatment.

FLASHCARD:

Schizoid Personality Disorder
1. Cluster A personality disorder, marked by detachment from social interactions and relationships, restricted range of emotional expression, and oblivion to subtleties of social interaction
2. Little desire for intimacy and close relationships; appear odd and aloof to others
3. Limited affective range; educational or occupational impairment likely, though may function well in jobs requiring little or no human contact (computers, movie operators, etc.)
4. Prefer solitary activities and hobbies often mechanical or abstract in nature (e.g., computer or mathematical games)
5. Very few activities from which these individuals derive pleasure, as they appear to have a limited capacity for enjoying sensory, bodily, or interpersonal experiences
6. As children or adolescents, these individuals are likely to have experienced poor peer relationships, academic underachievement, and teasing
7. Distinguishable from Avoidant Personality Disorder because of the heightened sensitivity and fear of rejection in the latter. In Schizoid P.D., there is not the motivation for contact in the first place
8. Schizotypal, Paranoid, and Antisocial Personality Disorders often co-occur
9. Risk for developing Major Depressive Disorder or becoming homeless, possibly due to the lack of a social support networks
10. Rare in clinical settings, because lack of self-referral. Psychosocial stress may lead the person to seek treatment

Treatment
1. Usually solution-focused, addressing immediate concerns
2. Lack of interpersonal engagement prevents deep therapeutic, longer term interactions

QUESTION:
When praised by others, individuals with Schizoid Personality Disorder are most likely to:

ANSWERS:
A. demonstrate heightened emotionality.
B. counter the praise with self-criticism.
C. respond with indifference.
D. be suspicious of the motivation behind the praise.

RATIONALE:
C is correct, as persons with Schizoid Personality Disorder typically respond to praise with indifference and aloofness. A is incorrect, as this is the opposite of what is true, and would be more typical of a cluster B personality disorder; B is incorrect, as this would be more typical of someone with a self-deprecating attitude, for example, a person suffering from depression, or low self-esteem. D is incorrect, as this is more characteristic of schizotypal disorder.

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