Schizoid personality disorder is one of the three personality disorders included in the cluster ‘A’ grouping. Cluster ‘A’ personality disorders are characterized by odd or eccentric behavior. The other two personality orders included in this grouping are Schizotypal personality disorder, and paranoid personality disorder.
Social isolation and emotional detachment are the core symptoms leading to a schizoid personality diagnosis.
Many people suffering from schizoid personality disorder continue to function fairly well in society. Although these individuals may struggle with all types of relationships, but often gravitate to employment where human interaction is limited or superficial such as night security officers, lab workers, or computer programmers.
”The word schizophrenia was coined by the Swiss psychiatrist Eugen Bleuler in 1908, describing the separation of function between personality, thinking, memory, and function” (2022). Within Bleuler’s 1908 exposition in schizophrenia (The Prognosis of Dementia Praecox: The Group of Schizophrenias), he appears to originate the term schizoid.
Schizoid personality disorder has been present in all five editions of the DSM. “Until the introduction of schizotypal personality disorder into DSM in 1980, schizoid personality disorder was the predominant non-psychotic diagnosis within the schizophrenia spectrum” (Siever, et al., 2012).
Schizoid was used by the psychoanalytical community to denote a defensive style of taking a “position” or “stance” by withdrawing into the self (2012).
Schizoid personality disorder usually begins by early adulthood, though some features may be noticeable during childhood. These features may cause you to have trouble functioning well in school, a job, socially or in other areas of life. However, you may do reasonably well in your job if you mostly work alone.
Schizoid personality disorder patients:
- prefer to be alone (avoid social activities)
- don’t enjoy close relationships, even with family members
- have no friends outside of first degree relatives
- have little desire for sexual relationships
- can’t experience pleasure
- have difficulty expressing emotions and appropriately reacting to situations (difficulty relating to others)
- are aloof, showing little emotion
- appear emotionless, indifferent and cold to others
- may lack motivation and goals
- do not react to praise or critical remarks from others
- chooses solitary jobs and activities
- might daydream and/or create vivid fantasies of complex inner lives.
Little is known about the causes of Schizoid personality disorder. Scientist believe there is both genetic and environmental roles contributing to the disease. Perhaps, fitting into the diathesis stress model that theorizes that “that disorders develop as a result of interactions between pre-dispositional vulnerabilities (the diathesis), and stress caused by life experiences” (Murphy, 2021a).
Epigenetics also helps describe disease as specific inherited genes that are activated by environmental exposures. “A gene is subject to external influences that may activate gene expression” (Murphy, 2021b). There is a higher risk for schizoid personality disorder in families of schizophrenics. This suggests that a genetic susceptibility for the disorder might be inherited. Many mental health professionals speculate that a “bleak childhood where warmth and emotion were absent contributes to the development of the disorder” (WebMD).
Prevalence and Diagnosis of Schizoid Personality Disorder
“Schizoid encompasses a constellation of features of social indifference and constriction of affect that affects approximately 3% to 5% of the population nationally” (Cook et. al., 2019). While this personality disorder is not uncommonly diagnosed in adults, it is rarely diagnosed in children.
DSM lists the following criteria for diagnosis:
A. A pervasive pattern of indifference to social relationships and a restricted range of emotional experience and expression, beginning by early adulthood and present in a variety of context, as indicated by at least four of the following:
- neither desires nor enjoys close relationships, including being part of a family;
- almost always chooses solitary activities;
- rarely, if ever, claims or appears to experience strong emotions, such as anger and joy;
- indicates little if any desire to have sexual experiences with another person (age being take into account);
- is indifferent to the praise and criticism of others;
- has no close friends or confidants (or only one) other than first degree relatives;
- displays restricted affect, e.g., is aloof cold, rarely reciprocates gestures or facial expressions, such as smiles or nods.
B. Occurrence not exclusively during the course of Schizophrenia or a Delusional Disorder.
Schizoid Personality Disorder or an Autism Spectrum Disorder
Perhaps, part of the reason few children are diagnosed with schizoid personality disorder is because of the overlap of symptomology with autism spectrum disorders. A child exhibiting traits of “proneness to isolation and limitations in range of affect, have historically been more readily attributed to autistic psychopathy in children” (2019). Some reports suggest that patients with schizoid personality disorder “are more affected by deficits in social motivation, whereas those with autism spectrum disorders are more affected by deficits in social skills or capacity” (2019). The overlap is a recognized problem and specifically noted in DSM-V.
Risks and Complication
People with this disorder are at an increased risk of:
- Developing schizotypal personality disorder, schizophrenia or another delusional disorder
- Other personality disorders
- Major depression
- Anxiety disorders
Treatment for Schizoid Personality Disorder
People with schizoid personality disorder rarely seek treatment. This disorder is “rigid and persistent in its resistance to exterior influences.” People with schizoid personality disorder are typically unwilling to accept treatment and when they do, they are more resistant to therapeutic strategies” (Nirestean, et al., 2012).
Because of the preferred social isolation, the concept of therapy is not appealing. People with disorder often don’t see a need to correct their relationship issues, not to mention the avoided social interaction that is inherent in a therapy session.
Therapists are challenged with building trust with the schizoid patient. This can be time consuming.
According to WebMD medication is typically not used to treat schizoid personality disorder, however, it may be prescribed to treat associated symptoms such as depression or anxiety.
Cook, M., Zhang, Y., & Constantino, J. (2019). On the Continuity Between Autistic and Schizoid Personality Disorder Trait Burden. The Journal of Nervous and Mental Disease, 208(2), 94-100.
Nirestean, A., Lukacs, E., Cimpan, D., & Taran, L. (2012). Schizoid personality disorder—the peculiarities of their interpersonal relationships and existential roles. Personality and Mental Health, 6(1), 69-74.
Siever, L., Triebwasser, J., Chemerinski, E., & Roussos, P. (2012). Schizoid Personality Disorder. Journal of Personality Disorders, 26(6), 919-926.