Schizoid personality disorder

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Template:DiseaseDisorder infobox Schizoid personality disorder (SPD) is a personality disorder characterised by a lack of interest in social relationships, a tendency towards a solitary lifestyle, and emotional coldness. SPD is reasonably rare compared with other personality disorders. Its prevalence is estimated at less than 1% of the general population¹.

Contents 1 Diagnostic criteria (ICD-10) 2 Diagnostic criteria (DSM-IV-TR) 3 Status of SPD as a mental disorder 4 SPD and other disorders 4.1 Schizoid personality disorder and schizophrenia 5 Treatment 6 See also 7 External Links 8 References

Diagnostic criteria (ICD-10)

According to the ICD-10, schizoid personality disorder is characterised by at least three of the following criteria:

• Emotional coldness, detachment or reduced affectivity.
• Limited capacity to express either positive or negative emotions towards others.
• Consistent preference for solitary activities.
• Very few (if any) close friends or relationships, and a lack of desire for such.
• Indifference to either praise or criticism.
• Taking pleasure in few, if any, activities.
• Indifference to social norms and conventions.
• Preoccupation with fantasy and introspection.
• Lack of desire for sexual experiences with another person.

Diagnostic criteria (DSM-IV-TR)

The DSM-IV-TR, a widely used manual for diagnosing mental disorders, defines schizoid personality disorder as:

A. 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 four (or more) of the following:

1. neither desires nor enjoys close relationships, including being part of a family
2. almost always chooses solitary activities
3. has little, if any, interest in having sexual experiences with another person
4. takes pleasure in few, if any, activities
5. lacks close friends or confidants other than first-degree relatives
6. appears indifferent to the praise or criticism of others
7. shows emotional coldness, detachment, or flattened affectivity

B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects of a general medical condition.

Status of SPD as a mental disorder

It is disputed whether SPD should be considered a "disorder" at all, since it does not necessarily involve any suffering either for the affected individual or for others. Many people are critical of society's tendency to pathologise certain personality styles simply because they are unconventional. In their opinion, such a tendency is incompatible with the idea that an individual may choose any lifestyle that he or she desires, as long as it does not disrupt the social order. Others think that, in some cases, strong SPD symptoms may result in an affected person living a dull and unfulfilling life. They think that this is a sufficient argument for maintaining SPD as a personality disorder. Some argue that a strong differentiation should be made between Schizoid Personality Type and Schizoid Personality Disorder, the former being merely a pattern of or trend toward elective solitude, and the latter being a genuine and literal lack of ability to become socially engaged, the degree of which would ordinarily indicate a developmental disorder if the accompanying social skills were also retarded in that way.

SPD and other disorders

SPD is believed by some to correlate with the INTJ and INTP personality types in the Myers-Briggs Type Indicator (MBTI). SPD is far more common amongst males than females, although this could be due in part to the fact that schizoid symptoms are far less socially acceptable in women.

SPD shares several aspects with depression, avoidant personality disorder and Asperger's Syndrome, and can be difficult to distinguish from these other disorders. However, there are some important differentiating features:

• While people who have SPD can also suffer from a clinical depression, this is certainly not always the case. Unlike depressed people, persons with SPD generally do not consider themselves inferior to others, although they will probably recognise that they are different.
• Unlike avoidant personality disorder, those affected with SPD do not avoid social interactions due to anxiety or feelings of incompetence, but because they are genuinely indifferent to social relationships; however, in a 1989 study², "schizoid and avoidant personalities were found to display equivalent levels of anxiety, depression, and psychotic tendencies as compared to psychiatric control patients".
• Unlike Asperger's Syndrome, SPD does not involve physical symptoms such as hand-flapping or lack of eye-contact. Other symptoms that are typical of Asperger's syndrome, but not of SPD, are an impairment in the use of nonverbal communication, strict adherence to routines or rituals, and a preoccupation with parts of objects. People who are afflicted with Asperger's syndrome often have very intense interests, while people with SPD are typically more indifferent with regard to their activities (however, in a sample of schizoid children, Sula Wolff noticed that "Having special interest patterns differentiated highly between schizoid and control boys".) SPD does not affect the ability to express oneself or communicate effectively with others, and is not believed to be related to any form of autism.

Schizoid personality disorder and schizophrenia

There is also disagreement about the relationship between SPD and schizophrenia. Some argue that the two conditions are entirely unrelated except by the origin of the word (meaning "split", in the case of SPD it is the individual that is "split" from society, rather than the actual mind being damaged), while others maintain that SPD exhibits a subset of the symptoms of schizophrenia and may, in rare cases, be an indicator of the onset of the more serious disease. There is a wider consensus to link schizotypal personality disorder with schizophrenia.

Treatment

People who have SPD generally do not seek psychological treatment, except when they are compelled to enter therapy to solve another problem, such as an addiction. They may benefit from social skills training, although it can be argued that an improvement in social skills does not address the personality disorder itself. Since schizoid traits are very similar to negative schizophrenic symptoms atypical antipsychotics may have efficacy in alleviating them.

See also

• Asperger's syndrome
• Avoidant personality disorder
• Schizotypal personality disorder

External Links

• Oppressed Group: Schizoid, A Personality, Not a Disorder: An essay defending the position that SPD is not a valid mental disorder.
• A comprehensive overview of SPD with many references.

References

• [1] Weismann, M. M. (1993). "The epidemiology of personality disorders. A 1990 update." Journal of Personality Disorders, Spring issue, Suppl., pp 44-62.
• [2] Overholser JC, "Differentiation between schizoid and avoidant personalities: an empirical test", Can J Psychiatry. 1989 Nov;34(8):785-90