What is Schizoid Personality Disorder?
Often misunderstood and labelled as loners, awkward or cold, schizoid personality disorder is a mental illness that is not well known and highly misunderstood. Schizoid personality disorder is a mental illness that refers to people who exhibit a pattern of detachment from social relationships as well as a limited expression of emotions, particularly in relation to other people.
According to the DSM-5, to meet the criteria for schizoid personality disorder a person must exhibit four or more of the following seven symptoms.
Firstly, people with schizoid personality disorder do not desire or enjoy close relationships, including being part of a family. These people do not appear to have a need for intimacy or to be part of a social group; they are indifferent to opportunities for close relationships.
Secondly, these people almost always choose solitary activities. They have a preference for being alone, appearing to socially isolate themselves and will often choose activities that do not involve interaction with other people.
Thirdly, they will have little, if any, interest in having sexual experiences with another person.
Fourthly, they will take pleasure in few, if any, activities.
Fifthly, people with schizoid personality disorder tend to lack close friends or confidants other than first-degree relatives, although many seclude themselves even from family.
Sixthly, these people appear indifferent to the praise or criticism of others. They are not generally bothered by what others think of them whether this be positive or negative and rarely respond appropriately to social cues e.g. reciprocating gestures or facial expressions.
Seventhly, they show emotional coldness detachment or flattened affectivity. These people do not report an experience of strong emotions and their affect often appears to be restricted.
Schizoid personality disorder should also not occur during the course of schizophrenia, a bipolar disorder, a depressive disorder with psychotic features, another psychotic disorder or autism spectrum disorder.
It should also be confirmed that these symptoms are not attributable to the physiological effects of another medical condition. People with schizoid personality disorder will often respond passively to differing life circumstances. Many of these people appear somewhat directionless and do not express strong desire to pursue any particular goals.
What are the risk factors for schizoid personality disorder?
People with relatives with schizophrenia or schizotypal personality disorder may be more likely to develop schizoid personality disorder. Furthermore, people who have experienced risk-associated stress throughout their childhood and adolescence, including major depressive disorder may also hold a greater predisposition for schizoid personality disorder. In adult prisoners, those with a history of childhood institutionalisation were found to be associated with traits of schizoid personality disorder.
What are the treatment options?
Although schizoid personality disorder is associated with a poorer quality of life and a potentially debilitating mental illness, research into the treatment of this personality disorder has been scarce and inconclusive. Originally, it was thought that low doses of atypical antipsychotics may be used to alleviate social deficits and blunted affects however research has since concluded that this is not an effective method.
Psychotherapy also proves challenging in treating schizoid personality disorder, largely due to the difficulties in establishing relationships with a therapist and a low motivation for treatment. Some research suggests that cognitive behavioural therapy CBT may be useful in addressing some of the underlying symptoms of schizoid personality disorder however more research is needed in this area.