Diagnostic Criteria for Schizoid Personality Disorder

1. 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 appears indifferent to the praise or criticism of others
   6. shows emotional coldness, detachment, or flattened affectivity

   The Dimensional Perspective

   Here is a hypothetical profile for Schizoid Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306):

   High Neuroticism
   Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.
   
   Low Extraversion
   Social isolation, interpersonal detachment, and lack of support networks; flattened affect; lack of joy and zest for life; reluctance to assert self or assume leadership roles, even when qualified; social inhibition and shyness.
   
   
   High Openness
   Preoccupation with fantasy and daydreaming; lack of practicality; eccentric thinking (e.g., belief in ghosts, reincarnation, UFOs); diffuse identity and changing goals: for example, joining religious cult; susceptibility to nightmares and states of altered consciousness; social rebelliousness and nonconformity that can interfere with social or vocational advancement.
   
   
   Low Agreeableness
   Cynicism and paranoid thinking; inability to trust even friends or family; quarrelsomeness; too ready to pick fights; exploitive and manipulative; lying; rude and inconsiderate manner alienates friends, limits social support; lack of respect for social conventions can lead to troubles with the law; inflated and grandiose sense of self; arrogance.
   
   
   Low Conscientiousness
   Underachievement: not fulfilling intellectual or artistic potential; poor academic performance relative to ability; disregard of rules and responsibilities can lead to trouble with the law; unable to discipline self (e.g., stick to diet, exercise plan) even when required for medical reasons; personal and occupational aimlessness.

   Specific Affects

   Emotional coolness or aloofness (absence of warm, tender feelings for others), constricted affect, indifference to praise or criticism or to the feelings of others, anhedonia, shyness, distrust, introversion, discomfort with intimacy, loneliness, anxieties concerning the mother-child symbiosis and other close relationships, feelings of utter unworthiness--but also of superiority, self-consciousness and feeling ill at ease with people, oversensitivity, destructive feelings, painful feelings, overwhelming anxiety (or even psychosis), emotional distance, intense loneliness, inordinate guilt over masturbation, fear of going crazy, sensitivity to slights (Stone, pp. 2712-2717).

   Anhedonia, aversiveness, or introversion; social anxiety; depression (Gunderson & Philips, pg. 1445).

   Character Weaknesses and Vices *

   • prefers to be alone
   • prefers solitary activities
   • emotionally constricted
   • indifferent to sex
   • no close friends*
   • aloof
   • indifferent to opinion

   * Derived from Michael Stone's (pg. 22) list of the "personality traits" of DSM-III-R Schizoid Personality Disorder. Descriptors marked with an asterisk, he says, are not true personality traits.

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   The Behavior Perspective

   Motivations

   Want to avoid interpersonal relationships because others are intrusive and unrewarding (Beck & Freeman, pg. 120).

   Behaviors

   Detachment from social relationships, avoidance of opportunities for intimacy and close relationships, spending most of their time alone, almost always choosing solitary activities or hobbies, prefering mechanical or abstract tasks, showing little interest in having sexual experiences with another person, maintaining an indifference to the approval and criticism or others, not responding appropriately to social cues.

   Difficulty expressing anger, lack of direction and goals, reacting passively to adverse circumstances, difficulty responding appropriately to important life events, lack of social skills, lack of desire for sexual experiences, forming few friendships, dating infrequently, often not marrying, occupational functioning often impaired (American Psychiatric Association, pp. 694-695).

   Associated Disorders

   Brief psychotic episodes, Delusional Disorder, Major Depressive Disorder, Schizophrenia (American Psychiatric Association, pg. 695).

   Dysthymic Disorder, Social Phobia, Agoraphobia (Gunderson & Philips, pg. 1445).

   The Life Story Perspective

   Childhood

   "Retrospective assessment suggests that patients with schizoid personality disorder often have histories of grossly inadequate, cold, or neglectful early parenting, which often began early in life. Psychodynamic theories suggest that these traumatic experiences create an expectation that relationships will not be gratifying and a subsequent defensive withdrawal from others" (Gunderson & Philips, pg. 1445).

   Intrusive mothering, detached fathering.

   next: Symptoms, Causes and Risk Factors

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   Reviewed: 04/2006