Schizoid Personality Disorder DSM: Signs And Symptoms

Updated August 27, 2020

Medically Reviewed By: Laura Angers

Schizoid Personality Disorder is one of the “Cluster A personality disorders” on the Diagnostic and Statistical Manual of Mental Disorders. Individuals who have “Cluster A personality disorders” are characterized by the manual as odd or eccentric.

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Schizoid Personality Disorder is not very common in the population as the percentage of people who have the disorder range from 3.1% to about 4.9%. The disorder is also more common in males than in females.

The disorder is often difficult to diagnose as people with the disorder don’t often show distress with the condition. They usually just prefer to be left alone, where they take pleasure in the very few things that might interest them.

The American Psychiatric Association APA defines the disorder as a widespread form of detachment from social relations and a limited range of expressing emotions in interpersonal environments, starting early adulthood and may manifest in different contexts.

Diagnostic Criteria

The American Psychiatrically Association in its Diagnostic and Statistical Manual of Mental Disorders put forward a set of criteria of which if four or more are present, an individual may be said to have Schizoid Personality Disorder

  • No desire for or enjoyment of close relations, which includes family relationships.
  • The continuous and consistent choice of solitary activities.
  • Little to no interest in performing sex with another person.
  • Derivation of pleasure from few to no activity.
  • Lack of intimate friendships or confidants except for first-degree relatives.
  • The appearance of indifference to the appreciation or judgment of others.
  • Detachment, flattened affect, or emotional coldness.

An individual can’t be said to have the disorder if it occurs exclusively during schizophrenia, a bipolar disorder, or depressive disorder with psychotic features or any other psychotic disorder.

Individuals with an autism spectrum disorder or who have medical conditions that explain the other symptoms can also not be diagnosed with the disorder.

Signs and Symptoms of Schizoid Personality Disorder

No desire for or enjoyment of close relationships, including family relationships

People with Schizoid Personality Disorder tend not to want close relationships, including family relationships. They are usually not interested in starting, building, or maintaining any relationship. This extends from home to school to the workplace. They usually prefer to do things alone.

The continuous and consistent choice of solitary activities

Since people with Schizoid Personality Disorder don’t enjoy being with other people, one of the symptoms they all tend to exhibit is the consistent choice to act on things alone. They usually will not do anything with others. They tend to thrive with activities that allow them to be alone such as certain mechanical tasks or abstract tasks like puzzles, math, or computer games.

Little to no interest in having sexual experiences with another person

The lack of interest in social relationships with other people often extends to the sex life of people with Schizoid Personality Disorder. They are usually not interested in sexual activities with other people. Whatever sexual activity they engage tends to be self-oriented.

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Derivation of pleasure from few to no activity

People with this disorder tend to derive pleasure from very few activities. They don’t get pleasure from most things other people may get pleasure from. They have reduced experiences of pleasure from their sense organs. They sometimes gain pleasure from being alone and from some of their solitary activities.

Lack of close friends or confidants other than first-degree relatives

Since people with Schizoid Personality Disorder prefer to be left alone and tend not to make friends, they often lack close friends and or confidants. They tend to be close only to those they probably grew up with.

The appearance of indifference to the praise or criticism of others

People with Schizoid Personality Disorder tend to be oblivious to the social interactions around them. They are usually not interested in what others have to say about them. This includes the praises or criticisms of others. They may be interested in their grades, for example, but not the praise or the critic of a teacher about their grades.

Emotional coldness, detachment, or flattened affectivity

People with Schizoid Personality Disorder tend to show very few facial expressions. They are often described as unemotional, and their poker or expressionless face is almost always on. When something happens in their lives, they tend not to react with strong emotions. The death of a loved one, for example, might be taken with the same calm and lack of emotional display as the news of cold tea spilled on the table.

They tend not to experience strong emotions like anger or joy. They also tend to be cold and aloof and distant.

Other Features of Schizoid Personality Disorder

Difficulty expressing Anger: people with Schizoid Personality Disorder often find it difficult to display or show anger regardless of the provocation. This makes those who know them to be further convinced that they lack emotions.

Lack of focus or direction: people with Schizoid Personality Disorder may sometimes appear not to have a clear focus or direction. For most people, there is an urge to be accepted socially, and this drives the goals of some people. People with the disorder don’t care much about what social graces and the opinions of people might not matter to them. They are thus not driven by what drives a lot of people and may appear directionless and unfocused.

Difficulty responding appropriately to adverse Events: people with Schizoid Personality Disorder tend to react passively and emotionlessly to adverse events. They are often unable to show the proper response to these events, retaining their calm, passive, and expressionless expression.

Lack of intimate relationships:  people with this disorder tend not to have any sexual or romantic relationships. People with the disorder often don’t get married. If they try to date someone, it is often because it has been forced on them. They are simply content and happy with being alone.

Work: People with Schizoid Personality Disorder tend to thrive well in areas of work that do not require social interaction. They tend not to do well with work that involves extended social interaction.

Brief Psychotic Episodes: people with this personality disorder might experience hallucinations or delusions that happen transiently when they are exposed to extreme levels of stress. These episodes don’t last long enough for a diagnosis to be made of another mental disorder.

A precursor to other mental disorders: in some instances, Schizoid personality disorder may lead to another mental disorder. In this case, Schizoid Personality Disorder is said to be the pre-morbid state of the individual before the new disorder.

Schizoid Personality Disorder can co-occur with other personality disorders such as schizotypal, paranoid, and avoidant personality disorders.

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Cause of Schizoid Personality Disorder

Symptoms of Schizoid Personality Disorder may first be noticed in childhood or adolescence. The cause is unknown, but there is some evidence of a genetic predisposition. There is an increased population of people with the disorder among relatives of people with schizophrenia or schizotypal personality disorder compared to the general population.

Differentials of Schizoid Personality Disorder

Schizoid Personality Disorder shares some symptoms with other mental disorders.

Schizoid Personality Disorder can be distinguished from delusional disorder, schizophrenia, and bipolar or depressive disorder with psychotic features by the fact that all these disorders have persistent delusions or hallucinations. People with Schizoid Personality Disorder might experience hallucinations or delusions but only briefly in periods of extreme stress.

It might be challenging to differentiate Schizoid Personality Disorder from Autism spectrum disorders. People with milder forms of Autism also show social impairments and often behave in stereotyped ways.

Substance Used Disorder can also show similar symptoms to Schizoid Personality Disorder.

Other personality disorders can also have symptoms similar to Schizoid Personality Disorder.

Characteristic social isolation and restricted affectivity are common to schizoid, schizotypal, and paranoid personality disorders. There are, however, ways of differentiating the disorders:

  • People with Schizoid Personality Disorder don’t have cognitive and perceptual distortions, unlike people with Schizotypal Personality Disorder.
  • People with Paranoid Personality Disorder tend to be suspicious and have paranoid ideation, unlike people with Schizoid Personality Disorder.
  • People with Avoidant Personality Disorder tend to have limited social interactions because they are scared of being embarrassed, being rejected, or being found inadequate, unlike people with Schizoid Personality Disorder. The latter is generally not bothered by the opinions of others.
  • People with Obsessive-compulsive Personality Disorder may also not display an affinity for social interaction. This, however, comes from a focus on work and discomfort with emotions. They can get intimate with others.

People who show high levels of introversion on the extraversion introversion scale might show some of the symptoms of Schizoid Personality Disorder. People who have just moved from one cultural background to another culture e.g., people who have moved from rural to urban environments or immigrants to a new country, might also show symptoms similar to Schizoid Personality Disorder.

They can’t, however, be said to have Schizoid Personality Disorder, except they show these symptoms to the extreme in inflexible and maladaptive ways, which cause significant functional impairment or subjective distress.

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Conclusion

If you are concerned that you or someone you care about might have a Schizoid Personality Disorder, you need not worry. You can get further information about the disorder from competent mental professionals at BetterHelp.

Reference

Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington [etc.]: American Psychiatric Publishing. 2013


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