Schizoid personality disorder involves a lack of interest or detachment from others along with a limited range of emotion expression. Those with overt ScPD are more clearly observed as loners by others, while individuals with covert ScPD are likely to mask their symptoms in order to fit in. There is very little research on this condition, and medication is not recommended unless someone has comorbid conditions. Social skills training may be beneficial for people who seek it out on their own.
- Schizoid personality disorder involves disinterest or detachment from people along with little to no expression of emotions. Someone may have overt or covert ScPD, which impacts their presentation.
- Individuals with ScPD may self-medicate or experience suicidal thoughts. In certain circumstances, this may place them at a higher risk of suicide attempts and substance use disorder.
- There are no medications or psychotherapy treatments designed specifically for ScPD, though individuals who pursue services may benefit from social skills training that incorporates their interests.
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What is Schizoid Personality Disorder (ScPD)?
Schizoid personality disorder is characterized by having a limited range of emotions that impact someone’s social functioning. It is common for individuals with ScPD to be described as aloof or introverted due to their blunted affect and detachment from others. As a result of ScPD, someone may isolate themselves and even avoid social interactions altogether. [1] This personality disorder is complex in nature and can negatively impact someone’s life, which is why affected individuals must be properly diagnosed so they can receive the appropriate treatment.
Overt vs. "secret" schizoid personality disorder
The two major types of this condition are overt and secret (or covert) schizoid personality disorder. While it may be difficult for the general population to identify someone with ScPD, those with the overt subtype are easily recognized as different from others due to their isolative behaviors and infrequent displays of emotion.
It is more difficult to pinpoint covert ScPD because these individuals often socialize in much the same way as others do. People with this type of ScPD have learned to behave a certain way in various settings and situations, such as at work or school, in order to fit in. So, while their socialization may not be quite as impaired as that of individuals with overt ScPD, they still have underlying difficulty experiencing emotions, sharing their feelings, and forming close bonds with others.
Key symptoms & traits
Individuals with schizoid personality disorder tend to possess certain signs as a result of their condition. Schizoid symptoms are considered more stable than those of other personality disorders, meaning they persist with the same severity over time. Schizoid symptoms include: [2]
- Lacking a desire for close bonds with others, including friends and family
- Gaining little to no enjoyment from sensory experiences traditionally viewed as enjoyable
- Possessing little to no close friends and very few relationships with relatives
- Demonstrating subtle, if any, emotional reactions in social settings
- Presenting as self-absorbed, aloof, or distant due to difficulty engaging with others
- Dating and engaging in sexual activity very infrequently, if at all
- Pursuing solitary hobbies
- Demonstrating difficulty picking up on social cues, leading to a lack of concern for others’ views of them
- Displaying passivity in response to major life events
- Presenting with a perceived lack of direction due to having no desire for traditional life events, such as marriage and having children
In the rare instances when individuals with ScPD disclose their feelings, they will report some discomfort in social interactions. This shows that many of the above symptoms are not absolute.
Causes & risk factors
There is very little research on this class of personality disorders. However, what little evidence that exists suggests that people with ScPD may have increased bilateral white matter volume in the motor pathways of their brains. This is believed to potentially cause impairments in sensory perception, emotion expression, attention, and language comprehension. These same structural changes are also thought to potentially contribute to negative symptoms and cognitive disorganization in other schizophrenia spectrum illnesses. [1]
Other data suggest that schizoid personality disorder may potentially develop in individuals who were raised by detached and neglectful caregivers. [2] These relationships may lead children to believe that all relationships lack satisfaction and meaning, which is an ideology they can carry with them through adulthood. However, ScPD develops from a combination of environmental, genetic, and biological factors, so while this factor may contribute, this alone cannot cause the condition.
How is Schizoid Personality Disorder diagnosed?
Individuals must undergo a comprehensive mental health evaluation in order to be diagnosed with schizoid personality disorder. Mental health professionals will compare someone’s reported symptoms and clinical signs with criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) as part of the assessment process.
In order to be diagnosed with ScPD, someone must display a pattern of disinterest/detachment from social bonds or a limited range of emotion expression in social interactions. In addition, they must display four or more other ScPD symptoms (such as choosing solitary activities, lacking desire for sexual experiences with others, or showing minimal interest in social norms or expectations, etc.). [2]
These symptoms must emerge by early adulthood in order for someone to be diagnosed with schizoid personality disorder. If someone displays symptoms after that time, they may be attributed to another psychiatric condition or a medical condition.
Versus other conditions
Schizoid personality disorder presents similarly to some other mental health concerns. This makes it crucial for individuals to receive a thorough evaluation so they can be connected with the appropriate treatment.
ScPD vs. Schizotypal personality disorder
These two schizophrenia spectrum disorders cause social impairments. However, individuals with schizotypal personality disorder also experience distorted cognitive patterns, including magical thinking, odd beliefs, and unique communication methods. [1] These are not present in individuals who have schizoid personality disorder.
ScPD vs. Avoidant personality disorder
This personality disorder is one of the conditions most commonly comorbid with ScPD, but the two conditions should not be mistaken for one another. The main difference between ScPD and avoidant personality disorder is that individuals with the latter often wish to engage with others despite having intense difficulty doing so. [1] Those with ScPD more often lack this desire altogether.
ScPD vs. Autism spectrum disorder
Individuals may believe social difficulties due to ScPD are actually the cause of autism spectrum disorder, since ASD is more well-known. [1] However, autism spectrum disorder is associated with more significant social impairments and other behavioral concerns such as aggression, rigid behaviors, and fixations.
ScPD vs. Schizophrenia
As with schizotypal personality disorder, ScPD and schizophrenia are both schizophrenia spectrum conditions that cause social impairments. However, schizophrenia is a far more pervasive condition that can also lead to psychotic symptoms such as delusions and hallucinations. As a result, someone with schizophrenia typically experiences more drastic functional concerns compared to someone with ScPD. [1]
Complications & comorbid disorders
The three conditions most commonly comorbid with ScPD are other personality disorders: paranoid personality disorder, schizotypal personality disorder, and avoidant personality disorder. Individuals with any personality disorder are at a higher risk of substance use disorder as well as suicidality. [1] Therefore, anyone with schizoid personality disorder should be monitored for signs of substance misuse and suicidal thoughts.
Schizoid Personality Disorder and substance use
In most cases, individuals with ScPD who use substances do so in an attempt to self-medicate and cope with emptiness or being different from others. Substance use can complicate the treatment process for schizoid personality disorder as well as worsen symptoms such as social isolation. Early identification of these concerns is important to properly manage ScPD and prevent substance use disorders from developing.
Treatment approaches
There are no large-scale research studies on treatment (either psychotherapy or pharmacological) for schizoid personality disorder. Therefore, it is difficult to determine the best options for individuals with this condition. In terms of pharmaceuticals, there are no medications specifically designed for ScPD. Due to the limited evidence of effectiveness, pharmacological treatment of ScPD is not advised unless it is used to address a comorbid psychiatric condition, but research is ongoing. [1]Â
Social skills training may be recommended for individuals who are motivated to better manage their condition. [2] If someone does receive psychotherapy, sessions may be more fruitful if they initially center on their hobbies and branch out slowly from there.
Coping with ScPD: Strategies for individuals
One of the best ways for individuals with schizoid personality disorder to manage their condition is to build purpose through self-care and meaningful activities. They can interact with others as they are comfortable, as having at least one supportive person in their life can be beneficial.
Supporting loved ones living with ScPD
Loved ones of those with schizoid personality disorder may wish to urge their loved one toward treatment. However, this is discouraged unless they present with significant safety concerns. [3] The best way to support someone with ScPD is to educate yourself on the condition, be patient with your loved one, and avoid pressuring them into activities they aren’t motivated to do. Loved ones can also suggest activities that do not require social interaction or have an emotional component, as these may naturally be of more interest to someone with ScPD. [2]
Outlook and prognosis
Seeking professional mental health treatment for ScPD can be difficult. However, if someone is aware of the impact ScPD has on their life and is motivated to make a positive change, their outlook is generally expected to be good. It is important to note that individuals with ScPD who do not seek treatment do not necessarily have a bad prognosis, especially since symptoms are expected to be stable across the lifespan. Someone with ScPD is more likely to experience a poor prognosis if recreational substance use develops into substance use disorder.
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