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The current study sought to provide evidence for a measure of schizoid personality disorder (SZD PD) traits using the Five-Factor Model framework of personality. In the first study, undergraduate participants ( n = 496) completed the Five-Factor Schizoid Inventory (FFZI) and other self-report measures. The first half of the sample was used to develop the FFZI, while the second half was used to validate it. The FFZI demonstrated excellent internal consistency, convergent validity with measures of SZD PD and hypothesized IPIP-NEO facets, and discriminant validity with other PDs and non-hypothesized IPIP-NEO facets. The second study recruited MTurk participants ( n = 181) and demonstrated preliminary support for the reliability and validity of the FFZI in an online, community sample. Ultimately, these data suggest that the FFZI is a useful measure of SZD PD and provide further evidence that SZD PD can be conceptualized as a maladaptive extension of introversion traits., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The present case report describes a 19-year-old male patient whose main symptoms were emotional coldness, absence of close relationships, difficulty experiencing pleasure with other people, and lack of motivation to work or to continue his studies. A schizoid personality disorder was diagnosed as a product of early maladaptive patterns such as inhibition, emotional deprivation, social isolation, and inadequacy. Likewise, a rigid and fragmented family context was evidenced, with an affective absence of parents and a focus on strict behavioral rules. The study aimed to intervene, from a cognitive clinical approach, the early maladaptive patterns and symptoms that maintained the features of schizoid personality disorder in the patient. For this purpose, cognitive behavioral therapy was carried out, with techniques such as debates, images to reparentalize, assignment of tasks, use of humor, and social skills training, among others. In conclusion, it can be stated that the early maladaptive patterns maintained the schizoid personality symptomatology. Finally, it was demonstrated through clinical and psychometric criteria that cognitive behavioral therapy decreased schizoid personality behaviors in the patient., Competing Interests: The authors declare that they have no conflict of interest with the published data., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

This study evaluated the potential of ChatGPT, a large language model, to generate mentalizing-like abilities that are tailored to a specific personality structure and/or psychopathology. Mentalization is the ability to understand and interpret one's own and others' mental states, including thoughts, feelings, and intentions. Borderline Personality Disorder (BPD) and Schizoid Personality Disorder (SPD) are characterized by distinct patterns of emotional regulation. Individuals with BPD tend to experience intense and unstable emotions, while individuals with SPD tend to experience flattened or detached emotions. We used ChatGPT's free version 23.3 and assessed the extent to which its responses akin to emotional awareness (EA) were customized to the distinctive personality structure-character characterized by Borderline Personality Disorder (BPD) and Schizoid Personality Disorder (SPD), employing the Levels of Emotional Awareness Scale (LEAS). ChatGPT was able to accurately describe the emotional reactions of individuals with BPD as more intense, complex, and rich than those with SPD. This finding suggests that ChatGPT can generate mentalizing-like responses consistent with a range of psychopathologies in line with clinical and theoretical knowledge. However, the study also raises concerns regarding the potential for stigmas or biases related to mental diagnoses to impact the validity and usefulness of chatbot-based clinical interventions. We emphasize the need for the responsible development and deployment of chatbot-based interventions in mental health, which considers diverse theoretical frameworks., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hadar-Shoval, Elyoseph and Lvovsky.)

Lower serum levels of low-density lipoprotein cholesterol (LDL-C) have been suggested to indicate higher suicide risk and various psychiatric symptoms. Previously, we reported that lower serum LDL-C levels are associated with loneliness, social phobia, isolated life with little social support, and lower trust in others among young non-clinical females. Thus, we hypothesize that schizoid personality traits may be associated with lower serum LDL-C. We here verified this hypothesis using non-clinical data and clinical data with schizophrenia. Using the database from the Midlife in Japan (MIDJA), a cohort of residents living in Tokyo, we analyzed whether schizoid-related interpersonal characteristics were associated with LDL-C. In addition, we assessed the association between blood biomarkers including LDL-C and schizoid personality traits in 101 adult non-clinical volunteers. Finally, we evaluated the interaction between LDL-C and social decision making of patients with schizophrenia. In female non-clinical volunteers, serum LDL-C level was a predictive factor and negatively correlated with schizoid personality traits. Female patients with schizophrenia, whose serum LDL-C levels were lower, tended not to trust other females. The present findings suggest that LDL-C may influence schizoid personality traits in females, which provide a basis for further investigation into the biological aspects of schizoid personality disorder.

Schizoid personality disorder (SZPD) is a Cluster A personality disorder whose essential feature is a lifelong pattern of detachment from social relationships and a restricted range of emotional expression. Although SZPD has been in every edition of the Diagnostic and Statistical Manual of Mental Disorders, empirical research on this disorder is actually limited, due to the fact that SZPD is rarely encountered in clinical settings. In fact, individuals with SZPD rarely present for treatment, as their isolation is often ego-syntonic; therefore, the prevalence of SZPD is not clearly established. Suicide ideation may be a running theme for individuals with SZPD. However, suicidality in SZPD is actually an underestimated topic. Aiming to draw more attention to this underestimated issue, with this paper the authors intend to provide a list of studies on suicidality in individuals with SZPD or traits, in the form of a clinical mini-review. Reported studies show that an underlying SZPD, or the presence of schizoid traits too, appear to be definitely a major risk factor for completed suicide and serious suicide attempts. This maladaptive personality disorder seems to not allow the individual to ask for help and to deny him the comforts of intimacy. Therefore, clinicians should be aware that schizoid traits suchs as solitary lifestyle, loneliness, emotional detachment, and impaired communication ability, are features associated with a vulnerability to suicidal behavior. We recommend the clinical assessment of this symptoms' constellation, in order to address patients with SZPD to most proper treatment.

Social avoidance in young patients is a clinically worrisome phenomenon that characterizes impending schizophrenia, but that also constitutes a core phenomenon in avoidant personality disorder (AvPD), schizoid personality disorder (ScPD), and in autism spectrum disorder (ASD). Especially in the absence of any other clinically relevant phenomena, understanding the origins of social avoidance may be one the most challenging tasks in assessing whether adolescents and young adults are at risk for developing schizophrenia. Descriptive and psychometric assessments only allow to comment on the absence or the presence of this phenomenon, but do not capture the origins and the meaning of social avoidance. Based on a narrative review, we highlight the importance of a phenomenological approach to unveil the Gestalt of social avoidance in these mental disorders, including and appraisal of the underlying mental structures and attachment styles. The phenomenological approach allows to distinguish the Gestalt of social avoidance between AvPD, ScPD, ASD, and beginning schizophrenia, to ensure correct diagnostic labelling and optimal treatment, and to avoid unwarranted stigmatization., (Copyright © 2021. Published by Elsevier B.V.)

The dynamics of the concept of the continual development of mental disease from the constitution that was the most clearly formulated by a Russian psychiatrist Th. Tiling in the discussion with the German psychiatrist C. Neisser is presented. The concept of Th. Tiling influenced E. Bleuler's approach to the description of basic and accessory symptoms of schizophrenia and also on E. Kretschmer's concept of constitution and mental disease. Main characteristics of cycloid and schizoid personality of E. Kretschmer's concept are presented. The author notes the very broad E. Kretschmer's understanding of 'psychesthetic proportion', which state explains not only the diversity of schizoid types but also many psychotic psychopathological phenomena. In addition to the altered affectivity, autism was the second basic symptom of schizophrenia, which mild manifestations form the basis for E. Kretschmer systematics of schizoid types. E. Kretschmer's understanding of autism was broader than Bleuler's and was presented by E. Kretschmer as a symptom derived from special schizoid affectivity (psychesthetic proportion). The critics of E. Kretschmer's concept by some contemporary German psychiatrists is also considered.

Background: The study presents the use of the Unified Protocol (UP) in a case of a male diagnosed with major depressive disorder and schizoid and depressive personality traits. The therapeutic focus of UP is to identify maladaptive behaviors of emotion regulation and to train new regulation strategies such as cognitive re-appraisal or emotional exposure exercises., Method: This is a single-case research study. The intervention was carried out in twenty 1-hour sessions for 6 months. After treatment completion, follow-ups were conducted at three, six, and twelve months., Results: The results of the 12-month follow-up revealed a clinically significant change in depressive symptomatology (RCI BDI-II = -5.51), negative affect (RCI NEGATIVE PANAS = -3.61), quality of life (RCIICV-Sp = 4.61) and schizoid (RCIMCMI-III-Schizoid = -4.36) and depressive (RCIMCMI-III-Depressive = -5.24) personality traits. Schizoid and depressive personality traits did not interfere with the application, course, and compliance with treatment. These results are discussed with regard to similar studies, also based on the use of the UP to work on emotion regulation in the treatment of emotional disorders with clinical comorbidity., Conclusions: The training of emotion regulation strategies through UP could be an effective proposal to treat emotional disorders with pathological personality traits comorbidity.

Although evidence with respect to its prevalence is mixed, it is clear that fathers perpetrate a serious proportion of filicide. There also seems to be a consensus that paternal filicide has attracted less research attention than its maternal counterpart and is therefore less well understood. National registries are a very rich source of data, but they generally provide limited information about the perpetrator as psychiatric, psychological and behavioral data are often lacking. This paper presents a fully documented case of a paternal filicide. Noteworthy is that two motives were present: spousal revenge as well as altruism. The choice of the victim was in line with emerging evidence indicating that children with disabilities in general and with autism in particular are frequent victims of filicide-suicide. Finally, a schizoid personality disorder was diagnosed. Although research is quite scarce on that matter, some research outcomes have showed an association between schizoid personality disorder and homicide and violence.

Aim: Schizoid (ScPD) and Schizotypal (SPD) personality disorders are rare and severe disorders. They are associated with high liability to schizophrenia and present an attenuated form of its negative symptoms, which are considered a putative endophenotype for schizophrenia. The trans-diagnostic study of negative symptoms in non-psychotic populations such as ScPD/SPD might provide useful markers of a negative-symptom domain; however, little is known about their neurobiological substrates. The aim of the study was to investigate differences in gray and white matter volumes in subjects with ScPD/SPD compared to a group of healthy controls., Methods: Structural magnetic resonance images were obtained from 20 never-psychotic subjects with ScPD/SPD and 28 healthy controls. Resulting values from clusters of differences were correlated in patients with relevant clinical variables (O-LIFE scale)., Results: ScPD/SPD presented greater bilateral white matter volume compared to healthy controls in the superior part of the corona radiata, close to motor/premotor regions, which correlated with the O-LIFE subtest of cognitive disorganization. No differences were found in regional gray matter or global gray/white matter volumes., Conclusion: Greater volumes in motor pathways might relate to cognitive symptoms and motor alterations commonly present in schizophrenia-related disorders. Given the established link between motor signs and psychosis, structural alterations in motor pathways are suggested as a putative biomarker of a negative-symptom domain in psychosis subject to further testing., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Social anhedonia and social anxiety are two constructs with similar behaviors including avoidance of and withdrawal from social situations. In three studies, the current research aimed to test whether social anhedonia could be discriminated from social anxiety using the most common measure of social anhedonia, the Revised Social Anhedonia Scale (RSAS). In Study 1, an item-level factor analysis of the RSAS found two factors: Social Apathy/Aversion and Social Withdrawal. In Study 2, this two-factor structure was confirmed in a separate sample. In Study 3, a model with social anhedonia and anxiety scale scores loading on separate factors fit better than a model with social anhedonia and anxiety loading on a single factor. Social anhedonia and anxiety displayed differential associations with negative schizotypy and emotion processing. Findings suggest that the RSAS is successful in measuring social anhedonia distinct from social anxiety., (© The Author(s) 2015.)

Introduction: A personality disorder is a pervasive and enduring pattern of behaviors that impacts an individual's social, occupational, and overall functioning. Specifically, the cluster A personality disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. Patients with cluster A personality disorders tend to be isolative and avoid relationships. The quality of life may also be reduced in these individuals, which provokes the question of how to treat patients with these personality disorders. The purpose of this review is to evaluate the current literature for pharmacologic treatments for the cluster A personality disorders., Methods: A Medline/PubMed and Ovid search was conducted to identify literature on the psychopharmacology of paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. There were no exclusions in terms of time frame from article publication or country of publication, in order to provide a comprehensive analysis; however, only articles that contained information on the cluster A disorders were included., Results: Minimal evidence regarding pharmacotherapy in paranoid and schizoid personality disorders was found. Literature was available for pharmacologic treatment of schizotypal personality disorder. Studies evaluating the use of olanzapine, risperidone, haloperidol, fluoxetine, and thiothixene did yield beneficial results; however, treatment with such agents should be considered on a case-by-case basis., Discussion: Most of the literature analyzed in this review presented theoretical ideas of what may constitute the neurobiologic factors of personality and what treatments may address these aspects. Further research is needed to evaluate specific pharmacologic treatment in the cluster A personality disorders. At this time, treatment with pharmacologic agents is based on theory rather than evidence.

As early as 1926, the Kiev-based child psychiatrist Grunya Efimovna Sukhareva (Груня Ефимовна Сухарева) (1891-1981) published a detailed description of autistic traits in a number of children in a scientific German psychiatry and neurology journal. She initially used the term "schizoid (eccentric) psychopathy" but later replaced it with "autistic (pathological avoidant) psychopathy" to describe the clinical picture of autism. Her original article was available almost two decades before the case reports of Asperger and Kanner; nevertheless, Sukhareva's pioneer work has been greatly overlooked. Here we present her description of autistic psychopathy in relation to the DSM-5 criteria of today.

Behavioral and cognitive dysfunction, particularly social and communication impairments, are shared between autism and schizophrenia spectrum disorders, while evidence for a diametric autism-positive schizophrenia symptom profile is inconsistent. We investigated the shared phenotype at a personality trait level, particularly its resemblance to schizoid personality disorder, as well as differential aspects of the autism-schizophrenia model. Items of the autism spectrum quotient (AQ) and schizotypal personality questionnaire (SPQ) were pseudo-randomly combined, and were completed by 449 (162 male, 287 female) non-clinical participants aged 18-40. A factor analysis revealed three factors; the first represented a shared social disorganization phenotype, the second reflected perceptual oddities specific to schizotypy while the third reflected social rigidity specific to autism. The AQ and SPQ were strongly correlated with Factor 1 (AQ: r = 0.75, p < 0.001; SPQ: r = 0.96, p < 0.001), SPQ score was correlated with Factor 2 (r = 0.51, p < 0.001), particularly in cognitive-perceptual features (r = 0.66, p < 0.001), and AQ score was strongly correlated with Factor 3 (r = 0.76, p < 0.001). Furthermore, there was no relationship between Factor 1 and Factor 2. Thus, there is robust evidence for a shared social disorganization phenotype in autistic and schizotypal tendency, which reflects the schizoid phenotype. Discriminating and independent dimensions of schizotypal and autistic tendency exist in Factors 2 and 3, respectively. Current diagnostic protocols could result in different diagnoses depending on the instrument used, suggesting the need for neuromarkers that objectively differentiate autistic and schizotypal traits and resolve the question of commonality versus co-morbidity.

The sense of agency, which is the awareness that "I am the one who causes action," is important in understanding passive schizophrenic symptoms and bodily self-consciousness. However, this potential linkage between subjective self-other attribution (explicit agency) and automatic self-monitoring of an action (implicit agency) has not been examined fully. The present study included two experiments conducted with the same group of healthy participants (N=48) in order to examine explicit (Exp. 1) and implicit (Exp. 2) measures of the sense of agency in speech. Exp. 1 suggested that participants who tend not to attribute a fed-back voice to themselves (the other-attribution group) might have a stronger tendency toward auditory hallucinations, as measured by the Auditory Hallucination Experience Scale 17 (AHES-17). Furthermore, the results of Exp. 2 suggested that this other-attribution group might not utilize auditory feedback during speech production, indicating the expected link between explicit and implicit agency. These results are discussed in relation to the sense-of-agency model, wherein people are understood to construct the online "self" monitoring of action., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

While treatment of personality disorders in general is often described as difficult and filled with many obstacles, knowledge is still limited regarding the specific treatment challenges for DSM's Cluster A individuals. The purpose of this paper is to explore these challenges, as illustrated by the case study of a schizoid patient who underwent psychodynamic therapy for over a year. Deep and unconscious interpersonal fears that complicated treatment, and how these fears had to be taken into account in therapeutic interventions, will be explored. Strong countertransference reactions, especially those evoked by long silences and constant management of optimal therapeutic distance, will also be discussed. This paper also proposes some reflections on the limitations of DSM's conceptualization of the schizoid personality disorder, and how a dynamic understanding of relational fears and ambivalence in these patients may be crucial to treatment.

Objective: To determine whether, in the general population, individuals in numerous abnormal body weight categories had higher odds of having personality disorders (PDs) than normal-weight individuals. Although personality functioning is hypothesized to be associated with body weight, there is a dearth of empirical evaluation of this topic., Methods: The association of body weight (five categories: underweight [body mass index [BMI] <18.5]; normal [18.5 or=40]) with personality disorders was investigated using data from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (n = 43,093). Lifetime paranoid, schizoid, antisocial, histrionic, avoidant, dependent, and obsessive-compulsive PDs were examined, as assessed by the Alcohol Use Disorders and Associated Disabilities Interview Schedule-DSM-IV version (AUDADIS-IV)., Results: After adjusting for sociodemographics, Axis I disorders, schizophrenia, physical health conditions, and comorbid PDs, extreme obesity was associated with antisocial or avoidant PDs (adjusted odds ratio (AOR) range = 1.66-1.73), whereas underweight was associated with increased odds of schizoid PD (AOR = 1.89). The pattern of associations differed when stratified by gender. Overweight men had lower odds of paranoid PD (AOR = 0.73). Women with higher-than-normal body weights had higher odds of paranoid, antisocial, and avoidant PDs (AOR range = 1.33-2.50), whereas underweight women more often met the criteria for schizoid PD (AOR = 1.95)., Conclusions: Higher-than-normal body weight is associated with paranoid, antisocial, and avoidant PDs for women, whereas overweight men have lower rates of paranoid PD and underweight women have higher odds of schizoid PD. Possible clinical implications of this research are discussed.

We report the case of a 31 year old healthy man without coronary risk factors, who made a suicide attempt with insulin caused by a chronic schizoid psychosis. The man was admitted to the hospital 14 hours later with non-specific chest pain and dizziness as clinical signs of a lateral wall myocardial infarction. The coronary angiography demonstrated intact coronary circulation and a broad area of myocardial damage of the left ventricular lateral wall. It is hypothesized that coronary artery vasospasm induced by hypoglycemia/hyperinsulinemia caused the myocardial infarction.

A case of unusual postmortem mutilation of a victim's body is presented. After killing his father, the son decapitated his body and dissected the scalp free, forming a mask of the father's head and neck. The young man wore the scalp-mask over his own head to imitate the father. The motive of the murder was revenge, and the postmortem mutilation was the realization of the perpetrator's fantasies, symbolically representing a penalty for the reprehensible past life of his father.

Millon Clinical Multiaxial Inventory (MCMI) scores from 299 suicidal psychiatric outpatients were cluster analyzed in hopes of identifying clinical subgroups and deriving specific treatment indications. The analysis revealed four personality profiles: Negativistic/Avoidant/Schizoid, Avoidant/Dependent/ Negativistic, Antisocial, and Histrionic/Narcissistic. This grouping was validated by examining demographics, diagnoses, and scores on several psychometric scales. Results showed few differences in demographics, diagnosis, or intelligence, but significant differences in depression severity, hopelessness, anxiety, problem-solving self-appraisal, and alcohol abuse. Implications for tailoring interventions for subtypes of suicidal patients are discussed.

The relationship between premorbid schizoid traits and the positive and negative symptoms assessed by the Andreasen's SANS and SAPS scales was studied in a sample of 115 DSM-III-R schizophrenics. For the assessment of the schizoid traits the abbreviated Philip's scale of premorbid social-personal adjustment was employed. Negative symptoms, excepting the attentional scale, but no positive symptoms were significantly correlated (p < or = .01) with the Philips's scale. These results suggest that the schizoid traits are the behavioral precursors of schizophrenic negative symptoms. The implications of the results for the genetic and vulnerability/stress models of schizophrenia are discussed.

The report covers a group of schizophrenic parents and their children (219 patients from 101 families); the author studied variants of premorbid personality traits, the patient's age at the onset of the disease, the duration of the initial period, its syndromes in the descending generation. Comparing signs in the pairs of parents-children the author detected the most stable signs in transmission to the descending generations. The following signs were attributed to such stable traits: schizoid personality traits, a short initial period, a psychopathlike syndrome in the initial period. Special tables were formed permitting to prognosticate the appearance of some signs in children when some signs were known in parents.

To determine the frequency of obsessive, compulsive, and schizoid behaviors in Tourette syndrome (TS), we prospectively questioned 246 patients with TS, 17 with attention-deficit disorder (ADD), 15 with ADD due to a TS gene, and 47 random controls. The comparative frequency of obsessive, compulsive, and repetitive behaviors--such as obsessive unpleasant thoughts, obsessive silly thoughts, echolalia, palilalia, touching things excessively, touching things a specific number of times, touching others excessively, sexual touching, biting or hurting oneself, head banging, rocking, mimicking others, counting things, and occasional or frequent public exhibitionism--were significantly more common in TS patients than in controls. The frequency of each of these was much higher for grade 3 (severe) TS. Most of these behaviors also occurred significantly more often in individuals with ADD or in individuals with ADD secondary to TS (ADD 2(0) TS). When these features were combined into an obsessive-compulsive score, 45.4% of TS patients had a score of 4-15, whereas 8.5% of controls had a score of 4 or 5. These results indicate that obsessive-compulsive behaviors are an integral part of the expression of the TS gene and can be inherited as an autosomal dominant trait. Schizoid symptoms, such as thinking that people were watching them or plotting against them, were significantly more common in TS patients than in controls. Auditory hallucinations of hearing voices were present in 14.6% of TS patients, compared with 2.1% of controls (P = .02). These symptoms were absent in ADD patients but present in ADD 2(0) TS patients. These voices were often blamed for telling them to do bad things and were frequently identified with the devil. None of the controls had a total schizoid behavior score greater than 3, whereas 10.9% of the TS patients had scores of 4-10 (P = .02). This frequency increased to 20.6% in the grade 3 TS patients. These quantitative results confirm our clinical impression that some TS patients have paranoid ideations, often feel that people are out to get them, and hear voices.

A long-term (the average 22.4 years) follow-up study of 757 schizophrenic patients displayed in 22% of the cases full recoveries, in 42,3% -- atypical types of recovery and in 35.7% -- characterisctic deficiency symptoms. At the time of the last follow-up 85.5% of the patients were living at home. 14.5% were permanently in hospital. The author gives a clinical analysis of the examined patients and prognostically favourable and unfavourable factors.

Conjoint therapy of marital partners is a technique that lends itself to the counseling efforts of health professionals. Its growing use has, however, brought with it seemingly inevitable pitfalls, such as inadequate assessment of individual needs and psychopathology, overzealous application and disregard of certain contraindications, management problems and goal definition that may be unclear to patients or more related to the therapist's personality than to an objective view of the marriage dynamics. Despite the difficulties and pitfalls of this relatively new field, conjoint therapy can be the treatment of choice when the primary difficulties are related to the inability to cope in the marital situation, even though functioning in other social roles is adequate.

This paper is presented primarily for its historical interest. The author's first attempted publication in psychiatry or psychoanalysis, it was submitted successively to two publications in 1949, rejected by each, and filed away until now. In it, the author suggests that transference phenomena constitute projections, and that all projective manifestations-including transference reactions-have some real basis in the analyst's behavior and represent, therefore, distortions in degree only. The latter of these two suggestions implies a degree of emotional participation by the analyst which is not adequately described by the classical view of him as manifesting sympathetic interest, and nothing else, toward the patient. It has been the writer's experience that the analyst actually does feel, and manifest in various ways, a great variety of emotions during the analytic hour. The analytic usefulness of this actual richness of emotional participation, by the analyst, is detailed.

A survey of the literature on the primary personality of schizophrenics shows that the essential concepts derive from Kraepelin (1893), E. Bleuler (who also introduced the technical term "schizoid", 1911) and C.G. Jung introversion; 1913). E Kretschmer (1921) adopted these preliminary findings and integrated them into his system of "Constitution" which greatly stimulated research in this field. Most of the following investigations confirmed his hypotheses on the basis of clinical impressions. A few only criticised his teaching, particularly as a theoretical concept. The musculo-somatotonic type apart, Sheldon's (1940) research agrees with Kretschmer to a large degree. Later investigators, however, could not sufficiently support Sheldon's constitutional biology on empirical grounds. No further pre-morbid types were developed in the following years, if one discards the somewhat rare "stormy" character (Arieti, 1955). All attempts to discover differences between the pre-morbid development of personality and the subheadings of schizophrenia failed. Pre-morbid sexual development is not typical, but the disturbances of contact are in the foreground. Whether schizophrenics differ later in their intelligence is still undecided. But it appears certain that, even before the start of their illness, they achieve a lower social status than their siblings. There exists a large experimental psychologic literature on relationships between the original personality, symptoms and psychophysiologic correlates in which it is confirmed again and again that bad pre-morbid adaptation corresponds closely with the severity of symptoms and loss of achievement. There are no consonant result of investigations into the frequency of schizoid structures in schizophrenics, in psychiatric control groups and in the normal population. Psychometric techniques have been used only rarely, but existing publications confirm in principle that schizophrenics are markedly more schizoid than control groups. As with schizophrenia, there are contrasting ideas as to the cause and pathogenesis of the pre-morbid personality. Psycho- and socio-genetic, behavioral, genetic and neurochemical hypotheses have their adherents. According to recent studies of adoption the genetic factor appears to predominate. The clinician relies on pre-morbid development of the personality in his search for a "kink in the life line" or in his assessment of the quality of remissions. There is general agreement that a schizoid primary personality has an unfavorable influence on the long-term prognosis. This is still true today, in spite of modern possibilities of treatment and rehabilitation. Prophylactic aspects have been discussed for a long time but have remained unhelpful clinically. Often it may be difficult to distinguish between schizoids and mild hebephrenias. In spite of this the clinical concept "schizoid" should never be used for "mild schizophrenia"...

The therapist's emotional reactions and attitudes in time-limited short-term therapy are presented. Limitations of time and scope this kind of therapy must be dealt with emotionally by the therapist; emotional reactions and attitudes can be expected to vary according to the therapist's personality structure; schizoid, depressive, compulsive or hysterical. Transference in time-limited short term therapy can be very intense but is easier to indendify. This has implications for countertransference reactions caused by the patient's transference.

This paper explores two marital constructs set forth by Peter Giovacchini. The first is based on a symbiotic reenactment in which the investment of both partners is tenacious and reciprocal, an attachment which Giovacchini refers to as a "character object" relationship. It represents intrapsychic homogramy. In the second construct, this deep form of attraction is absent and the dyadic bond is superficial, frequently transitory. The latter couples do not require an elementary, intrapsychic bond but do share particular defensive traits or symptoms. Thus these unions are termed "symptom object" relationships and are characterologically heterogamous. By means of a group case study approach, this distinction was statistically supported. Furthermore, it was found that homogamous marriages stay in treatment longer, maintain a lower divorce rate, and respond best to individual psychoanalytic psychotherapy. Heterogamous marriages, by contrast, show a higher divorce rate and tend to leave therapy prior to termination. The research also suggests that the initial treatment of choice for this type of marriage may well be conjoint or group psychotherapy.