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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.)

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.

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.

Avoidant personality disorder was introduced in DSM-III (American Psychiatric Association [APA], 1980), and debate persists regarding the utility of having two separate variants of the "detached personality." The present study addressed this issue through ratings of open-ended self-descriptions provided by community adults with high scores on schizoid versus avoidant personality traits ( N  = 229). The self-concept of individuals with avoidant personality style reflected a lack of positive self-regard and low self-efficacy/agency. Regarding schizoid personalities, neither positive nor negative self-regard, self-complexity, or self-efficacy/agency was found. Examination of specific variables yielded a relationship between avoidant personality styles, depression, and anxiety, consistent with literature noting simultaneous desire and fear of interpersonal relationships in avoidant patients (APA, 1980; Sheldon & West, 1990). Similarly, examination of individual variables yielded a negative association between schizoid personality styles and tolerance for contradictory aspects of the self, consistent with theoretical writings in this area (Kernberg, 1976; McWilliams, 2006). Results support the argument that these two personality styles represent distinct constructs. Findings support the utility of self-concept assessment to assist treatment planning and differential diagnosis. Treatment implications include using open-ended descriptions of patients' self-concepts to explore changes that may not be accessible via more structured forms of patient self-report.

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.

Schizoid personality pathology is among the most debilitating and enigmatic forms of personality pathology. Some have suggested that a potential etiological influence on schizoid pathology is trauma. Thus far, research on the association between trauma and schizoid pathology has focused primarily on type of trauma (e.g., abuse vs. neglect during childhood) rather than who perpetrated the trauma. This contrasts with recent research on trauma perpetrated by someone upon whom the survivor relies and/or trusts (i.e. betrayal trauma), which many studies show has a uniquely pernicious association with several forms of personality pathology. However, this has not yet been examined with respect to schizoid pathology specifically. In this study, we examined the relative associations between trauma varying degrees of betrayal and schizoid personality pathology in a sample recruited from Amazon's Mechanical Turk ( N  = 300) using a Bayesian approach to structural equation modeling. Results suggest that interpersonal trauma in general was associated with higher levels of schizoid pathology. Findings further indicate that for men but not women, trauma with a high degree of betrayal was uniquely associated with schizoid pathology. These findings contribute to the growing body of research suggesting the influence of interpersonal trauma in general and betrayal trauma in particular on personality pathology and have implications for future research on and intervention with people with high levels of schizoid pathology.

Purpose: The aim of the study is to present a description of a case of a person suffering from schizoid personality disorder with a focus on the mechanisms that influenced the life choices of the patient. Case description: 27-year-old man with schizoid personality disorder has been struggling with it since childhood, which mostly caused by his dysfunctional family. The man considers himself unique because he composes music, wants to write a book, set up a theatre and claims that he is able to discover a lot in math, but does not implement it while living in a fantasy world. Discussion: It is thought-provoking that a person with a personality disorder characterized, among other things, by being indifferent to the praise or criticism of others and displaying emotional coldness, detachment, or shallow emotionality, is interested in areas in which emotions embodied in art are one of the main forms of expression, and encountering feedback from others is intrinsically linked to this. One explanation for this may be that the contact with the audience in the patient's chosen fields of art (electronic music making) is not direct. Conclusions: Currently, treatment for schizoid personality disorder is long and difficult. This is mainly due to the fact that these individuals are often indifferent to the need for change, which can lead to a lack of motivation for any treatment. The main methods include psychodynamic psychotherapy, group psychotherapy and sometimes medication. [ABSTRACT FROM AUTHOR]

Schizoid personality disorder (SPD) has been characterised by a persistent detachment from, and indifference to, interpersonal relationships, alongside restricted range of expressed emotions, and limited rewards gained from social interactions, resulting in limited levels of socially healthy behaviour. Although the applicability of evidence-based psychological treatments, including cognitive therapy (CT), has been indicated, there is a noticeable scarcity of relevant academic literature that might inform clinical practice in mental health clinics. This rigorous single subject design study attempts to address such apparent gap in literature. Sixteen sessions of CT were undertaken with an individual diagnosed with SPD and comorbid mood disorder in a community-based mental healthcare setting. Formal standardised measurement, behaviour frequency sampling, and subjective data were utilised to systematically evaluate the outcomes, indicating a considerable improvement in psychosocial functioning. The paper highlights the pertinence of cognitive and behavioural strategies in helping schizoid individuals address their interpersonal difficulties, reduce emotional distress, acquire socially inclusive behaviour, and ultimately increase their psychosocial health, without the need for explicitly intervening with their underlying personality traits.

Although widely conceived as distinct conditions, higher-functioning autism spectrum disorder (ASD) and schizoid personality disorder (schizoid PD) share similar clinical symptomatology. This study explored the relationship between the two disorders by collecting extensively validated measures of autistic trait burden (Social Responsive Scale, Second Edition) and schizoid PD affectation (Diagnostic Interview for Genetic Studies) from clinically ascertained verbal males with and without autism ages 12 to 25 years (N = 72) via parent, teacher, and self-report. Although only a small minority of adolescents with ASD met full diagnostic criteria for schizoid PD, participants with ASD endorsed a continuous distribution of schizoid PD traits that reflected a pronounced pathological shift in comparison with those in the control group, with one half of ASD males experiencing three or more Diagnostic and Statistical Manual of Mental Disorders, 4th Edition schizoid PD criterion items "often" or "almost always." Results suggest significant amplification of schizoid PD trait burden in adolescents with ASD. ASD-specific interventions should be considered for patients with schizoid PD with premorbid histories of ASD.

Some psychiatric disorders are mostly overlapping and measures for facilitating differential profiles play a key role in the identification of a disease, course, prognosis, and management. This systematic review and meta-analysis aimed to (i) explore the association between the components of temperament and character model and three overlap psychiatric diagnoses including avoidant personality disorder (APD), schizoid personality disorder (SPD), and social anxiety disorder (SAD) and (ii) provide differential profiles for each of these disorders. The literature search was performed on 7 international scientific databases for all articles published in English, January 1990-June 2019. The pooled effect sizes were obtained using the correlation coefficients or the standardized mean differences between cases with SAD and healthy controls by the random-effects method. Fifteen correlational studies for APD and SPD and eight case–control studies for SAD met the criteria for entering meta-analysis. All three disorders were positively associated with harm avoidance (HA) and negatively associated with novelty seeking (NS), self-directedness (SD), and cooperativeness. APD and SPD were also negatively associated with reward dependence (RD). The differential profiles are as follows: NS (APD < SAD), HA (APD > SPD, SAD), RD (SPD < APD < SAD), SD (APD < SPD, SAD), cooperativeness (APD, SPD < SAD), and self-transcendence (ST: APD > SPD, SAD). It seems that HA, SD, and cooperativeness are the common core of these three diagnostic categories. More extreme tendencies in NS and RD, along with ST with a lower possibility, are the main traits in the differential profiles.

Objective: Criticisms and limitations of the categorical approach in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are discussed. In recent years, it has been suggested that an alternative approach, such as the dimensional model, is more advantageous. The Hierarchical Taxonomy of Psychopathology (HiTOP), which offers a dimensional-based framework, is presented as a new perspective. The study aimed to adapt the Dimensional Clinical Personality Inventory-Schizoid Personality Disorder (IDCP-SZPD), which was developed according to the HiTOP perspective and assesses schizoid personality disorder with a dimensional approach, into Turkish, and to examine its validity and reliability. Method: The Perth Alexithymia Questionnaire, Interpersonal Sensitivity Scale, Interpersonal Reactivity Index, The Interpersonal Attachment Styles Scale, Coolidge Axis II Inventory Plus Turkish Short Form, and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) Personality Questionnaire were used for convergent validity analyses. Convergent validity, exploratory, and confirmatory factor analyses were conducted for validity, while Cronbach's Alpha and test-retest analyses were used for reliability. Results: The factor analysis determined that the 10th, 17th, 18th, and 23rd items should be removed from the scale, and the scale showed a five-factor structure. According to the reliability analysis, Cronbach's alpha value was found to be 0.91 for the total scale and between 0.71 and 0.91 for the subscales. It was determined that the item-total item correlations of all items on the scale were above 0.30. Conclusion: Based on the findings, it is evident that the Turkish adaptation of the IDCP-SZPD has strong psychometric properties. Keywords: Schizoid Personality Disorder Scale, reliability, validity, adaptation [ABSTRACT FROM AUTHOR]

A new dimensional-based framework was proposed, the Hierarchical Taxonomy of Psychopathology (HiTOP). This study aimed to develop a specific version of the Dimensional Clinical Personality Inventory 2 (IDCP-2), focused on the assessment of the schizoid personality disorder (SZPD) according to the HiTOP. In stage 1, we developed a new factor to cover all SZPD traits, as presented in the HiTOP. Six factors (one new and five from the IDCP-2) composed the IDCP-SZPD. In stage 2, 434 adults from the community, aged from 18 to 67 years (M=31.6, SD=9.7), completed factors from three self-report measures: the IDCP-SZPD, PID-5, and FFaVA. The IDCP-SZPD factors and total score presented high reliability. Correlations and a bootstrap two-sample t-test comparison corroborated the expectations. Although we found evidence supporting the use of the IDCP-SZPD for the measurement of SZPD traits, further research is needed to verify the replicability of the present findings in samples composed of SZPD patients.

Schizoid personality disorder (SzPD) is characterised by flattened affect, limited capacity to express feeling, indifferent or disinterested attitude towards others with preference for solitary activities. It's east researched and hence most confusing personality disorder, both in terms of assessment and management leading to dropout or low engagement in the treatment process. The authors have attempted to propose a working model for SzPD ensuing their endeavour in management of a case. It's single case study design of a male presented with aimless behaviour, decreased social interaction, poor hygiene, daily alcohol consumption and feeling of boredom. CBT was initiated for depressive symptoms and alcohol dependence with occasional use of substances. The process and response to therapy indicated underlying psychopathology in personality after 13 sessions. Once diagnosis of SzPD was confirmed various techniques were used in therapy with total more than 65 sessions before termination was introduced. The outcome was significant reduction in alcohol intake, identifying triggers and its consequences. The sequel of social withdrawal and benefit of social interaction in occupational functioning. It's helpful to validate patient's unpleasantness and avoidance associated with social involvement as a milestone to build insight into the resulting consequences. The intervention helps in accepting as well as altering one's actions and appraisal of events. The indifferent attitude and limitation of establishing rapport in SzPD can induce burn-out in clinician. Briefing-debriefing sessions with a fellow clinical psychologist is beneficial to stay objective. [ABSTRACT FROM AUTHOR]

Background: Clinical and research findings have highlighted the role of interpersonal factors in suicidal behavior with high levels of intent and lethality. Schizoid personality disorder (SPD) is at the extreme end of interpersonal difficulties. Thus, we aimed to understand the contribution of SPD symptoms to suicide behavior and specifically to more lethal suicide attempts. Method: Four groups were investigated (N = 338): medically serious suicide attempters, medically non-serious suicide attempters, psychiatric and healthy controls. SPD symptoms, mental pain variants, and clinical characteristics were assessed. Results: Overall, attempters were characterized by higher levels of most SPD symptoms. Solitary lifestyle and emotional detachment were higher among medically serious suicide attempters relative to less-serious attempters. Emotional detachment doubled the risk for high lethality, beyond mental pain variables. Conclusions: SPD symptoms of interpersonal difficulties and low levels of emotional expressions are important risk factors for more severe suicidal behavior. Implications for identification of at-risk groups for suicide are discussed.

Schizoid personality disorder (ScPD) is one of the "odd cluster" or "cluster A" personality disorders in DSM-IV. In the present article, the authors review information pertaining to the psychometric characteristics of ScPD as gleaned from a search of relevant publications as well as from databases of personality disorder study groups. Comparatively little evidence exists for the validity and reliability of ScPD as a separate, multifaceted personality disorder. Some authors, moreover, have contended that the group of patients termed "schizoid" actually fall into two distinct groups--an "affect constricted" group, who might better be subsumed within schizotypal personality disorder, and a "seclusive" group, who might better be subsumed within avoidant personality disorder. The research-based justification for retaining ScPD as an independent diagnosis is sufficiently sparse for it to seem reasonable to remove ScPD from the list of personality disorders in DSM-V, and instead to invite clinicians to code for schizoid traits using a dimensional model.

Patients with schizoid personality disorders (SPD) often challenge clinicians because of their seemingly detached and restricted affective behaviour, which may be interpreted as lack of motivation for treatment and lifestyle changes. However, Bleuler indicated the intrapsychic dynamics of ambivalence in schizoid disorder, and it has been discussed in later literature on psychopathology. Schizoid ambivalence refers to contrasting feelings in patients of a seemingly emotionally detached appearance that may curtain an inner, heightened sensitivity and longing for closeness. This article introduces different diagnostic and theoretical descriptions of the ambivalence construct in the schizoid personality disorder. The discussion is elaborated by means of a case example, presenting both the patient's and professionals' points of view on the treatment process. We use the concepts of treatment alliance and countertransference as explanatory models in the discussion of how the schizoid ambivalence may affect the treatment relationship.

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.

In 2 studies, we examined the reliability and validity of an interpersonal measure of schizoid personality disorder (SZPD) based on nonverbal behaviors and interpersonal interactions occurring during interviews. A total of 556 male jail inmates in the United States participated in Study 1; 175 mentally disordered offenders in maximum security hospitals in the United Kingdom participated in Study 2. Across both samples, scores on the Interpersonal Measure of Schizoid Personality Disorder (IM-SZ) exhibited adequate reliability and patterns of correlations with other measures consistent with expectations. The scale displayed patterns of relatively specific correlations with interview and self-report measures of SZPD. In addition, the IM-SZ correlated in an expected manner with features of psychopathy and antisocial personality and with independent ratings of interpersonal behavior. We address implications for assessment of personality disorder.

Reprinted from JOPPPAH 23(2) Winter, 2008. This article investigates the relationship between traumatic events from conception to birth and Schizoid Personality Disorder, Dysfunction, and Deprivation. From extensive experiential work with clients, based on the work of the British psychiatrist, Dr. Frank Lake, and her own personal experiences, the author discusses the very painful schizoid personality dysfunctions and deprivations relating to traumas of great severity in the first trimester of life. Loss of bonding and fear of intimacy are explored, along with dissociation and boundaries, seen as learned behavior in the womb. Case studies and statements from clients are included. [ABSTRACT FROM AUTHOR]

Some psychiatric disorders are mostly overlapping and measures for facilitating differential profiles play a key role in the identification of a disease, course, prognosis, and management. This systematic review and meta-analysis aimed to (i) explore the association between the components of temperament and character model and three overlap psychiatric diagnoses including avoidant personality disorder (APD), schizoid personality disorder (SPD), and social anxiety disorder (SAD) and (ii) provide differential profiles for each of these disorders. The literature search was performed on 7 international scientific databases for all articles published in English, January 1990‑June 2019. The pooled effect sizes were obtained using the correlation coefficients or the standardized mean differences between cases with SAD and healthy controls by the random‑effects method. Fifteen correlational studies for APD and SPD and eight case–control studies for SAD met the criteria for entering meta-analysis. All three disorders were positively associated with harm avoidance (HA) and negatively associated with novelty seeking (NS), self-directedness (SD), and cooperativeness. APD and SPD were also negatively associated with reward dependence (RD). The differential profiles are as follows: NS (APD < SAD), HA (APD > SPD, SAD), RD (SPD < APD < SAD), SD (APD < SPD, SAD), cooperativeness (APD, SPD < SAD), and self-transcendence (ST: APD > SPD, SAD). It seems that HA, SD, and cooperativeness are the common core of these three diagnostic categories. More extreme tendencies in NS and RD, along with ST with a lower possibility, are the main traits in the differential profiles. [ABSTRACT FROM AUTHOR]

This paper examines seminal psychoanalytic theory regarding the etiology of schizoid personality disorder and discusses considerations for treatment. In light of prevalent theory and citing case material, essential features of the analyst's calibrated emotional presence in the treatment of those suffering from this affliction, as well as the promotion of a curative sense of ordinariness, are discussed. In line with this, particular attention is paid to the challenges, resistances and suffering experienced by both patient and analyst as they attempt to relate. Primary among these challenges is the debilitating sensitivity, isolation, and loneliness of the schizoid person, which complicates the desire to relate, confining the person to the shadows of interpersonal life. [ABSTRACT FROM AUTHOR]

This study explored the hypothesis that body weight is reduced in male children and adolescents with schizoid personality disorder or Asperger's disorder. The body weights of 33 consecutively admitted male subjects with one of these disorders were retrospectively assessed with percentiles for the body mass index (BMI). The mean percentile (+/- SD) for the BMI was 31.6 +/- 27.6 and differed significantly from the expected value of 50 (P<0.001). Ten subjects had a BMI of < or = 10th age percentile. Post hoc comparisons revealed that BMI percentiles were (a) reduced to a similar extent in patients with schizoid personality disorder and Asperger's disorder and (b) reduced to a greater extent in patients with abnormal eating behaviour. During childhood and adolescence both diagnoses are associated with an increased risk of being underweight. Population-based BMI percentiles are useful for detecting associations between specific psychopathological syndromes and body weight.