Understanding Schizoid Personality Disorder

May 14, 2023 | Divyanshi Singh | Psychology

Personality disorders are a set of mental health problems marked by out-of-step behaviors and thought patterns with cultural norms, and those who suffer from these diseases have mental and behavioral characteristics that make it difficult for them to function and integrate into society (Proulx, 2021). 

This article provides insight into the epidemiology, etiology, and treatment options for Schizoid Personality Disorder.

Schizoid personality disorder constitutes one of the personality disorders and its defining trait, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a persistent detachment from social interactions and limited emotional expression in social circumstances (Bennett, 2017). An individual must exhibit at least four of the following characteristics in order to be termed as a schizoid (Bennett, 2017):

1. Close relationships are not something the individual desires or enjoys.

2. Other than direct relatives, the individual has no close friends.

3. The person has an emotional detachment and/or a frigid demeanour.

4. Praise or criticism has no effect on them.

5. They are uninterested in most, if not all, activities.

6. They usually always opt for self-directed activities.

7. The person has little to no desire to engage in sexual activity with another person.

Due to the lack of expression dispensed by individuals with schizoid personality disorder and the social isolation they prefer, it can be quite arduous to understand them, while separating their characteristics from those suffering from other mental health issues. Hence, let’s bust some myths about this condition. 

Myths and Facts

Schizoid Personality Disorder v/s Schizophrenia

Although these two mental health conditions sound similar, they have little in common (Proulx, 2021). In fact, as schizoid personality disorder is not a psychotic disorder like schizophrenia, it falls in a completely different category of the DSM (Proulx, 2021). While the two disorders might have some similarities in their genetic causes, people with schizoid personality disorder do not lose touch with reality or experience hallucinations and delusions the way those with schizophrenia do (Proulx, 2021). 

Due to these kinds of misconceptions, it’s crucial to differentially diagnose schizoid personality disorder from other mental health conditions such as psychotic disorders, autism spectrum disorders, substance use disorders, and other personality disorders (Bennett, 2017). It’s also possible that some people simply prefer solitude. A person can be diagnosed with schizoid personality disorder only if these traits lead to distress or impairment in daily functioning (Bennett, 2017). 

Schizoid Personality Disorder, Violence, and Daily Functioning

Although it’s a common belief that people with schizoid personality disorder are aggressive, there’s no evidence to back this claim (Proulx, 2021). People with schizoid personalities, on the other hand, don’t get furious very often and instead have flat emotional responses (Proulx, 2021). Even when directly provoked, someone with a schizoid personality disorder may exhibit a cool demeanour, masking their true feelings (American Addiction Centres, 2020). However, their lack of expression is not to be confused with a lack of emotions altogether. 

Another widely accepted theory surrounding schizoid personality disorder which is just another myth is the idea that people with this condition cannot function normally (Proulx, 2021). While impairment in daily functioning is a major part of personality disorders, Cluster A personality disorders (such as schizoid personality disorder, schizotypal personality disorders, paranoid personality disorder, etc.) often exhibit higher functioning than others (Proulx, 2021). Despite the fact that schizoid personality disorder is a high-functioning disorder, people with it have functional limitations due to their reclusiveness and detachment from life, and they prefer to see themselves as spectators rather than participants in life (Proulx, 2021). Musical instrument maintenance, software development, and long-haul haulage are all popular choices for people with schizoid personality disorder as these require the least amount of social interactions (American Addiction Centres, 2020). 

What Causes Schizoid Personality Disorder?

Although unambiguous data on the etiology of schizoid personality disorder is scarce, it is hypothesised that heredity plays a substantial role in its diathesis (Friba & Gupta, 2021). Heritability rates for schizoid personality disorder have been estimated to be around 30% in twin studies employing self-report questionnaires (Fariba & Gupta, 2021). Inherited traits and dispositions, early experiences, upbringing, education, and social interactions are all variables that determine one’s personality, and all of these factors together may have a role to play in the development of this condition (Cherry, 2021). Furthermore, males are diagnosed with this illness significantly more commonly than females, and they may experience more disability as a result (Bennett, 2017). Isolation, a lack of friendships, and low academic achievement may be signs of schizoid personality disorder in childhood and/or adolescence (Bennett, 2017). 

Treatment & Management

Individuals with schizoid personality disorder are not likely to seek therapy, thus referrals may come from family or healthcare professionals concerned about the person’s “eccentricity” or isolation, or from a fear of psychosis (Adshead & Jcob, 2012). Treating this condition can be challenging for a multitude of reasons but mainly because therapy is the primary treatment for schizoid personality disorder and it entails not only interacting with another person, but also interacting on a deep, candid, and sincere level, which people with schizoid personality disorder try to avoid to the greatest extent possible (American Addiction Centres, 2020). Supportive therapy, problem-solving therapies, or cognitive behavioural techniques to improve social skills or challenge cognitive belief system patterns may be beneficial (Beck, et.al., 2004, as cited in Adshead & Jacob, 2012). 

Although there are no approved medications to treat schizoid personality disorder, co-occurring conditions such as anxiety and depression can be treated using medication, in conjunction with practices like CBT which have been found to be helpful for people with schizoid personality disorder (Cherry, 2021; Proulx, 2021). 

Conclusion

According to certain studies, schizoid personality disorder has a prevalence of less than 1% (Fariba & Gupta, 2021). However, this does not mean that the disorder can be dealt with callously. Unfortunately, in comparison to other personality disorders, schizoid personality disorder has been almost completely disregarded, therefore treatment options are limited and little researched (Fariba & Gupta, 2021). If left undiagnosed and untreated, schizoid personality disorder can have catastrophic psychological consequences, putting individuals at higher risk for depression and anxiety (Fariba & Gupta, 2021). As a result, it is critical that the healthcare system works towards identifying at-risk individuals and educating the individual and their family about how the disorder manifests itself and how they can navigate their lives through it. Although the condition is usually long-term, chronic, and life-threatening, those who live with it can lead productive lives with the right care and treatment (Cherry, 2021).