What is the difference between schizoid and avoidant personality disorder?
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The relationship between schizoid personality disorder (SPD) and avoidant personality disorder (AvPD) has been a subject of controversy for decades.[1][2] Show Today it is still unclear and remains to be seen if these two personality disorders are genuinely distinct, but overlapping, personality disorders, or if they are merely two different phenotypic expressions of the same underlying disorder. Both have been associated with a shared genetic risk factor and the same polymorphism within the ANKK1 gene.[3][4] There is also some evidence that AvPD (like SPD) is a personality disorder of the schizophrenia spectrum.[5] Originally, schizoid personality disorder involved social avoidance combined with marked ambivalence regarding the desirability of social contact. It included indifference or even cold disdain oscillating with longing for normal relationships. Through the efforts of Theodore Millon, this complex idea was later divided across two disorders with the emergence of a separate AvPD construct and the idea of ambivalence was lost.[6] According to the differential diagnosis guidelines provided in the text of the DSM-IV the two conditions are distinguished by the extent to which the individual desires social contact versus being indifferent to it. But such distinctions are often difficult to apply in practice, as patients often have unclear, marginal, or shifting status on those elements thought most crucial for differential diagnosis. In the case of the avoidant and schizoid PDs, however, both the problem and its solution may be more academic than real. First, research indicates that all of the avoidant symptoms except social withdrawal correlate negatively with the schizoid symptom list and that differential diagnosis is not difficult.[7] Second, as pointed out by Benjamin (1993), schizoid PD is exceedingly rare and the diagnostic quandary may never occur in practice.[6] Schizoid personality disorder is characterized by a pervasive pattern of detachment from and general disinterest in social relationships and a limited range of emotions in interpersonal relationships. Diagnosis is by clinical criteria. Treatment is with cognitive-behavioral therapy. (See also Overview of Personality Disorders Overview of Personality Disorders Personality disorders in general are pervasive, enduring patterns of thinking, perceiving, reacting, and relating that cause significant distress or functional impairment. Personality disorders... read more .) In schizoid personality disorder, the ability to relate to others meaningfully is limited. About 3.1 to 4.9% of the general US population have schizoid personality disorder. It is slightly more common among men. Schizoid personality disorder may be more common among people with a family history of schizophrenia or schizotypal personality disorder. Comorbidities are common. Up to half of patients have had at least one episode of major depressive disorder Major depression (unipolar disorder) Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown... read more . They often also have other personality disorders, most commonly schizotypal Schizotypal Personality Disorder (STPD) Schizotypal personality disorder is characterized by a pervasive pattern of intense discomfort with and reduced capacity for close relationships, by distorted cognition and perceptions, and... read more , paranoid Paranoid Personality Disorder (PPD) Paranoid personality disorders is characterized by a pervasive pattern of unwarranted distrust and suspicion of others that involves interpreting their motives as malicious. Diagnosis is by... read more , borderline Borderline Personality Disorder (BPD) Borderline personality disorder is characterized by a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations... read more , or avoidant Avoidant Personality Disorder (AVPD) Avoidant personality disorder is characterized by the avoidance of social situations or interactions that involve risk of rejection, criticism, or humiliation. Diagnosis is by clinical criteria... read more . Etiology of ScPDHaving caregivers who were emotionally cold, neglectful, and detached during childhood may contribute to the development of schizoid personality disorder by fueling the child's feeling that interpersonal relationships are not satisfying. Symptoms and Signs of ScPDPatients with schizoid personality disorder seem to have no desire for close relationships with other people, including relatives. They have no close friends or confidants, except sometimes a 1st-degree relative. They rarely date and often do not marry. They prefer being by themselves, choosing activities and hobbies that do not require interaction with others (eg, computer games). Sexual activity with others is of little, if any, interest to them. They also seem to experience less enjoyment from sensory and bodily experiences (eg, walking on the beach). These patients do not seem bothered by what others think of them—whether good or bad. Because they do not notice normal clues of social interaction, they may seem socially inept, aloof, or self-absorbed. They rarely react (eg, by smiling or nodding) or show emotion in social situations. They have difficulty expressing anger, even when they are provoked. They do not react appropriately to important life events and may seem passive in response to changes in circumstances. As a result, they may seem to have no direction to their life. Rarely, when these patients feel comfortable revealing themselves, they admit that they feel pain, especially in social interactions. Symptoms of schizoid personality disorder tend to remain stable over time, more so than those of other personality disorders. Diagnosis of ScPD
For a diagnosis of schizoid personality disorder, patients must have a persistent pattern of
This pattern is shown by the presence of ≥ 4 of the following:
Also, symptoms must have begun by early adulthood. Differential diagnosisClinicians should distinguish schizoid personality disorder from the following:
Treatment of ScPD
General treatment Treatment Personality disorders in general are pervasive, enduring patterns of thinking, perceiving, reacting, and relating that cause significant distress or functional impairment. Personality disorders... read more of schizoid personality disorder is the same as that for all personality disorders. No controlled studies have been published about psychotherapies or drug therapy for schizoid personality disorder. Generally, efforts to share interest in impersonal topics (eg, possessions, collections, hobbies) that appeal to people who prefer solitary pursuits can help establish a relationship with a patient and perhaps facilitate a therapeutic interaction. Cognitive-behavioral approaches that focus on acquiring social skills may also help patients change. Because patients with schizoid personality disorder lack interest in other people, they may not be motivated to change. Can you be schizoid and avoidant?Schizoid personality disorder is more likely to coexist with other types of personality disorders, like: paranoid. avoidant. schizotypal.
What personality disorder is similar to schizoid?Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors.
Which mental illness is most comorbid with avoidant personality disorder?Comorbidity. AVPD is often comorbid with depression and substance abuse, and is likely to be associated with increased odds of suicidal ideation and attempts,2,6,9 explaining, perhaps in part, why AVPD may be a significant predictor of chronic depression.
How can you tell if someone is schizoid?Symptoms. Prefer being alone and choose to do activities alone.. Don't want or enjoy close relationships.. Feel little if any desire for sexual relationships.. Feel like you can't experience pleasure.. Have difficulty expressing emotions and reacting appropriately to situations.. |
