Causes and Symptoms of Schizoid Personality Disorder

ScPD is one of 10 unique personality disorders, but they all share four core features:

• Distorted thinking patterns
• Problematic emotional responses
• Interpersonal difficulties
• Under- or over-regulated impulse control

People with personality disorders deviate from cultural expectations in their feelings, ways of thinking, and behaviors and often blame others for their problems. Individuals with ScPD are not only detached from social relationships, but they also express little emotion and avoid any activity that may involve emotional closeness.

Researchers divide personality disorders into three clusters: A, B, and C, depending on the symptoms. ScPD falls within Cluster A, along with paranoid personality disorder and schizotypal personality disorder. Atypical, eccentric behavior and thinking are common characteristics of these conditions, along with social awkwardness and social withdrawal. To be diagnosed, a person must experience functional impairment or subjective distress due to these symptoms.

A person with ScPD exhibits a limited ability to relate to others. It begins in early adulthood, occurs more often among men, and may be more common when there is a first-degree family history of schizophrenia or schizotypal personality disorder. About half of the people doctors diagnose with the condition have also had a major depressive episode, or they exhibit one of the other personality disorders, such as borderline, paranoid, schizotypal, or avoidant.

People who have ScPD may experience a variety of symptoms, some of which manifest during childhood:

• Prefer to be alone
• Difficulty experiencing pleasure
• No enjoyment with close relationships
• A low desire for sex with another person
• Humorless, indifferent, or emotionally cold
• Lack of goals or motivation
• Difficulty expressing emotions, including anger

People with ScPD show little concern with what others think of them and have a lifelong pattern of indifference to others. Praise and criticism have little effect. These individuals often appear aloof, self-absorbed, or socially inept to others. Dating and marriage are rare occurrences. Many prefer to spend time by themselves, participating in solitary activities and hobbies. Sensory experiences that others find pleasurable, such as walking on a beach or observing a colorful sunset, are less enjoyable to a person with ScPD.

The causes of ScPD are unknown, but people with a family history of the condition are more likely to develop it. People who have schizophrenia or a schizotypal personality disorder also have a higher risk. Researchers believe a combination of genetic and environmental factors in early childhood leads to the development of the disorder. Studies show that people with emotionally cold or neglectful caregivers may be more likely to develop ScPD.

The first steps in the diagnostic process include a full medical and personal history and a physical exam. This allows the physician to rule out underlying medical symptoms as the cause. Some medical providers may refer their patients to a mental health professional for further evaluation. For an ScPD diagnosis, the person must exhibit at least four of the symptoms outlined in the DSM-5, the American Psychiatric Association’s guidelines.

People with ScPD have a higher risk of alcohol or drug abuse, self-destructive or violent behavior, self-harm, or other mental health disorders. They may experience a lack of productivity and have difficulty keeping a job. As with other personality disorders, those who avoid treatment for their ScPD have a greater risk of hospitalization.

All three disorders present with a limited ability to connect socially with others and a lack of emotional expression. However, unlike the other two disorders, people with ScPD are unlikely to exhibit symptoms of paranoia or hallucinations. Individuals with schizotypal personality disorder or schizophrenia may have unusual conversational speech patterns, such as rambling or vague thoughts.

ScPD is a long-term, chronic illness that generally does not improve over time. Studies show that people with this condition often fail to seek treatment due to their tendency to isolate themselves. Common therapy techniques, such as talk therapy, are usually ineffective because these individuals have difficulty connecting with their therapist. Some do well in group therapy. Friends and family can be most supportive by limiting their expectations for emotional connection and intimacy.