Schizoid Personality Disorder In The DSM: Signs And Symptoms

Schizoid personality disorder is one of the cluster A personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is published by the American Psychiatric Association. Schizoid personality disorder can be rare, with studies indicating that less than 1% of the population lives with this condition. 

The American Psychiatric Association describes schizoid personality disorder as a widespread form of detachment from social relationships and a limited range of expressing emotions in interpersonal environments starting in early adulthood. This mental illness is often difficult to diagnose, as people who experience it might not show distress. They usually may prefer to be left alone, taking pleasure in fewer activities.

Diagnostic criteria

The DSM-5 includes a set of criteria for an official diagnosis of schizoid personality disorder. An individual may be diagnosed with the disorder if four or more criteria are present. The diagnostic criteria include the following: 

• No desire for or enjoyment of close relations, including family relationships

• The continuous and consistent choice of solitary activities

• Little to no interest in sexual activities with another person

• Derivation of little pleasure from activities

• Lack of intimate friendships or relationships except for first-degree relatives, in some cases 

• The appearance of indifference to the appreciation or judgment of others

• A pattern of detachment, flattened affect, or emotional coldness

Signs and symptoms of schizoid personality disorder

There are several symptoms of schizoid personality disorder that can be explored in more significant detail, including the following. 

No desire for or enjoyment of close relationships, including family relationships

People with schizoid personality disorder may not crave close relationships, even including with family members. They may be uninterested in starting, building, or maintaining interpersonal relationships, potentially extending from home to school to the workplace. They might also prefer to partake in activities alone without social interaction. 

The continuous and consistent choice of solitary activities

As people with schizoid personality disorder might not enjoy spending time with others, one of the symptoms they may exhibit is the consistent choice to act alone. They may tend to prefer activities that allow them to be alone, including mechanical tasks or abstract activities like puzzles, math games, or video games. 

Little to no interest in having sexual experiences with others 

The lack of interest in social relationships with others may extend to sex. Whatever sexual activity they in which they engage may be self-oriented. 

Derivation of pleasure from few or no activities

People with schizoid personality disorder may derive pleasure from fewer activities than others and may not have similar interests to those around them. They may have reduced experiences of pleasure from their senses but might gain pleasure from being alone and completing solitary activities.

Lack of close connections other than first-degree relatives

Since people with schizoid personality disorder often prefer to be left alone and struggle to make close friends, they might not have many relationships and may only be close to those with whom they grew up. Others might also be estranged from their family. 

The appearance of indifference to praise or criticism 

People with schizoid personality disorder might struggle to pay attention to the social interactions around them. They may be uninterested in what others say about them, including praise or criticism. They may be interested in their grades, for example, but not the teacher's praise or criticism about their grades.

Emotional coldness, detachment, or flattened affectivity

People with schizoid personality disorder may show few facial expressions. They are often described as unemotional and may struggle to make expressions when an intense or emotional event occurs. For example, the death of a loved one might be taken with a lack of emotional display or tears. They may not experience strong emotions like anger or joy and feel cold, aloof, or distant.

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Other features of schizoid personality disorder

A few other features may be associated with this mental illness, including the following. 

Difficulty expressing anger

People with schizoid personality disorder often find it difficult to display anger, regardless of the provocation. This difficulty may cause others to perceive that they lack emotions. 

Difficulty with focus or direction 

People with schizoid personality disorder may sometimes appear not to have a clear focus or direction. For many people, there is an urge to be accepted socially, and this urge may drive them to complete tasks. Since people with schizoid personality disorder might not care about social acceptance, and people's opinions might not matter to them. They are often not driven by values or societal morals and may appear directionless and unfocused.

Lack of intimate relationships

Individuals with schizoid personality disorder might avoid sexual or romantic relationships, including marriage. If they try to date someone, they might do so out of pressure. Often, people living with this condition feel content and happy when alone. 

Solitary work

People with schizoid personality disorder may thrive in areas of work that do not require social interaction. For example, they might work in software engineering, technology, or writing industries. 

Brief psychotic episodes

People with this personality disorder might experience hallucinations or delusions that happen transiently when exposed to extreme stress levels. These episodes often don't last long enough for a differential diagnosis of another mental illness to be made.

Connections with other mental illnesses 

In some instances, schizoid personality disorder may lead to another mental health condition or co-occur. Schizoid personality disorder often co-occurs with other personality disorders, such as schizotypal, paranoid, or avoidant personality disorder. 

What are the causes of schizoid personality disorder?

Symptoms of schizoid personality disorder may first be noticed in childhood or adolescence. The cause is considered unknown, but studies have found a 30% genetic hereditary rate. An increased population of people with schizoid personality disorder have relatives with schizophrenia or schizotypal personality disorder. 

Differentials of schizoid personality disorder

Although schizoid personality disorder may have some symptoms overlapping with other personality disorders, there are several ways to differentiate them, including the following.

Length of delusions 

Schizoid personality disorder is distinguished from schizophrenia, bipolar disorder, and depressive disorder with psychotic features because it does not produce persistent delusions or hallucinations. People with schizoid personality disorder might experience hallucinations or delusions briefly in periods of extreme stress, but it is not constant. 

Cognitive distortions 

People with schizoid personality disorder may not experience profound cognitive and perceptual distortions, unlike people with schizotypal personality disorder.

A lack of paranoia 

People with paranoid personality disorder tend to be suspicious and have paranoid ideation, unlike people with schizoid personality disorder.

A lack of preoccupation with social opinions 

People with avoidant personality disorder tend to have limited social interactions because they are often afraid of embarrassment, rejection, or inadequacy, unlike those with schizoid personality disorder. People with schizoid personality disorder may not be bothered by the opinions of others.

Concerns similar to schizoid personality disorder 

People who show high levels of introversion might show some of the symptoms of schizoid personality disorder. In addition, people who have recently moved from one cultural background to another culture might show symptoms of withdrawal and difficulty with emotions in interpersonal environments. However, these experiences are often considered normal and not symptoms of a personality disorder unless they persist and profoundly impact someone's life long-term. 

Counseling options 

If you are concerned that you or someone about whom you care might have schizoid personality disorder, you don't have to face these concerns alone. You can get further information about the disorder from licensed mental health professionals through an online platform like BetterHelp. If going to a therapist's office makes you uncomfortable, you might try online therapy, which research has shown to be as effective as in-person therapy. 

An online platform lets you communicate with your therapist via videoconference, phone, or in-app messaging. You can also be matched with a therapist experienced with personality disorders. When you sign up, you can note your symptoms and preferences for therapy, which can offer you control over the treatment process.