Schizoid Personality Disorder

The symptoms of schizoid personality disorder often center on the individual’s ability to feel social connection and inclusion—but they also include characteristics associated with the individual’s inner life experiences. Like other personality disorders, the symptoms of schizoid personality disorder (ScPD) typically affect: 

• How the individual thinks about themselves and others.
• How the individual controls their own behavior. 
• How they relate to the behavior of others in social situations.
• How they respond emotionally to outside stimuli.

As with other mental illnesses, the severity of ScPD typically exists on a spectrum and can vary among individuals. Professionals establish a diagnosis of ScPD based on the following symptom criteria: 

• The individual shows marked detachment from social relationships.
• They display a limited range of emotional expression in socially interactive settings. 
• There is apathy, lack of enjoyment, and/or lack of desire to have close relationships.
• The individual prefers solitary activities.
• They lack close friends or intimate relationships. 
• They display emotional detachment or lack of affect. 
• There is a lack of concern regarding criticism or praise from others.
• There is little or no interest in sexuality and sexual experiences. 

Further diagnostic criteria include:

• Symptoms are not episodic; that is, the patient displays a chronic history of schizoid personality disorder (ScPD) behaviors.
• The symptoms cannot be attributed to a physiological condition.
• Symptoms occur outside the context of other affective disorders featuring psychotic behaviors, including, but not limited to, autism spectrum disorder, manic depression, and schizophrenia.
• Symptoms emerge in adolescence or early adulthood. 

While it can be useful to keep the above criteria in mind, just because an individual expresses some of these traits does not mean they have schizoid personality disorder. Several other factors may influence the emergence of similar characteristics, including natural temperament and childhood exposure to a parent or caregiver with the same characteristics. Many are influenced by outside factors, such as cultural attitudes and behavioral norms. In some cases, symptoms might be caused by another mental health condition in the Diagnostic and Statistical Manual of Mental Disorders, such as schizotypal personality disorder, avoidant personality disorder, or one of many other personality disorders and psychiatric disorders that cause similar symptoms.

Researchers have yet to uncover a specific etiology of schizoid personality disorder, but a growing number of studies indicate that its cause is likely the result of a combination of factors, including heritability and early environmental influences.

Heritability

While more research is required to fully understand the potential connection between ScPD and genetic heritability, there are notable studies that may provide some clues. For example, data from twin studies suggest that over 2/3 of people exhibiting long-term ScPD traits may have a genetic disposition towards the disorder.

Environmental Influences

Evidence suggests that parenting style may play a significant role in the development of ScPD from childhood. For example, permissive and perfectionist parenting styles may increase the risk of personality disorders in adolescents.

There may also be a relationship between lack of emotional connection between child and parent and the development of ScPD. For some individuals, this may impede the development of social bonds and interpersonal connectedness with others—a hallmark trait in people with ScPD.

Also, childhood trauma,³ including emotional, sexual, and physical abuse, may be a precursor to personality disorders.

Depending on the length and severity of symptoms, treatment for ScPD typically involves a combination of methods. The first goal of treatment is typically to develop a healthy client-therapist relationship. Often, individuals with ScPD fear establishing close relationships and may find the idea of a relationship with a therapist particularly troubling. This may result in the patient withholding information or communicating untruthfully—thus rendering the therapy ineffective. 

Once a solid rapport is built, the goal of treatment is typically to minimize the often distressing symptoms of the disorder and assist individuals in learning coping mechanisms to subvert the negative ways in which ScPD can impact their daily lives. 

Medication

Currently, no medications are used specifically for treating ScPD, but they may be used to treat any co-occurring conditions. These may include antidepressants, anti-anxiety medications, low-dose antipsychotics, and some types of mood stabilizers. 

Medications don’t work in every case, and some may exacerbate the symptoms of ScPD. A thorough diagnosis from a mental health professional who is able to prescribe medication is essential when determining if, and what type of, medications may be helpful in treating the disorder’s symptoms. Do not start, stop, or change medications without first consulting with your physician or other qualified health professional.

Other treatment options

Group therapy featuring one or a combination of psychotherapeutic techniques may be effective for helping people with ScPD, but it is typically used as an advanced form of treatment. Once a person has formed a relationship with their psychotherapist and has begun to respond to individual therapy, group therapy can help them learn to interact in social situations and practice interpersonal skills.  

In some cases, family therapy may be beneficial as a way to seek treatment, particularly because ScPD often affects those who are personally closest to the individual with the disorder. Like group therapy, family therapy isn’t always a first-line treatment method but may be added later. Family therapy is often helpful for identifying and altering familial attitudes and behaviors that may exacerbate the disorder.

One of the primary components of family therapy in the United States is psychoeducation. This teaches the patient and their family members about the disorder—specifically focusing on diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association, the therapist’s policies, the emergence of symptoms, treatment options, and ways to cope and manage interpersonal interactions.

Self-care

Self-care techniques can help support therapeutic efficacy. This may be particularly true for techniques centered on self-reflection, such as journaling, and mindfulness practices, such as meditation and yoga. Regular physical activity can help manage comorbid mental illnesses, such as depression and anxiety. 

While there is no causal link between ScPD and substance use disorders, they are often co-occurring. Substance use may intensify symptoms of schizoid personality disorder or mask them, creating a hindrance to therapeutic treatments. For this reason, it’s recommended that people living with ScPD avoid use of drugs and alcohol.

It can be vital for those with schizoid personality disorder to seek help from a mental health professional promptly, and family and loved ones can also benefit from seeking assistance. Talk therapy can provide a way to better understand the disorder and methods of coping with its sometimes difficult symptoms. Those who don’t feel comfortable with traditional in-person therapy may benefit from online therapy, which provides sessions via audio, video, or live chat.

Also, the Centers for Disease Control and Prevention (CDC) has a comprehensive list of resources where individuals may find local professionals who treat ScPD and related disorders. 

The following are some additional resources for education, caregiver tips, and support for people experiencing ScPD as well as their families:

• United Brain Association
• The National Mental Health Association
• National Alliance on Mental Illness
• Mental Health America
• The American Psychiatric Association

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.

Please also see our Get Help Now page for more immediate resources.

Current research on schizoid personality disorder is sparse, and little is known clinically about its causes or treatments with the highest efficacy rates. The research that does exist, however, contributes to a better understanding of the disorder so that mental health professionals can isolate the factors that may cause it and develop more treatment options to accommodate each person’s unique circumstances. 

Another 2020 study examined the effect of the COVID-19 pandemic on the three categorical clusters of personality disorders (A, B, and C) to gain insight into how individual symptoms were impacted and how it uniquely affected each cluster. 

Researchers hypothesized that people within the cluster A category (including those with ScPD) may be more likely to react with marked suspicion and foster conspiracy theories. However, some individuals with personality disorders may have used valuable adaptive coping strategies during the pandemic that they might be able to use in other contexts after the pandemic. The study’s authors concluded that the results might serve as a way to inform therapeutic strategies to be used in telepsychology and telepsychiatry moving forward.

Another 2020 study published in the National Library of Medicine examined the potential connection between autistic spectrum disorder (ASD) and schizoid personality disorder traits. The resulting data indicated that the two conditions overlap symptomatically and may develop similarly. Experts concluded that successful methods of treatment and support for those with ASD may also help individuals with ScPD develop better social adaptation skills and coping strategies to improve their quality of life.

Here are some key statistics on schizoid personality disorder:

• Schizoid personality disorder affects approximately 0.9% to 3.1% of people in the U.S.
• It’s estimated that ScPD heredity rates are roughly 30%.
• Up to 50% of patients with ScPD have at least one episode of major depressive disorder. 
• Research on treatment efficacy for those with ScPD is currently limited, partly because people with ScPD don’t typically seek treatment for the disorder specifically, but for symptoms of comorbid conditions, such as depression and anxiety. Still, past research on treatment success for personality disorders suggests that an estimated 25.8% of patients with personality disorders experience symptom relief, or complete recovery, within a year of treatment.