Personality Disorders Part 1

Schizoid PD, Avoidant PD, Schizotypal PD, & Paranoid PD

Schizoid Personality Disorder Overview

Characterized by a pervasive pattern of detachment from social relationships and a very limited range of emotions in interpersonal situations

• Can be described as a style of indifference towards others

• Rarely form intimate relationships/do not care to do so

• Alone in life but not lonely

Treatment for a Client with Schizoid PD

Focus on increasing the value of social relationships and social skills training

• However unlikely to seek treatment

Schizoid PD Descriptors

Must exhibit at least four of following characteristics

1. Lack of desire or enjoyment of close relationships with others

2. Preference for solitary activities

3. Has little interest in sexual relationships

4. Takes pleasure in few activities

5. Seems indifferent to praise or criticism

6. Lacks close friends other than first degree relatives

7. Exhibits emotional coldness or detachment

Avoidant Personality Disorder Overview

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

• Asocial because they are interpersonally anxious and fearful of rejection

• Often feel chronically rejected by others and pessimistic about future

• Tend to become extremely dependent on those whom they are close to

Treatment for a Client with Avoidant PD

Focuses on behavioral interventions for anxiety and social problems — therapeutic alliance is predictive of treatment success

Avoidant PD Descriptors

Individual must show at least four of the following characteristics

1. Avoids occupational activities involving significant interpersonal contact b/c of fears of rejection or disapproval

2. Unwilling to get involved with people unless certain of being liked

3. Shows restraint within intimate relationships because of fear of being shamed or ridiculed

4. Preoccupied with concerns of being criticized or rejected in social situations

5. Inhibited in new interpersonal situations

6. Views self as socially inept, inferior, or unappealing

7. Unusually reluctant to take personal risks or engage in new activities

Schizotypal Personality Disorder Overview

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with/reduced capacity for close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior

• Typically socially isolated

• Think and behave in odd and unusual ways

• Holds odd beliefs

• Tend to be highly suspicious

This disorder is viewed as lying on same continuum as schizophrenia & genetic research supports this theory

Treatment for a Client with Schizotypal PD

Often seek treatment b/c of symptoms of anxiety or depression — treatment focuses on alleviating symptoms and increasing social skills

• Drug therapy used to address problems in cognition and related comorbid depression

Schizotypal PD Descriptors

Must exhibit at least five of the following characteristics

1. Ideas of reference (misinterpreting events as relating directly to them)

2. Odd beliefs or magical thinking

3. Bodily illusions or other unusual perceptions

4. Odd thinking and unusual speech

5. Suspiciousness

6. Inappropriate or constricted affect

7. Peculiarities in behavior and appearance

8. Lack of close friends other than first degree relatives

9. Social anxiety that does not diminish with familiarity and tends to be related to paranoid fears

Paranoid Personality Disorder Overview

A pervasive and unjustified pattern of distrust and suspiciousness

• Will assume that others are out to harm or trick them and will interpret others’ motives as malevolent

• Feelings of hostility toward other people are common, very sensitive to criticism and often have an excessive need for autonomy

Treatment for a Client with Paranoid PD

Focuses on development of trust and cognitive therapy to change mistaken assumptions of others

Difficulties with treatment?

Paranoid PD Descriptors

Must exhibit at least four of the following descriptors

1. Suspects that others are exploiting, harming, or deceiving him/her

2. Preoccupied with unjustified doubts about the trustworthiness of others

3. Reluctant to confide in others b/c information will be used maliciously

4. Reads hidden or threatening meanings to benign remarks or events

5. Persistently bears grudges

6. Perceives attacks on his/her character or reputation that are not apparent to others and is quick to react or counterattack

7. Recurrent suspicions without justification of partner’s fidelity