personality - lecture 7 paranoid and schizoid personalities

what do paranoid PD, schizotypal PD, and Schizoid PD have in common

feature personality characteristics that are relativly inflexible and occur across most situations (criterion C)

begin in at least adolescences or early adult hood (criterion D)

which two disorders do not appear in the AMPD

paranoid and schizoid PD

key features of paranoid PD

pervasive distrust and suspiciousness of others

• particular fear of being harmed by others

suspiciousness does not solely occur within episodes of psychosis and is characteristic

associated with social anxiety

what is the prevalence of paranoid PD

relatively low, less than 5%

about 2.3-4.4%

what FFM traits are associated with paranoid PD

high neuroticism

low extraversion (introverted)

low agreeableness (callous, hostile)

what pathological traits are associated with paranoid PD

psychoticism: unusual thoughts & beliefs, perceptual dysregulation

detachment: suspiciousness, intimacy avoidance, withdrawal.

what pathological trait FACET drives a diagnosis of paranoid PD

suspiciousness in detachment

how might someone with paranoid PD experience difficulties in personality functioning (criteria A)

impairments in self-functioning (identity, self-direction)

impairments in interpersonal functioning (empathy, intimacy)

why might there be self-functioning difficulties with identity in paranoid PD

unable to see themselves as someone who is not constantly under threat of risk/deception

chronically defensive and emotional detached due to fear

project their fears onto others

why might there be self-functioning difficulties with self-direction with paranoid PD

goals shaped by preoccupation with protecting oneself

goals may become unadaptable if they involve shifting toward obtaining feedback from others

why might there be interpersonal difficulties with empathy in paranoid PD

inability to see from someone else’s perspective

chronic assumption that others have hidden and harmful motives

lack of emotional insight to understand their suspiciousness is causing interpersonal difficulties

why might there be interpersonal difficulties with intimacy for paranoid PD

intimacy avoidance due to severe suspiciousness and borderline-delusions about being taken advantage of

chronic suspiciousness of others can lead to hostile interactions

may form close ties with others who share similar paranoia (but could change when threat is perceived)

paranoid personality genes factor

heredity in families with schizophrenia

propensity for delusional-like thinking

included within the schizophrenia spectrum

is paranoid pd included in the ICD-11/AMPD

no

paranoid PD environment factor

individuals may be ‘odd’ and ‘eccentric’ during childhood/adolescence and therefore prone to bullying, reinforcing paranoia.

what makes paranoid PD different than schizophrenia?

paranoia exists outside of episodes of psychosis, its chronic across time

paranoid personality exists before onset of psychotic features

key features of schizoid PD

pervasive pattern of detachment from others

• more of a lack of preference to be around others

limited range of emotional expression

pattern of negative-like symptoms on psychosis spectrum

aloofness does not solely occur in episodes of psychosis

what is the prevalence of schizoid PD

rare, 3.1-4.9%

what FFM traits match schizoid PD

highish neuroticism

low extraversion

what pathological traits match with schizoid PD

detachment and antagonism

schizoid PD pathological trait: Detachment facets

intimacy avoidance (kinda just doesn’t care), withdrawal, anhedonia (doesn’t feel joy), restricted affectivity (no wide range of emotions)

schizoid PD pathological trait: antagonism facets

callousness - people come off as harsh/sticking to the facts

why might there be self-functioning difficulties with identity for schizoid PD

weak sense of self - feeling empty, disconnected

lack of strong personal values or clear self-concept

identity is relatively absent

why might there be self-functioning difficulties with self-direction in schizoid PD

few interest in personal goals and lack of ambition

solitary activities engaged in without strong sense of purpose or direction

lack of motivation may lead to less drive for career aspirations

why might there be interpersonal difficulties with empathy in schizoid PD

difficulties feeling or responding to others’ emotions - may be able to understand other’s emotions intellectually

negative-like symptoms may lead to being cold, distant, and indifferent to others

why might there be interpersonal difficulties with intimacy in schizoid PD

little to no interest in creating close relationships

relationships are due to practical needs

preference for solitude

lack of need for social validation

schizoid PD genes factor

heredity in families with schizophrenia

included within the schizophrenia spectrum

propensity for avolition and anhedonic-like experiences

is schizoid PD included in the ICD-11 and AMPD

no

schizoid PD environment factor

poor peer relationships and solitariness during childhood/adolescence

may underachieve in school due to lack of interest

subject to potential teasing by peers

what makes schizoid different than schizophrenia

aloofness occurs outside of psychotic episodes, negative symptoms are consistent

schizoid personality exists before onset of psychotic features

however, that brief psychotic episodes (minutes-hours) may occur in response to stress

key diagnostic distinctions between schizoid and autism

stereotyped behaviors and interests in ASD not schizoid

impairment of social interactions and skills in ASD not schizoid

why was paranoid and schizoid excluded from AMPD

largely unsupported by empirical evidence as isolated PD

high rates of comorbidity with other PDs, especially schizotypal.

if elevated traits of these disorders are the only features of personality pathology, may be better specified by its maladaptive traits

what are better ways of explaining paranoid and schizoid pd

as profiles of personality pathology that describe personality dysfunction within other disorders

can specify pathological traits aht coincide with other more common types of personality pathology