3- Cluster A (Paranoid, Schizoid, Schizotypal) Personality Disorders (Memorable Psychiatry Lecture)

Source: https://www.youtube.com/watch?v=KA-QZHjmMx8

Correct answer: C. Focusing on the underlying inflexible personality traits and processes

Explanation:
The video emphasizes that a checklist or “cookbook” approach is often unhelpful for personality disorders. Instead, understanding how extreme, inflexible personality traits lead to predictable behavior patterns is more clinically meaningful.

Which core approach is emphasized as most useful when understanding personality disorders?

A. Memorizing DSM diagnostic criteria word-for-word
B. Using symptom checklists similar to SIGECAPS
C. Focusing on the underlying inflexible personality traits and processes
D. Diagnosing based on the presence of comorbid anxiety

Correct answer: C. Paranoid, schizoid, schizotypal

Explanation:
Cluster A personality disorders are characterized as odd or eccentric and include paranoid, schizoid, and schizotypal personality disorders.

Which personality disorders belong to Cluster A according to the DSM?

A. Avoidant, dependent, obsessive-compulsive
B. Antisocial, borderline, narcissistic
C. Paranoid, schizoid, schizotypal
D. Schizophrenia, schizoaffective, delusional disorder

Correct answer: C. Their features make individuals less likely to seek help

Explanation:
Cluster A disorders often involve social withdrawal, mistrust, or eccentricity, which reduces help-seeking behavior. This contributes to underdiagnosis and misdiagnosis.

Why do Cluster A personality disorders often fail to come to clinical attention?

A. They usually remit spontaneously
B. Patients lack insight into their behavior
C. Their features make individuals less likely to seek help
D. They are typically diagnosed only in inpatient settings

Correct answer: B. Persistent distrust and suspiciousness toward most people

Explanation:
Paranoid personality disorder is marked by pervasive mistrust and suspiciousness, including doubts about loyalty and beliefs that others intend harm.

Which feature best characterizes paranoid personality disorder?

A. Fixed, systematized delusions lasting years
B. Persistent distrust and suspiciousness toward most people
C. Emotional detachment and restricted affect
D. Fear of social rejection due to feelings of inadequacy

Correct answer: C. Paranoid PD involves shifting suspicious ideas, schizophrenia involves fixed delusions

Explanation:
In paranoid personality disorder, suspicious ideas are numerous, shifting, and non-fixed, whereas schizophrenia typically involves stable, organized delusional systems.

Which distinction best differentiates paranoid personality disorder from schizophrenia?

A. Paranoid PD includes hallucinations, schizophrenia does not
B. Paranoid PD involves fixed delusions, schizophrenia does not
C. Paranoid PD involves shifting suspicious ideas, schizophrenia involves fixed delusions
D. Paranoid PD occurs only in adolescence

Correct answer: C. Low agreeableness

Explanation:
Paranoid personality disorder reflects extremely low agreeableness, particularly difficulty with trusting others.

Paranoid personality disorder is best explained in the OCEAN model as an extreme of which trait?

A. High neuroticism
B. Low openness
C. Low agreeableness
D. High conscientiousness

Correct answer: B. Preference for solitude with little distress about isolation

Explanation:
Schizoid personality disorder is marked by detachment from social relationships and emotional coldness, with patients typically not distressed by their isolation.

Which feature is most characteristic of schizoid personality disorder?

A. Fear of rejection and desire for closeness
B. Preference for solitude with little distress about isolation
C. Fixed bizarre delusions
D. Emotional instability and impulsivity

Correct answer: C. Schizoid patients are indifferent to social connection

Explanation:
Unlike avoidant personality disorder (Cluster C), schizoid personality disorder involves low desire for relationships, not fear-based avoidance.

How does schizoid personality disorder differ from avoidant personality disorder?

A. Schizoid patients desire relationships but fear rejection
B. Avoidant patients lack emotional expression
C. Schizoid patients are indifferent to social connection
D. Avoidant personality disorder is part of Cluster A

Correct answer: B. Extremely low extraversion

Explanation:
Schizoid personality disorder reflects extreme and inflexible introversion, making extremely low extraversion the best trait mapping.

Schizoid personality disorder most closely aligns with which OCEAN trait pattern?

A. High neuroticism
B. Extremely low extraversion
C. High openness
D. Low conscientiousness

Correct answer: B. Intentional social withdrawal vs amotivation

Explanation:
In schizoid personality disorder, social isolation is intentional and preferred, whereas in schizophrenia it often results from negative symptoms such as avolition and affective flattening.

Which feature helps differentiate schizoid personality disorder from schizophrenia?

A. Presence of hallucinations
B. Intentional social withdrawal vs amotivation
C. Presence of paranoid delusions
D. Early age of onset

Correct answer: B. Magical thinking and unusual beliefs

Explanation:
Schizotypal personality disorder involves odd beliefs, including magical thinking, ideas of reference, and unusual perceptual experiences.

Which symptom is most characteristic of schizotypal personality disorder?

A. Complete emotional detachment
B. Magical thinking and unusual beliefs
C. Recurrent manic episodes
D. Fear of abandonment

Correct answer: C. They are unusual perceptual experiences rather than true hallucinations

Explanation:
DSM terminology emphasizes “unusual perceptual experiences” in schizotypal personality disorder, with generally preserved reality testing, distinguishing them from schizophrenia.

Which statement about perceptual experiences in schizotypal personality disorder is most accurate?

A. They are identical to schizophrenia hallucinations
B. Reality testing is usually completely absent
C. They are unusual perceptual experiences rather than true hallucinations
D. They always progress to psychosis

Correct answer: C. They fear being judged for their odd beliefs and behavior

Explanation:
Unlike schizoid personality disorder, social avoidance in schizotypal personality disorder is often anxiety-driven, related to fear of judgment.

Why do individuals with schizotypal personality disorder often avoid social relationships?

A. They lack emotional capacity
B. They prefer complete isolation
C. They fear being judged for their odd beliefs and behavior
D. They are indifferent to praise or criticism

Correct answer: C. There are genetic and clinical links, with some patients later developing schizophrenia

Explanation:
Research shows genetic overlap and a significant risk (≈30%) of progression to schizophrenia, but progression is not inevitable.

Which statement best reflects the relationship between schizotypal personality disorder and schizophrenia?

A. They are unrelated conditions
B. Schizotypal PD is simply a milder personality variant
C. There are genetic and clinical links, with some patients later developing schizophrenia
D. All patients with schizotypal PD eventually develop schizophrenia

Correct answer: C. It is classified as a personality disorder but lies on the schizophrenia spectrum

Explanation:
Although schizotypal personality disorder shows strong links to schizophrenia, it is officially classified as a personality disorder in DSM-5-TR. Conceptually, it occupies a borderline position between personality pathology and psychotic disorders.

Which statement about the classification of schizotypal personality disorder is most accurate?

A. It is officially classified as a psychotic disorder
B. It is not recognized by the DSM
C. It is classified as a personality disorder but lies on the schizophrenia spectrum
D. It maps clearly onto a single OCEAN trait

Correct answer: C. They share overlapping features such as paranoia and perceptual disturbances

Explanation:
Cluster A disorders (especially paranoid and schizotypal PD) share paranoia, odd beliefs, and perceptual disturbances with psychotic disorders, increasing the risk of misdiagnosis.

Which statement best explains why Cluster A personality disorders have the highest risk of being misdiagnosed as psychotic disorders?

A. They commonly present with mood instability
B. They frequently involve substance-induced symptoms
C. They share overlapping features such as paranoia and perceptual disturbances
D. They typically progress rapidly to schizophrenia

Correct answer: C. Directed toward most or all people in the individual’s life

Explanation:
A defining feature of paranoid personality disorder is pervasive mistrust, meaning suspicion is not limited to a single individual or situation but extends broadly across relationships.

In paranoid personality disorder, suspiciousness is best described as being:

A. Limited to romantic partners
B. Triggered only by traumatic experiences
C. Directed toward most or all people in the individual’s life
D. Confined to periods of stress

Correct answer: C. Indifference to praise and criticism

Explanation:
Schizoid personality disorder involves emotional coldness and detachment, including indifference to both praise and criticism, which contributes to social withdrawal.

Which emotional response pattern is characteristic of schizoid personality disorder?

A. Heightened emotional reactivity
B. Strong sensitivity to criticism
C. Indifference to praise and criticism
D. Fear of social humiliation

Correct answer: B. Estrangement from family and lack of close confidants

Explanation:
Individuals with schizoid personality disorder often show estrangement from family and lack close relationships, reflecting detachment rather than anxiety-driven avoidance.

Which social pattern is commonly seen in schizoid personality disorder but was not emphasized in avoidant personality disorder?

A. Social avoidance due to fear of judgment
B. Estrangement from family and lack of close confidants
C. Desire for connection with limited success
D. Intense fear of abandonment

Correct answer: C. Fear of being judged for eccentric beliefs and behavior

Explanation:
Unlike schizoid PD, social isolation in schizotypal PD is often driven by interpersonal anxiety, particularly fear of judgment related to odd beliefs, eccentric behavior, or unusual appearance.

In schizotypal personality disorder, which factor most strongly contributes to social isolation?

A. Lack of interest in relationships
B. Emotional flattening
C. Fear of being judged for eccentric beliefs and behavior
D. Indifference to interpersonal feedback

Correct answer: C. It does not map cleanly to a single trait, though multiple traits may be involved

Explanation:
Schizotypal personality disorder does not map cleanly onto a single OCEAN trait, though associations with high openness, high neuroticism, and low extraversion have been described.

Which statement best reflects the relationship between schizotypal personality disorder and the OCEAN trait model?

A. It maps clearly onto low agreeableness
B. It maps primarily to low conscientiousness
C. It does not map cleanly to a single trait, though multiple traits may be involved
D. It reflects extreme introversion alone

Correct answer: B. “Schizoid avoids”

Explanation:
The phrase “schizoid avoids” helps reinforce the core pattern of intentional social withdrawal and detachment seen in schizoid personality disorder.

Which mnemonic interpretation from the video best helps recall schizoid personality disorder?

A. “Schizoid is suspicious”
B. “Schizoid avoids”
C. “Schizoid is psychotic”
D. “Schizoid is dramatic”