Does not experience strong emotions
Does not desire or enjoy close relationships
Avoids social activities that involve significant interpersonal contact
Feelings of detachment or estrangement from others
Has no close friends
Indifferent to praise or criticism
Aloof, cold affect
Exhibits little observable change in mood
As noted above, people with schizoid personality disorder maintain contact with reality. Also, men may be more likely to have this disorder than women.
The exact cause of personality disorders is not known, however, several theories attempt to explain the cause. Biologic theorists believe chromosomal or nervous system disorders are the cause. Social theorists believe learned behavior responses cause the disorders. Psychodynamic theorists use deficiencies in ego development to explain the causes.
People with schizoid personality disorder do not have schizophrenia, but it is thought that many of the same risk factors in schizophrenia may be factors causing schizoid personality disorder. Relatives are not thought to be at risk for developing this disorder.
What follows is a brief overview of the cause of schizophrenia in an attempt to explore what may be the cause of schizoid personality disorder.
The cause of schizophrenia has not yet been determined, although research points to the interaction of genetic endowment and major environmental upheaval during development of the brain. Lines of research involving genetic studies and evidence for neurodevelopmental disruption are beginning to converge: neurodevelopmental disruption may be the result of genetic and/or environmental stressors early in development, leading to subtle alterations in the brain. Furthermore, environmental factors later in development can either exacerbate or ameliorate expression of genetic or neurodevelopmental defects. The overarching message is that the onset and course of schizophrenia are most likely the result of an interaction between genetic and environmental influences. The results of this research may in part be applicable to causes of schizoid personality disorder.
A psychological evaluation may be performed; questionnaires and personality tests aid in the diagnosis. To be deemed schizoid personality disorder, symptoms must not occur solely during a schizophrenic episode.
People with this disorder rarely seek treatment. The treatment can be difficult due to their initial reduced capacity or desire to form a relationship with a health professional. A non-intrusive support group can alleviate feelings of solitude and fears of social interactions and close relationships. Individual therapy, in most cases, has proven relatively ineffective and often temporarily addresses immediate conditions instead of seeking to terminate the disorder entirely.
Medications are not usually recommended as treatment for schizoid personality disorder. However, they are sometimes used for short-term treatment of extreme anxiety states associated with the disorder.
Individual therapy that successfully attains a long-term trust level can be useful in some cases of schizoid personality disorder by providing an outlet for patients to transform their false perceptions of friendships into a genuine relationship. As a therapist-client relationship develops, the patient may begin to reveal imaginary friendships and terrors of dependency. Individual psychotherapy can gradually effect the formation of a true relationship between therapist and patient.
Group therapy in people with schizoid personality disorder is another potentially effective form of treatment. Although patients may initially withdraw from the therapy group, they often become more participatory as a comfort level is gradually established. Protected by the therapist who must safeguard schizoids from criticism from other group members, patients have the opportunity to conquer fears of intimacy by engaging in communication and making social contact in a supportive atmosphere.
The social consequences of serious mental disorders—family disruption, loss of employment and housing—can be calamitous. Comprehensive treatment, which includes services that exist outside the formal treatment system, is crucial to ameliorate symptoms, assist recovery, and, to the extent that these efforts are successful, redress stigma. Consumer self-help programs, family self-help, advocacy, and services for housing and vocational assistance complement and supplement the formal treatment system. Consumers, that is, people who use mental health services themselves, operate many of these services. The logic behind their leadership in delivery of these services is that consumers are thought to be capable of engaging others with mental disorders, serving as role models, and increasing the sensitivity of service systems to the needs of people with mental disorders.