SZPD Questions.

Hello. I am confused about the DSM/ICD diagnostic criteria and how it applies to me. A school psychologist over 10 years ago said something about me like "asperger traits", but apparently Asperger syndrome was eliminated and no longer exists. Also i don't think i meet the DSM criteria for autism as i don't have sensory issues/meltdowns.

Recently I have been researching SZPD(i identify at least partially with most of the symptoms, except asexuality), and was curious if the diagnostic traits are rigid or flexible. Like for example, with " Shows emotional coldness, detachment, or flattened affectivity" if you sometimes you do smile, get mad, or have emotion related changes in tone of voice(briefly), but are generally emotionaly cold and display flat affect 80-90% of the time.
Also about "Appearing indifferent to either praise or criticism from others." Does this have to be all of the time, or just most of the time? Is this even something you can observe yourself? I would say i am receptive to some criticism and dont care about some and generally either dislike or dont care about praise.

I have other questions about criteria too if it's ok to post.

I would say the onset of full blown SZPD like symptoms for me was in 2019(age 19-20), the early stages were in 2019, and solidified in 2021. Would smoking weed (very strong CA medical grade+concentrates) at an early age (14-18) have to do with developing this?

I have made an appointment to recieve mental health services next month. Is there anything i should bring up to a psychiatrist/psychologist re: this?

Hi and welcome.

"Aspergers" still exists, but it now comes under the umbrella of Autism Spectrum Disorder (ASD). Many people still refer to diagnoses as Autism or Aspergers though- they've always know it as that. More recent research has led to the disorders being given that name instead- it all being on a spectrum in that there are people on that spectrum who might have some very mild symptoms and can manage to deal with their world quite well within their limitations, right through to people who have severe, non-verbal symptoms and limited functioning.

My understanding is that getting a full diagnosis involves quite an involved assessment process- I've not been formally diagnosed with ASD myself, but my treatment team and I agree that the symptoms fit.

As with any disorder, you may not have every symptom on the list- or it may not affect you to a degree that it causes obvious problems. I don't have meltdowns as such, but I do have periods where I become totally overwhelmed and need to find quite space. And to most people when I am in that state, I can hold it together and unless they know me well, they likely wouldn't notice I was struggling.

I've had lots of psychologists over the years offer me their "diagnosis". Many I didn't spend long enough dealing with for them to get to know me enough to really make that assessment. There's a big difference between an off-hand comment about some of your behaviours and someone making a formal assessment, or dealing with you over a long enough period of time where they can see how you respond to things and basing an assessment off that.

Something I have found helpful is looking through the other forums here and seeing what resonates with me. You don't have to be able to identify with everything being said, but I've found it's helped me understand my own behaviours more, and whether they fit in with what other people are saying or not. I first started out on my journey of diagnosis over 10 years ago- and we've tried out lots of them. Some really made sense, and others really didn't. But reading other people's experiences was one of the most helpful things in working out what was going on for me, and sometimes finding the words for it. No two people's diagnosis and symptoms are going to look exactly the same.

aks1 wrote:I have made an appointment to recieve mental health services next month. Is there anything i should bring up to a psychiatrist/psychologist re: this?

They will likely ask you loads of questions, but if you want to mention that you've been reading about SzPD and there's a lot that resonates you can. Personality disorders can't be diagnosed in a single session- again they need to see how you react and behave over time. And they start developing during early childhood. I would recommend writing out your history and any questions you want to ask though before you go to take with you - either to hand to them or prompt yourself. I've found I always end up forgetting important stuff, and I just find it an exhausting process to get through.

aks1 wrote:Also about "Appearing indifferent to either praise or criticism from others." Does this have to be all of the time, or just most of the time? Is this even something you can observe yourself? I would say i am receptive to some criticism and dont care about some and generally either dislike or dont care about praise.

I have other questions about criteria too if it's ok to post.

Most personality disorder criteria- for symptoms to be diagnosable it is about severely how they affect you. I don't know a lot about SzPD specifically (I have more Avoidant/Dependent and some Borderline symptoms), but feel free to ask- that's what the forum is here for.

Dsm criteria
1. Neither desires nor enjoys close relationships, including being part of a family.
-This one is kind of iffy. I would say i dont mind interacting with my family, but maybe can describe it as "apathy" unless i get really lonely. Also sometimes call "remnant" friends and just chat. But the idea of not having friends doesnt bother me but dont mind them either, so maybe apathy too?
I do desire to have a wife and talk to her from time to time, but i think the want a wife also has the sexual desire aspect.

2. Almost always chooses solitary activities. - Mostly Yes
-since "covid" and mask mandates, have been going out with family more possibly for the sake of getting a ride, then doing solitary activities once i reach the destination. Some bizzare socialization with family on the way there/at the destination, then retrating to solitary activities such as wandering around or observing pigeons.

3. Has little, if any, interest in having sexual experiences with another person.
-I have never related to this symptom.

4. Takes pleasure in few, if any, activities.
-I would say not many activities, but probably more than a few.

5. Lacks close friends or confidants other than first-degree relatives.
-Partially.
For around 2 years, ive only really talked to 2 former friends, and nearly exclusively via call/text. One is not a close friend and i call him if im bored or if i see something that intrerests him. Havent physically seen him since 2019. Another one i call from time to time and confide in him.
Regular contact with most first degree relatives.

6. Appears indifferent to the praise or criticism of others
-Maybe. I dont know if this is something observable by me. I care about things i care about, I described this more in my initial post.
Father described it like "appear indifferent to ideas not your own." Known to be calm, cool when yelled at.
.
7. Shows emotional coldness, detachment, or flattened affectivity.
-Mostly
Emotional coldness, Y emotional detachment, maybe if someone can explain this to me.
Flat affect, i usually display flat affect, but i feel like blunt affect or severely reduced is a better description. Have shown anger, sometimes crack brief smiles, laughs etc.

Maybe ill do an ICD one too, i relate to more on that.

Edit to initial post: Beginning development of full blown characteristics was probably 2018(aged 18-19)

Now I'll do Icd 10.

Few, if any, activities provide pleasure.
-Same as previous reply (Dsm)
Displays emotional coldness, detachment, or flattened affectivity.
-Same as previous reply
Limited capacity to express warm, tender feelings for others as well as anger.
-i don't hug my parents. I can't say for sure if I even love them. I probably feel some sort of attachment to them and "I might feel sad /cry if they died". I have been infatuated with a girl in the past(before symptom onset) so I think I am capable of attachment/infatuation but I don't know about love. I enjoyed hugs from girls in high school.
I also had trouble with guilt in the past, but I eventually developed a feeling of guilt/remorse.
I rarely get visibly angry or display anger. A time I recall when I was mad I felt "internally distraught" I don't know if I displayed it facially or not. Have had yelling outbursts in the past but are rare.
Appears indifferent to either praise or criticism from others.
-Same as previous
Little interest in having sexual experiences with another person (taking into account age).
-Same as previous
Almost always chooses solitary activities.
-Same as previous
Excessive preoccupation with fantasy and introspection.
-This is the symptom I relate to the most. Since a young age have always had a vivid fantasy world. Violent fantasies, loving fantasies, narcissistic fantasies, etc.
Extremely introspective, nearly constant when alone. This may disappear during severe OCD episodes. This may be a consequence of isolation.
Neither desires, nor has, any close friends or confiding relationships (or only one).
-I don't relate to this wording. Maybe low desire for non sexual relationships/befriending other men?
Marked insensitivity to prevailing social norms and conventions; if these are not followed, this is unintentional.
-Maybe to probably. But if I lived in a different society would it still be the case? If you write some examples, I could respond better. Like describe if I care about said norm or not.

aks1 wrote:Also about "Appearing indifferent to either praise or criticism from others." Does this have to be all of the time, or just most of the time?

"Have to be?" I havn't the slightest idea! The symptoms, I can recognize on myself though, are stable. They never vanish, or at least not in my case.

All the criteria are seen from the outside and most of the time, but more importantly seen as not normal. So it's not a self-help thing, or self-identification.

Like:
" Shows emotional coldness, detachment, or flattened affectivity"

It's something others perceive, does not have to be true. But if you look cold and not caring to everybody you meet, they will perceive it and react accordingly, which is generally hostile behavior. Also they won't be able to read you, which usually makes empaths crazy and start hallucinating and project their own motivations. You can probably see the same in others yourself, when it happens, but it's unlikely you would see it in yourself. Eventually perhaps, or if you get recorded.

"Appearing indifferent to either praise or criticism from others."

Again something others perceive. When they praise, they expect the same or at least some form of rapprochement, a bond to be created, and a lot of other things. You are supposed to react in certain ways, like gratitude and give meaning to it. It's a manipulation technique, so you have to act manipulated. If you don't, they won't know what motivates you, nor how to handle you. Same with criticism, you are supposed to act in a certain way, like correct your behavior, or justify, or get upset, or ask for forgiveness. Those two make all the narcissists incapable of relating and controlling, so most people will be uncomfortable at best. Most will rage for criticism, or give the silent treatment for praise. It's what people bond over in general, so it makes close relationships impossible.

The problem is that if you take those criteria as some sort of grocery list, and then ask yourself how you feel about it, and if it conforms to your own self-image, then it is pretty much meaningless and does not indicate anything. Most people's self-image is quite often the exact opposite of what they actually are, because they wish to be something they are not. It's part of growing up and it has to be that way, but those diagnosis are actually about finding cause to actual problems.

And no, it's not caused by drugs, although of course it might show similar for some drugs. All people that drink act like sociopaths, it does not make them one. It won't make them become one either even though for other people it does not really make a difference. You have to be trained like this by caregivers or other people in your environment. If you get criticized all the time, you learn to ignore it, because there is no reason not to. If each praise is followed by a backstab, you learn not to act on it, you know it's a trap. If any type of attachment you form is attacked and destroyed, you also learn not to show it. If all affectivity leads to problems, like bad people getting too close, you learn to not show any. If you have to deal with mind readers, looking cold is a good defense, they won't be able to find a right angle of attack.

Obviously most of those things are usually unconscious, but someone well trained will act those ways, because it's what they do and who they are.

The point of me asking this is more like, do I meet these symptoms enough that there's a point to me being evaluated. I think I meet most of them at least partially, but it's hard to say if any are 100% or more than 80%, though it may present a different way to a professional (have been noted as flat affect, odd speech before).

Someone started something like, that the DSM character is an extreme depiction that almost nobody meets in reality.

Should I just lay off it for a while, and wait to bring it up to a psychiatrist? As I think someone said the DSM isn't for lay people to interpret, and reading it can corrupt a diagnosis (It's important for me to be myself during this process as I wouldn't want a false diagnosis.).

Basically i would say the point of these posts/questions is to like see if there is "reasonable suspicion" that I even have this disorder. Like the point of this visit i have scheduled is to see if i have this, and if i probably don't have this, there is no point to me going.

aks1 wrote:The point of me asking this is more like, do I meet these symptoms enough that there's a point to me being evaluated. I think I meet most of them at least partially, but it's hard to say if any are 100% or more than 80%, though it may present a different way to a professional (have been noted as flat affect, odd speech before).

It's because this type of inquiry is putting the cart before the horse. You could have 100% of all the traits and still be just fine and adjusted. What matters is if you don't fit into your environment.

aks1 wrote:Someone started something like, that the DSM character is an extreme depiction that almost nobody meets in reality.

Well it's true, those are mostly myths. But just the same as I can give you an example of reckless behavior in an idealized form, which you might understand the possible ramifications, or bad consequences of it, it does not mean all reckless behavior or people will fall into problems or be disordered. Someone might do fine with some of that behavior if they are in the right environment.
So I can say being reckless is bad, but not always, and it does not mean it is part of your personality either. It only because a personality if it is your only choice when facing danger let's say, but some others might tend to be reckless, and the level is not the same for a doctor or a firefighter. In the second case, you need to be more reckless.

aks1 wrote:Should I just lay off it for a while, and wait to bring it up to a psychiatrist? As I think someone said the DSM isn't for lay people to interpret, and reading it can corrupt a diagnosis (It's important for me to be myself during this process as I wouldn't want a false diagnosis.).

It's fine you would look into it, but look at what is a personality disorder in the first place, before looking at the type. It's like talking about a red apple while only knowing what red is, but not an apple. There are plenty of red things out there, and they are not all apples. Also the fact it is an apple has nothing to do with the level of "redness". You can have super red thing, like pure red, and it's not an apple, while there are probably plenty of apples that are not pure red, and in fact, none of them are, they all have different colors even if you can usually more or less say this is red, and this is not.

aks1 wrote:Basically i would say the point of these posts/questions is to like see if there is "reasonable suspicion" that I even have this disorder. Like the point of this visit i have scheduled is to see if i have this, and if i probably don't have this, there is no point to me going.

Nobody here can tell you that. If you have suspicions, there is no harm in consulting, they have more experience that you have and people here have. On top of that they can look at body movement, and ask particular questions. If you have trouble fitting in society, then you might want to consult, and depending on the gravity, maybe they will give you diagnosis and maybe it will be what you think, or not. You could have physical problems too. Like doctors sometimes will try and rule out known disease, they are supposed to do that. Like hormonal imbalance, and things of that nature.

This being said, if you suspect something on the autistic spectrum, I would go nevertheless, because there might be issues that you are not aware of and a diagnostic in that sense is something that can be useful, because of the theory of mind issue in autism. Something like schizoid though, won't really tell you something you don't know already, same with all personality disorders. It's more of a social condemnation. Basically it is saying there is no hope for you, unless you do business with them, but they have no real plan to fix anything, but they will take your money and watch you struggle, assuming they are not full of prejudice, which is usually the case. It's like going to a dance floor while you are in a wheelchair. They will tell you it is normal to dance, that dance is what makes people happy and you have to find a way to do it all by yourself. If you don't, they will shame you, blame you and tell everybody to get away from you. Now of course, if you are schizoid, that might be a plus.

This being said, if you suspect something on the autistic spectrum

Some of these issues are unexplained by autism. Such as the emotional detachment, lack of active desire for friends, and the "fantasy/introversion". It may also be "Level 1 autism with heavy schizoid traits", but the problem with that is i don't know if i even meet the criteria for "full autism" after Asperger was eliminated.

It's fine you would look into it, but look at what is a personality disorder in the first place, before looking at the type.

Yes that is very important as you cant even be diagnosed unless you meet the general criteria. I may meet the DSM general criteria (significant social impairment??) but not sure about ICD-10, which uses distress(I'm usually unaware/not distressed about the condition, but if i actually think about the aspects, I find them to be disturbing sometimes. Also the loneliness may be disturbing).

I may fit the new category under icd 11 though as it is more broad and uses impairment. (Personality Disorder-Detachment.)