Abnormal Psychology

584 CHAPTER 13

this disorder appear to be emotionless and often don’t express anger, even when

provoked. And in fact, they often report that they rarely experience strong emotions

such as joy and anger (Livesley, 2001). In contrast to those with paranoid personal-

ity disorder, people with schizoid personality disorder generally aren’t suspicious

and are indifferent to other people (Skodol, 2005).

Not surprisingly, patients with this personality disorder function best when iso-

lated from others, which is true for the woman in Case 13.3; in fact, people with this

personality disorder generally don’t marry or express a desire for sexual intimacy.

In response to stress, they may have a very brief psychotic episode (from minutes to

hours). Table 13.7 presents some additional facts about schizoid personality disorder.

Table 13.6 • DSM-IV-TR Diagnostic Criteria

for Schizoid Personality Disorder

A. A pervasive pattern of detachment from social relationships and a restricted range of expres-

sion of emotions in interpersonal settings, beginning by early adulthood and present in a variety

of contexts, as indicated by four (or more) of the following:

(1) neither desires nor enjoys close relationships, including being part of a family

(2) almost always chooses solitary activities

(3) has little, if any, interest in having sexual experiences with another person

(4) takes pleasure in few, if any, activities

(5) lacks close friends or confi dants other than fi rst-degree relatives

(6) appears indifferent to the praise or criticism of others

(7) shows emotional coldness, detachment, or fl attened affectivity

B. Does not occur exclusively during the course of schizophrenia [Chapter 12], a mood disorder

with psychotic features [Chapter 6], another psychotic disorder [Chapter 12], or a pervasive de-

velopmental disorder [Chapter 14] and is not due to the direct physiological effects of a general

medical condition.

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders,

Text Revision, Fourth Edition, (Copyright 2000) American Psychiatric Association.

CASE 13.3 • FROM THE OUTSIDE: Schizoid Personality Disorder

A 33-year-old woman with three children became a cause of concern to social services be-

cause of her limited caring abilities. Investigations led to two of her children being taken

into [foster] care and, after a further period of 2 years, her third child was also taken away.

At this time she was referred to psychiatric services because she was felt to be isolated from

society and had such poor social function. It proved very diffi cult to engage her as she would

go to great length to avoid contact and it was uncertain to what extent she required compul-

sory treatment. Eventually, she was admitted under a compulsory order after threatening a

community worker.... After discharge from [the] hospital she was transferred to supportive

housing but resented the frequent monitoring of her progress, which she perceived as intru-

sion and tried to avoid contact.... She also developed a marked tremor on anti psychotic

drugs and these were steadily withdrawn and stopped altogether after 1 year and she re-

mained completely free of psychotic symptoms. However, the improvement revealed marked

schizoid personality features and she found it diffi cult to adjust to interacting with others

in her [community residence] and tried wherever possible to avoid them.... She functioned

better with no contact and so a transfer was agreed to a supported [apartment] where she

would be left undisturbed apart from one visit each week from a support worker and a full

review every 6 months. After 2 years she remains well on no treatment and is very happy

with her life, which despite little interaction with other people now includes regular contact

with her family.

(Tyrer, 2002, p. 470)