SScchhiizzooiidd PPeerrssoonnaalliittyy DDiissoorrddeerr
Individuals with schizoid personality disorders (SPD)
typically exhibit an inability to form social relation-
ships, including relationships with their family, as
well as a lack of interest in doing so. The DSM-IVcri-
teria for SPD include a pattern of detachment from
social relationships and a restricted range of affect in
interpersonal settings, as evidenced by at least four of
the following characteristics: the individual with SPD
neither desires nor enjoys close relationships (includ-
ing with his or her family); almost always chooses
solitary activities; has little or no interest in sexual
experiences; takes pleasure in few activities; lacks
friends or confidants (except for first-degree rela-
tives); is indifferent to praise or criticism; exhibits
emotional detachment, coldness, or flattened affect.
Although it was earlier believed that SPD was a pre-
cursor to schizophrenia, there has been no strong genetic
link found between these two disorders. Research has
suggested that there are genetic links between SPD
and Asperger syndrome, autism, and pervasive devel-
opmental disorder, not otherwise specified. Recent
epidemiological studies suggest that the prevalence
rate of SPD in the general population is between 1%
and 3%, and the prevalence rate in outpatient psychi-
atric settings is about 1%. The preference for solitude
and the lack of general distress in SPD may account
for the low prevalence rates in psychiatric popula-
tions. Behaviorally, individuals with SPD are often
described as “loners” or “lethargic,” and interperson-
ally they desire distance from others. They are likely
to feel comfortable with the interpersonal emptiness
of their lives.SScchhiizzoottyyppaall PPeerrssoonnaalliittyy DDiissoorrddeerr
Individuals with schizotypal personality disorder
(STPD) typically have odd or peculiar beliefs or
appearance accompanied by social and interpersonal
deficits. They tend to have cognitive and perceptual
disturbances and are eccentric in their communication
with others. Like individuals with schizoid personal-
ity disorder, those with STPD are socially isolated
and withdrawn, but the schizotypal personality also
involves oddities of thought, speech, and perception.
DSM-IVdiagnostic criteria for STPD include a perva-
sive pattern of social and interpersonal deficits
marked by acute discomfort with close relationshipsas well as eccentricities in thought, perceptions, and
behavior, as evidenced by at least five of the follow-
ing: ideas of reference (but not delusions of refer-
ence); odd or magical thinking; unusual perceptual
experiences; odd thinking and speech; suspiciousness
or paranoid thinking; inappropriate or constricted
affect; odd, eccentric behavior or appearance; lack of
a close friend other than first-degree relatives; and
excessive social anxiety that is associated with para-
noid fears. Individuals with STPD may present with
an erratic or bizarre manner, peculiar speech (vague
or overelaborated), ruminative thinking, and atypical
perceptual experiences that do not reach the level of
psychosis (e.g., illusions). These individuals may
report being clairvoyant or telepathic and are likely to
be superstitious. Epidemiological studies place preva-
lence rates in the general population at less than 1%
and prevalence rates in outpatient psychiatric settings
at less than 1%. Research has suggested a genetic link
between STPD and schizophrenic spectrum disorders.
Oddities of speech and behavior have been found in
children who later develop the disorder.HHiissttrriioonniicc PPeerrssoonnaalliittyy DDiissoorrddeerr
Histrionic personality disorder (HPD), formerly
called hysterical personality, describes individuals
who are overly dramatic, attention seeking, and highly
emotional. They are often uncomfortable in situations
where they are not the center of attention, and they are
likely to exhibit sexually seductive or provocative
behavior in their interactions with others. They consis-
tently use their physical appearance (i.e., unusual
clothes, makeup, hair color) to draw attention to them-
selves. They exhibit rapidly shifting, shallow emotions
that are often theatrical and exaggerated. Their speech
is impressionistic but lacking in detail. They often mis-
interpret relationships to be more intimate than they
actually are, and they are often highly suggestible.
They are usually self-centered and can be overcon-
cerned about the approval of others. Behaviorally, they
may be seen as seductive, and interpersonally, they tend
to have stormy interpersonal relationships. They often
are seen as emotionally labile, capricious, and emo-
tionally superficial. HPD has a prevalence rate in the
general population of about 2% and is more common
among women. It remains unclear whether the differ-
ential rate of diagnosis is due to gender bias.
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