Schizoid personality disorder: subtypes and signs of psychopathy

general information
Causes
Signs and symptoms of the disorder
Disorder in adolescents and children
Tendency to drug addiction in psychopathy
Diagnostics
Treatment
Complications
Prevention
Conclusion

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The character of each person is considered an individual trait that determines the further interaction of the individual with society. With psychopathy, a disturbance occurs in the emotional-volitional sphere. Schizoid psychopathy often manifests itself in childhood. It is important to promptly pay attention to pathological symptoms and seek psychotherapeutic help.

general information

Schizoid psychopathy or schizoid personality disorder is characterized by a tendency to live in one’s “inner world.” A person avoids the bright emotions that other people show. He is more comfortable in the world of “dreams and illusions”; emotional comfort is achieved only in complete solitude. The term schizoid in psychiatry refers to characteristic personality traits that are similar to split thinking (schizophrenia).

With schizoid psychopathy, a person is absolutely not interested in social life. The close circle keeps a kind of distance. Introverted life attitudes lead to isolation and emotional coldness. But at the same time, the “inner world” is very colorful.

The first description of schizoids was recorded in 1908. E. Bleier described people who are prone to “inner life.” In the USSR, schizoid psychopathy was first described by P. B. Gannushkin in 1933. The Soviet psychiatrist identified a separate type of schizoid - dreamers.

In schizoid disorder, as in schizophrenia, attention is occupied by questions, theories and various abstract constructs divorced from life. These arguments reveal logical inconsistency and internal inconsistency, reminiscent of split thinking. Such people are obscure to others; they give the impression of fanatical enthusiasts in subcultural movements.
Dunaevsky V.V. Personality disorders /V. V. Dunaevsky – Electronic textbook on psychiatry and narcology. – topic No. 17. – Psychopathy (personality disorders).

According to ICD-10, with personality disorder there are no pathological changes in the central nervous system. The condition is not caused by a mental disorder.

Characteristic personality traits in schizoid disorder:

Personal and behavioral disharmony (distress);
The abnormal behavior style is chronic;
Social maladjustment;
Abnormal behavioral reactions arose in childhood (juvenile) age and accompany the personality in every age period;
Ignoring social rules and norms.

Schizoids are characterized by increasing regression in the professional sphere. According to ICD-10, schizoid personality disorder is a subtype of specific disorders (F 60.1). The individual is limited in the ability to express his feelings and experience pleasure.

Variants of schizoid disorder

In schizoid personality disorder, a person may have two conditions.

Option 1. Asthenic

In the first case, autistic traits are determined. Patients are distinguished by excessive impressionability and a pronounced degree of their own insufficiency. Their inner world is hypersensitive, “mimosa-like,” manifested in extreme vulnerability and deep feelings of what is happening. Such persons are not only unable to participate in heated debates, but also cannot stand banal life situations where there are debates due to different points of view.

This group of people with schizoid personality disorder are timid and shy, suffering greatly from any rudeness and tormented by unusual innovations. Being in a crowd is unbearable for them, and being in society quickly tires them, so they consciously seek loneliness; they are comfortable coexisting in their fictional world.

The interests of such a person are reduced to the field of abstract knowledge in the field of philosophy or astronomy. Hobbies in schizoid personality disorder manifest themselves very clearly; they are characterized by unusualness and constancy of interests. Most often, hobbies with an intellectual and aesthetic bias are observed. However, even having become a fanatical reader, a person with schizoid personality disorder chooses an in-depth study of a certain topic, for example: the study of a specific historical era.

Option 2. Stenic

In the second type of schizoid personality disorder, the individual is distinguished by high efficiency, but such work zeal is manifested in a narrowly limited sphere of activity. The person is distinguished by pronounced practicality, caution, and pragmatic prudence. The individual has a wayward character with pronounced traits of despotism and lust for power.

Such a person is emotionally cold and detached from what is happening. She has no close friends, she does not accept a partnership style of relationship with colleagues. The patient is not able to listen to the interlocutor, therefore she is perceived as an insensitive person.

Causes

There are no exact causes of personality disorders, but there are several theories:

Schizoid personality disorder is an echo from childhood. The child has not received enough parental love and is therefore unable to show feelings towards himself and others. This is what adherents of psychodynamic therapy think;
Schizoid psychopathy is a disturbance in an individual’s self-image (I-concept). A person is disoriented in his personality and cannot identify parameters for his comfort. Self-psychologists think so;
Personality disorder is idiosyncratic thinking. Symptoms appear in early childhood - delayed psychophysical development, developmental delay. Thought processes are unclear, the child is unable to adequately assess the emotional state of the people around him. This is what adherents of cognitive psychology believe.

There are also suggestions that schizoid psychopathy tends to be genetic.

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Subtypes of schizoid disorder

According to another classification proposed by Theodore Millon, with schizoid personality disorder, a set of certain traits may be accentuated, which together constitute a subtype of the personality disorder.

Subtype 1. Flaccid schizoid

The individual exhibits manifestations of a depressive constitution. It is characterized by a minimal level of activity and a lack of vital energy. He is inert, inactive, lacking initiative. Passive and apathetic to everything that happens. He quickly gets tired of any activity and experiences chronic fatigue that cannot be eliminated by rest.

Such a person is sluggish, slow, perceived by others as “inanimate.” He is characterized by stiffness and angularity of movements, and his motor skills are characterized by monotony and poor range. To smooth out one’s own clumsiness, there is a desire to persistently practice individual sports, for example: yoga.

Subtype 2. Distant schizoid

Such a person deliberately isolates himself from society and leads an isolated and secluded lifestyle. Often an individual prefers seclusion and hermitage and retires to sparsely populated areas. Not only is it very difficult for him to establish any contacts with society, he deliberately avoids any interaction with the community, since he does not need communication at all. You won’t meet him in groups of friends or at public celebrations.

In everyday life, he is not able to resolve basic situations. He is helpless in matters of everyday life. For his life, he creates a “parallel world” in which he is calm and comfortable. He is often fascinated by collecting some rarities, and he does not strive to show off the collected collection to others.

Subtype 3. Depersonalized schizoid

Such a person with schizoid personality disorder not only avoids contact with other people, but also cannot establish relationships with herself. He perceives his own “I” as something alien and distant. His body and psyche are disconnected elements, existing independently and dissociated from each other.

Such a person is often perceived by others as mentally retarded, due to the fact that she is not able to draw logical conclusions from the material she has heard, read, or seen. However, such difficulties are not at all an indicator of a lack of intelligence, but the result of the fact that a person who does not understand himself does not understand the true meaning of the material he is learning.

He is incapable of flirting and building normal relationships with the opposite sex. Therefore, to achieve sexual satisfaction, he often displays activity in unnatural forms, for example: intimate meetings “on the phone” or masturbation under the windows of “reluctant spectators.”

Subtype 4. Emotional schizoid

This is an insensitive and emotionally cold nature. An individual is indifferent to everything that happens; he does not tend to show any emotions. He is unable to show either anger or tenderness. He is an imperturbable and unresponsive type, who is alien to understanding others, friendliness and compassion.

The person is completely indifferent to established social norms and rules. Often he has no reaction at all to significant criticism and serious conflict events, which is a specific defense. Such a person does not attach importance to his appearance, which once again confirms his contempt for established norms. At the same time, the individual is not at all worried that he is the object of ridicule.

Signs and symptoms of the disorder

Personality disorders always begin to appear in childhood or adolescence. Without timely psychotherapeutic correction, symptoms persist into adulthood.

Symptoms:

Emotional coldness and aloofness;
A person cannot get pleasure (actions, emotions);
There is no expression of feelings (joy, anger);
There is no emotional reaction to criticism or praise;
Sexual interest is weak or completely absent;
Tendency to solitude - immersion in fantasies;
Lack of close circle and desire to create a trusting relationship with someone.

In everyday matters, schizoids are completely helpless.

Individuals with schizoid psychopathy have one thing in common – autism. Such individuals are usually vulnerable and shy. Eccentricity, timidity and introversion are noted. Contact with the environment is difficult because they are emotionally cold, and their hobbies are quite original.
Personality disorders (psychopathy) in the practice of military medical examination / V. V. Kulikov, B. V. Shostakovich, S. V. Litvintsev, V. V. Nicheporenko, O. E. Chernov, A. S. Fadeev and L. V. Pustovalov. – Edition 3 – e.: M. – 2003. – 6 – 12 p.

With high intellectual abilities, productive creative activity is possible. The appropriate choice of profession helps to achieve significant results.

With schizoid personality disorder, there is a loss of internal integrity. But there is a certain paradox - along with emotional coldness towards other people’s problems, there is increased vulnerability and sentimentality when it comes to his personality.

But the tendencies of extreme gradations of emotions during stress in schizoids are different. Therefore, there are subtypes:

Sensitive – unable to withstand conflicts, vulnerability prevails;
Expansive people are incapable of empathy, restrained and impartial. When under stress, strong determination emerges.

Despite individual characteristic features, all have difficulty adapting to society. Outwardly, schizoid individuals always stand out - they wear strange clothes, look unkempt, and lack facial expressions. A person with a personality disorder ignores social norms and does not pay attention to others (monologues out loud).

Differences between men and women

Men with schizoid psychopathy completely “withdraw into themselves.” The man is absolutely not interested in anything. The desire for development or career growth is completely absent. The emotional coldness of such men is pronounced. They are incapable of sympathy and any manifestations of empathy. Schizoid men have a weakly expressed interest in the opposite sex. The need for intimate relationships is almost always absent.

It is possible to develop a sustainable interest in some hobby. The hobby is often “childish” (collecting wrappers, candy wrappers, postcards).

Weak emotional reactions are combined with an external “cold mask”:

Unchanging facial expression;
Monotonous speech (no emotion in the voice);
Lack of smile;
When speaking, there is no eye contact (eye to eye).

In women, schizoid personality disorder is diagnosed much less frequently. This is due to the maternal instinct, which is fixed at the genetic level. Therefore, motherhood is a natural protection for a woman.

But if schizoid disorder is diagnosed in a woman, then its course is more smoothed out. Only one pathological symptom (asexuality) may be present. But this does not cause significant discomfort in the woman and is not an obstacle to interpersonal contact.

Disorder in adolescents and children

In children, the first symptoms of schizoid personality disorder appear at a fairly early age (at 3–4 years). The child does not strive for active interpersonal contact and prefers solitude. With age, symptoms increase and in preschool age, pronounced manifestations of autism appear - pathological isolation.

Schizoid children have accelerated mental development, but at the same time lag behind in physical development. When schizoid psychopathy develops, children very early develop an interest in complex philosophical problems (life and death). Answers to simple questions are usually original and unusual.

At school, such children are prone to in-depth study of mathematics, since logical thinking is highly developed. In a group, schizoid children feel uncomfortable - they strive for privacy and do not participate in games.

Schizoid children retain pronounced features of autism, but this does not prevent them from studying and acquiring professional skills in the future.

Main symptoms:

Unsociability;
Emotional restraint;
Tension when interacting with society;
Avoidance of strangers;
Lack of attachment to loved ones;
Preference for solitude;
Unnatural motor skills (lack of plasticity);
Low modulated voice;
Indifference to others;
Long-term feelings of resentment.

The isolation of such children is due to the lack of an internal need for communication. Conflicts cause mental trauma, which leads to loss of mental balance. Pathological symptoms worsen, the child builds a kind of “wall” to isolate himself from the outside world.

In adolescence, emotional coldness and alienation become more obvious. The teenager is prejudiced against any person. Sometimes this is expressed by obvious hostility. There is a complete immersion in your “inner world”, hobbies are mostly intricate.

The teenager treats sexual contacts with contempt. But at the same time, his fantasies contain sexual images. Schizoids often have inflated self-esteem. They sincerely do not understand why others do not see and appreciate their outstanding talent. A teenager is not able to empathize and listen to his interlocutor. Therefore, from the outside, such a child seems cruel. In severe cases of schizoid disorder, a transitional state is formed - distrust develops into delusional alertness.

In rare cases, the beginnings of a personality disorder can be detected in early childhood (up to 3 years). The most characteristic manifestations include: monotonous behavior, difficulty adapting to unusual conditions, difficulties in interpersonal interaction. In such children, speech development is sharply delayed, and the formation of basic self-care skills is difficult. Early autism syndrome remains stable for several years. After which the pathological symptoms are compensated.
Smulevich A. B. Borderline mental disorders /A. B. Smulevich / - Scientific Center for Mental Health.

Schizoid personality type (schizoid personality traits)

Schizoid personality traits persist throughout life. But favorable life circumstances and environment can enable such a person to be adapted in the family and society, to develop professionally and to be fully socialized.

The schizoid personality type is characterized by a predominance of mental abilities over emotional ones. This creates a personality that is guided by ideas rather than feelings. Emotionally, they are vulnerable, sensitive and not syntonic, which gives rise to their clumsiness in communication. And using their intellectual capabilities, they strive to distance themselves from their social circle. They are characterized by interests in unusual, rare hobbies, sports, and they study rare languages. Hence the nickname among schizoids - “eccentrics”. Outwardly cold in communication, they describe themselves as follows: “I’m like a drop of hot wine in a glass of ice.”

All schizoid individuals are characterized by social avoidance, which manifests itself already at the age of 4-5 years. Such children do not play with their peers, prefer solitude, and their parents do not evoke the proper emotional response in them. At school age, unusual intellectual abilities often appear. Schizoid people have introverted, non-standard, original thinking; they have their own idea of the world, and their answers are often discouraging. At the same time, the movements of such children are rough, constrained, and clumsy. This does not apply to fine manual skills such as playing the piano, making handicrafts, or painting. Therefore, individuals with a schizoid bias can become brilliant musicians or artists.

By the age of 10-11, children gradually adapt to the external environment. They find a small number of friends with whom they communicate. There can be formal relationships with other people without emotional attachment. However, any opportunity to communicate or join a team is associated with tension and a feeling of discomfort.

The schizoid personality type is often combined with a characteristic somatotype - these people, as a rule, are tall, motorically clumsy, guided in life by their intellectual constructs, and are capable of extreme devotion to any idea. There is information that Hitler’s guards were recruited based on the criterion of having schizoid traits. Features such as bizarre hobbies and emotional non-syntonity give them a formal resemblance to patients with schizophrenia, although in essence, the schizoid personality type has nothing in common with schizophrenic illness. And in the premorbid period (the period before the onset/onset of the disease), a schizoid character is rarely found among patients with schizophrenia.

Tendency to drug addiction in psychopathy

Personality disorders have a direct connection with drug addiction. Since schizoids have prerequisites for drug addiction:

Inadequate self-esteem;
Communication problems;
Internal tension;
Inability to express emotions.

Teenagers are more likely to become addicted to psychoactive substances. A common motive is to facilitate interpersonal interactions and achieve self-confidence. The formation of addiction occurs very quickly. The addition of drug addiction to a personality disorder leads to an increase in pathological symptoms - isolation and callousness increases.

In schizoids, during a short period of drug addiction, a compulsive attraction to the drug arises. With chronic drug addiction, attacks of aggression occur, which alternate with apathy. During periods of low mood, panic attacks occur. Drug addiction, aggravated by a personality disorder, complicates rehabilitation measures. A person is not critical of his condition, so developing motivation for treatment is difficult.

Schizoid personality disorder is quite common among opiate addicts (20%). When a patient is included in treatment programs, passivity to what is happening is noted. But projective psychodiagnostic techniques are of interest. Drug addicts with personality disorders prefer to limit any interaction with society. If it is possible to involve the patient in a group treatment process, then long-term remission is noted.

Diagnostics

Diagnosis of SPD mainly involves a psychopathological examination of the personality. To do this, the psychiatrist conducts testing and evaluates the result using diagnostic scales (ICD 10).

Various information about the patient is also important for making a diagnosis:

Objective anamnesis - questioning relatives, acquaintances (teachers, classmates), analysis of medical documentation;
Subjective analysis - clinical interview. The psychiatrist conducts a questioning of the patient, creating the most confidential atmosphere.

Questions stimulate the patient to tell his own story. The doctor delicately directs the conversation in the right direction. The anamnesis is collected according to the principle - from past to present. This allows us to establish that schizoid psychopathy manifested itself already in childhood. But at the moment, the symptoms have reached extremes, which interferes with the patient’s adaptation to society.

The study of cognitive functions in persons with schizoid psychopathy reveals a number of abnormalities. The cognitive profile differs from mentally healthy people. However, it is not similar to the cognitive impairment associated with schizophrenia.
Psychological diagnosis of cognitive impairment in personality disorders: a model of schizoid disorder / D. V. Romanov, A. A. Shishova – 2010. – 463 – 464 pp.

Laboratory and instrumental diagnostic methods are prescribed to differentiate the diagnosis:

EEG;
MRI or CT;
Hormonal screening.

In children, schizoid psychopathy manifests itself in the form of inappropriate behavioral reactions. Therefore, the sooner parents seek help from specialists, the more favorable the prognosis will be.

Treatment

Personality disorder cannot be cured. The complex treatment method is aimed at a person’s social adaptation and improving interpersonal skills.

Psychotherapeutic techniques:

Cognitive therapy – awareness of one’s own emotions, the patient learns to enjoy actions or events;
Group therapy – stimulation for activities in society in a safe environment;
Behaviorist techniques - examples of interpersonal interaction in the format of a game;
Psychoanalytic technique - correction of destructive behavior patterns, elaboration of complexes and destruction of the defensive reaction - “dreams”.

Psychotherapeutic correction sessions, as a rule, are lengthy, since difficulties arise in establishing a trusting relationship with the patient.

What will happen if left untreated?

With mild or moderate schizoid psychopathy, specialist help may not be required. A comfortable “climate” in the family, a choice of profession taking into account personality characteristics help a person adapt to society. But in severe cases, without psychotherapeutic correction, there is a tendency to develop mental illness.