Other personality disorders and personality traits. Other personality disorders may be confused with schizoid personality disorder because they have certain features in com- mon. It is, therefore, important to distinguish among these disorders based on differences in their characteristic features. However, if an individual has personality features that meet criteria for one or more personality disorders in addition to schizoid personality dis- order, all can be diagnosed. Although characteristics of social isolation and restricted af- fectivity are common to schizoid, schizotypal, and paranoid personality disorders, by the lack of cognitive and perceptual distortions and from paranoid personality disorder by the lack of suspiciousness and paranoid ideation. The social isolation of schizoid per- sonality disorder can be distinguished from that of avoidant personality disorder, which is attributable to fear of being embarrassed or found inadequate and excessive anticipation of rejection. In contrast, people with schizoid personality disorder have a more pervasive detachment and limited desire for social intimacy. Individuals with obsessive-compulsive tion to work and discomfort with emotions, but they do have an underlying capacity for intimacy.
Individuals who are "loners" may display personality traits that might be considered schizoid. Only when these traits are inﬂexible and maladaptive and cause significant func- tional impairment or subjective distress do they constitute schizoid personality disorder.
Diagnostic Criteria 301.22 (F21)
A. A pen/asive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1. Ideas of reference (excluding delusions of reference).
2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness. belief in clairvoyance, telepathy, or “sixth sense"; in children and adolescents, bizarre fantasies or preoccupations).
3. Unusual perceptual experiences, including bodily illusions.
4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).
5. Suspiciousness or paranoid ideation.
Inappropriate or constricted affect.
Behavior or appearance that is odd, eccentric. or peculiar.
Lack of close friends or contidants other than first—degree relatives.
Excessive social anxiety that does not diminish with familiarity and tends to be as- sociated with paranoid fears rather than negative judgments about self.
B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder.
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Note: If criteria are met prior to the onset of schizophrenia, add “premorbid," e.g., “schizo- typal personality disorder (premorbid)."
The essential feature of schizotypal personality disorder is a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of be- havior. This pattern begins by early adulthood and is present in a variety of contexts.