A person who is shy, emotionally cold, shunning close relationships, introspective and prefers solitary activities, resides alone. There are no delusions and hallucinations. Which personality disorder is he likely to be classified into?
(a) Schizoid personality disorderRef: Complete review of psychiatry by Dr, Prashant Agrawal, etL, 2018, ch - 14, pg, 280Personality traits are 'enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts' (American Psychiatric Association 2000). The DSM-IV-TR used a "multi-axial" diagnostic system. This means that when a diagnosis was made using DSM-IV, attention was paid to five different areas, or axes, that may have affected the individual being diagnosed. Personality disorders were diagnosed on Axis II of the multi-axial system. This axis is reserved for very long-standing conditions of clinical significance. Mental retardation is the only other condition that was diagnosed on Axis II. In DSM-5. the most recent version, there are no axes.ClustersPersonality disorders are organized into three "clusters" in both the DSM-IV-TR and DSM-5. The disorders in each cluster share key features or have overlap in terms of the characteristics of individuals who are diagnosed within that cluster.Cluster A'The "Cluster A" personality disorders are characterized by odd or eccentric behavior. Individuals with the personality disorders in this cluster tend to experience major disruptions in relationships because their behavior may be perceived as peculiar, suspicious or detached. The "Cluster A" personality disorders include:* Schizotypal Personality Disorder* Paranoid Personality Disorder* Schizoid Personality Disorder'Cluster B'The "Cluster B" personality disorders are characterized by dramatic or erratic behavior. Individuals with the personality disorders in this cluster tend to either experience very intense emotions or engage in extremely impulsive, theatrical, promiscuous or law-breaking behaviors. The "Cluster B" personality disorders include:* Borderline Personality Disorder* Histrionic Personality Disorder* Antisocial Personality Disorder* Narcissistic Personality Disorder'Cluster C'The "Cluster C" personality disorders are characterized by anxiety. Individuals with the personality disorders in this cluster tend to experience pervasive anxiety and/or fearfulness. The "Cluster C" personality disorders include:* Dependent Personality Disorder* Obsessive-Compulsive Personality Disorder* Avoidant Personality DisorderPARANOID PERSONALITY DISORDERIndividuals with paranoid personality disorder view others as devious, deceptive, and covertly manipulative. They view themselves as righteous and mistreated by others and vulnerable and open to the possibility of being exploited and therefore need to be on guard. They fear being controlled, demeaned, and discriminated against. As a result, they are wary, suspicious, and looking for cues. The main affect is anger over presumed abuse and they may experience anxiety over perceived threats because of heightened sense of fear and vulnerability. paranoid behaviors that may be recognized, including: inability to confide in others, hostility if it is perceived they are being schemed against, reluctance to sign documents, excessive concern about confidentiality, and a history of repeated termination of employment. Pathological jealously concerning faithfulness of partners is also common Beck and Freeman also describe possible symptoms of paranoid personality disorder: tendency to attribute blame to others, difficulties considering alternative explanations,searching intensely and narrowly for evidence, inability to see humour in situations, strong need for independence, and inability to relax and close his or her eyes.SCHIZOID PERSONALITY DISORDERThe two striking features of schizoid personality disorder are first a lack of interpersonal relationships and the lack of desire to obtain such relationships. The second feature is the presence of'negative symptoms' in the absence of psychotic- like cognitive and perceptual distortions. Prevalence figures range from 0.5% to 7% in the general population and the diagnosis is more commonly made in men whereas the disorder is uncommon in inpatient psychiatric settings (American Psychiatric Association 2000; Fulton & Winokur 1993). Individuals construct their lives to limit interactions with others and usually select occupations that require minimal social contact and are sometimes in jobs that are below their level of ability. They have a tendency to turn inwards and away from the external world and see themselves as self-sufficient and independent and will sacrifice intimacy in order to preserve autonomy.They consider themselves to be observers rather than participants in the world around them. Some typical thoughts may include: 'going through the motions', 'why bother', 'who cares', 'rather do it by myself', 'emptiness inside', and 'life is unfulfilling'. Despite these thoughts, individuals may believe that they should strive to attain a more conventional lifestyle but recognize that they cannot respond in the same way as others to particular stimuli and may make emotional attachments with animals or inanimate objects. Others may see them as shy, withdrawn, reclusive, isolated, dull, uninteresting, and humourless. Their cognitive style is characterized by vagueness and poverty of thought or concrete thoughtform. Typical behaviours include lethargic and unexpressive movements that lack gestures or alternatively, rhythmic movements, slow and monotonous speech, poor spontaneous speech, or poverty of content of speech, limited eye contact, and may appear ill at ease. Although they may appear sad or anxious during close encounters, they are not inclined to show their feelings either verbally or through facial expressions.SCHIZOTYPAL PERSONALITY DISORDERThis disorder is revalent in approximately 3% of the general population (American Psychiatric Association 2000). The cognitive distortions in these individuals are the most severe of any in the personality disorders and generally consist of suspicious and paranoid ideation, ideas of reference, odd beliefs, magical thinking and illusions. Speech is coherent but may be vague, tangential, circumstantial, or overelaborate, and individuals may engage in emotional reasoning and personalization as a result of their concrete thought-form while affect is often inappropriate or restricted. Generally, the themes expressed by an individual will be unique to them but common thoughts include: believing they are being watched; knowing what people are thinking; feeling something bad is going to happen; believing that they are not going to be liked by others; supposing there are reasons for everything; and believing they are defective. Inappropriate behavior contributes to the extreme social isolation associated with this disorder. Common behavior includes peculiar mannerisms such as excessive hand washing and refusing to touch doorknobs, dressing in an unusual manner, and generally avoiding eye contact Individuals will largely desire social relationships and experience great pain as a result of their isolation. This along with increased stress results in fewer opportunities for reality testing with others and the possibility of deterioration to a psychotic condition.
Schizoid personality disorder
Paranoid personality disorder
Emotionally unstable personality disorder
Antisocial personality disorder
Personality Disorders