Monday, November 28, 2011

Schizoid wins the prize ...

... as one of the most misused psychological terms around.

I've seen this in queries at various forums. I've heard it dropped in casual conversation. First, it's often used as a noun: "He takes a crazy road trip with a philosopher, a serial killer, and a schizoid."

Sigh. It's not a noun. It's an adjective. It describes a set of traits that add up to a personality disorder.

Second, it's often used to describe someone who is psychotic. Hallucinating, delusional, et cetera. When people say, "he's a total schizoid," what they usually mean is "he appears to have schizophrenia, or several symptoms thereof."

Except ... "schizoid" and "schizophrenic" are quite different (and also different from "schizotypal" and "schizoaffective", but that's for another post). I guess the moral here is: be careful with your schizos.

Back to schizoid personality disorder. If you refer back to my quick and dirty guide to personality disorders, schizoid personality disorder is part of Cluster A, the odd or eccentric patterns of behavior. Specifically, schizoid personality disorder (according to the DSM IV-TR)  is a pattern of detachment from social relationships and a restricted range of emotion expression in interpersonal interactions characterized by at least four of the following:
  • Neither desiring nor enjoying close relationships--including familial ones
  • Choosing solitary activities
  • Little, if any, interest in sexual experiences
  • Taking pleasure in few, if any, activities
  • Lacking close friends or confidants
  • Indifferent to praise or criticism from others
  • Emotional coldness, detachment, or flattened affect
See? No hallucinations or delusions. In fact, symptoms can't occur in the presence of schizophrenia (or any other psychotic disorder) or an autism spectrum disorder. To get diagnosed with schizoid personality disorder, the symptoms have to be impairing, and they have to be present across the person's environments.

Schizoid personality disorder is one of the more  oft-questioned "disorders." Here's an example of why: I actually know someone who I believe has this disorder, and I can tell you that it's very hard on his family ... but it doesn't seem to bother him at all. Folks with this disorder don't often seek treatment because they aren't in distress. The people around them might be tremendously distressed, but the person himself? Meh. He could take 'em or leave 'em. Sure, he might be brilliant, but applying that brilliance? Meh. Passion? Meh. Dreams? Meh.

Meh.

Oh ... and also ... this is one of the personality disorders that's going to disappear in May 2013 when the APA rolls out the shiny new DSM V. I mean, folks currently diagnosed with this disorder won't suddenly be undiagnosed; this just means the way of describing and classifying the symptoms is going to look somewhat different.

Anyhoo, schizoid. Does it make any more sense now? Ever read any books with a character like this? And what do you think about diagnosing a person with a disorder if it's not actually causing the person any distress?

Because it's Monday, I highly recommend you visit Lydia to read her Medical Monday post, and then Laura for her Mental Health Monday post. They are some of the most un-meh bloggers I know.

15 comments:

  1. Fascinating and informative, as always, Sarah. I'm sure I'm guilty of the "schizoid" reference myself. And you don't mention it, but thanks to TV and movies, schizophrenic has also come to mean "multiple personality disorder" to a lot of people which is also off base. Thanks for your post and for stating these very interesting psychological facts in a way that makes them easy to understand.

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  2. Wow. You seriously just educated me. An adjective? Yeah, sounds logical. But for some reason, it is easy to use the word as a label when describing a character. I know I'm guilty of using it, especially in a dialog segment. It just doesn't feel right saying 'he's acting like a ....' as opposed to 'he is', even though it's correct. Thank you for pointing it out!!

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  3. I vaguely knew that schizoid was not the same as schizophrenic, thanks to an abnormal psychology class I took in college, but I had forgotten all the details. Thanks -- I've always found this topic fascinating!

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  4. Oh, I didn't know it was an actual diagnosis (despite having taken an abnormal psych class in university. Most of which I've forgotten). I just thought it was a slang bullies used. It makes sense that people confuse the terms since the spellings are so slimilar.

    Great post as always, Sarah.

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  5. I always found these confusing--which is why I leave it to you professionals to help me figure out the differences!

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  6. OOOh good one, Sarah!

    The one I actually hear more from people is using "schizophrenic" in order to mean "multiple personality disorder." As in, "he got all schizophrenic on me and I didn't know which "personality" would show up". I hear it all.the.time. used in this way! Have you heard this one too?

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  7. wow. What a super-interesting post. See, and I thought schizoid PD would be like acting out and stuff. But it's not. It sounds the exact opposite!

    Now I'm wondering if you can suddenly have this problem or if it's always there... I guess I mean I wonder if it emerges or something. Or if it can be triggered. *sigh* ;p

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    1. (Replying 6 years later in case anyone else stumbles upon this)
      It doesn't just show up out of nowhere. It appears during childhood and stays throughout the rest of one's life. However, unlike Autism, the condition actually worsens with age.

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  8. Love this information, Sarah. Fascinating. What a tragic diagnosis--the sufferer is not the diagnosed person, and the diagnosed person couldn't care less. With all this maladaptive cognition (?), does a person with schizoid traits function independently in society? Are the people around him a necessary support system?

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  9. Oh, interesting. I even have a psych degree and didn't realize this. The symptoms to me, sound very much like the autism stuff, but apparently without some of the tics? (maybe missing the obsessive end?) and has a lot of overlap with sociopathology, but maybe not lacking the conscience? I know I've always assumed and schiz comes with hallucinations. Then again, I've never used schizoid as a descriptor.

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  10. With so many personality disorders...is anyone ever considered normal? And what defines normal?

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  11. I hate it when people use this term to describe someone. My aunt is schizophrenic, and it caused quite a bit of distress and sadness in our family before being treated (I'm pretty sure she didn't receive treatment until mid-40s).

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  12. I don't think I've used schizoid, but if I did, I didn't know it wasn't another word for schizophrenia. Sounds much different!

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  13. LOL - be careful with your Schizos. I think that is my phrase of the week. :D

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  14. Although, moat Schizoids (myself included) use it as a noun because it is easier than saying "people with Schizoid PD" or "Schizoid individuals". It like how the adjectives of "black" and "white" have over time become nouns to represent "black" people and "white" people.
    Also, SzPD and Autism Spectrum Disorder are not mutually exclusive...it would just be near impossible to diagnose both of these in one person.
    As a final note, never rely too heavily on the DSM. It is far too easy for a depressed introvert to fit the bill, and there are many key traits of Schizoids that are not even taken into consideration for an official diagnosis...

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