What is the main difference between avoidant and schizoid personality disorders?

Avoidant Personality Disorder is a personality disorder where individuals are timid and shy, and because they are so uncomfortable and afraid of rejection or criticism, they avoid social contact. However, they do wish to have friends, unlike individuals with schizoid personality. In addition, they are self-critical and have low self-esteem. If affected individuals are given strong guarantees of uncritical acceptance, however, they will make friends and participate in social gatherings.

Epidemiology
Prognosis
Comorbidity

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by 4 (or more) of the following:

  1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.

  2. Is unwilling to get involved with people unless certain of being liked

  3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed

  4. Is preoccupied with being criticized or rejected in social situations.

  5. Is inhibited in new interpersonal situations because of feelings of inadequacy.

  6. Views self as socially inept, personally unappealing, or inferior to others.

  7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing

Psychotherapy is the main treatment of choice, and group modalities may be even more helpful. Cognitive behaviour therapy (similar approach for social phobia), psychodynamic therapy, and schema therapy have all be studied.[5] Therapists should encourage gradual exposures into the world, and stay aware of threats to the patient's self-esteem.

Recommended Reading

Buy on Amazon

PsychDB is an Amazon Associate and earns from qualifying purchases. Thank you for supporting our site!

Personality Disorder Guidelines

Guideline Location Year PDF Website
World Federation of Societies of Biological Psychiatry (WFSBP) International 2009 - Link

For Patients

For Providers

Articles

Research

3) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

4) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

Schizoid personality disorder is characterized by a pervasive pattern of detachment from and general disinterest in social relationships and a limited range of emotions in interpersonal relationships. Diagnosis is by clinical criteria. Treatment is with cognitive-behavioral therapy.

In schizoid personality disorder, the ability to relate to others meaningfully is limited.

About 3.1 to 4.9% of the general US population have schizoid personality disorder. It is slightly more common among men. Schizoid personality disorder may be more common among people with a family history of schizophrenia or schizotypal personality disorder.

Comorbidities are common. Up to half of patients have had at least one episode of major depressive disorder Major depression (unipolar disorder) Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown... read more . They often also have other personality disorders, most commonly schizotypal Schizotypal Personality Disorder (STPD) Schizotypal personality disorder is characterized by a pervasive pattern of intense discomfort with and reduced capacity for close relationships, by distorted cognition and perceptions, and... read more , paranoid Paranoid Personality Disorder (PPD) Paranoid personality disorders is characterized by a pervasive pattern of unwarranted distrust and suspicion of others that involves interpreting their motives as malicious. Diagnosis is by... read more , borderline Borderline Personality Disorder (BPD) Borderline personality disorder is characterized by a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations... read more , or avoidant Avoidant Personality Disorder (AVPD) Avoidant personality disorder is characterized by the avoidance of social situations or interactions that involve risk of rejection, criticism, or humiliation. Diagnosis is by clinical criteria... read more .

Having caregivers who were emotionally cold, neglectful, and detached during childhood may contribute to the development of schizoid personality disorder by fueling the child's feeling that interpersonal relationships are not satisfying.

Symptoms and Signs of ScPD

Patients with schizoid personality disorder seem to have no desire for close relationships with other people, including relatives. They have no close friends or confidants, except sometimes a 1st-degree relative. They rarely date and often do not marry. They prefer being by themselves, choosing activities and hobbies that do not require interaction with others (eg, computer games). Sexual activity with others is of little, if any, interest to them. They also seem to experience less enjoyment from sensory and bodily experiences (eg, walking on the beach).

These patients do not seem bothered by what others think of them—whether good or bad. Because they do not notice normal clues of social interaction, they may seem socially inept, aloof, or self-absorbed. They rarely react (eg, by smiling or nodding) or show emotion in social situations. They have difficulty expressing anger, even when they are provoked. They do not react appropriately to important life events and may seem passive in response to changes in circumstances. As a result, they may seem to have no direction to their life.

Rarely, when these patients feel comfortable revealing themselves, they admit that they feel pain, especially in social interactions.

Symptoms of schizoid personality disorder tend to remain stable over time, more so than those of other personality disorders.

  • Clinical criteria (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5])

For a diagnosis of schizoid personality disorder, patients must have a persistent pattern of

  • Detachment from and general disinterest in social relationships

  • Limited expression of emotions in interpersonal interactions

This pattern is shown by the presence of 4 of the following:

  • No desire for or enjoyment of close relationships, including those with family members

  • Strong preference for solitary activities

  • Little, if any, interest in sexual activity with another person

  • Enjoyment of few, if any, activities

  • Lack of close friends or confidants, except possibly 1st-degree relatives

  • Apparent indifference to the praise or criticism of others

  • Emotional coldness, detachment, or flattened affect

Also, symptoms must have begun by early adulthood.

Clinicians should distinguish schizoid personality disorder from the following:

  • Social skills training

No controlled studies have been published about psychotherapies or drug therapy for schizoid personality disorder.

Generally, efforts to share interest in impersonal topics (eg, possessions, collections, hobbies) that appeal to people who prefer solitary pursuits can help establish a relationship with a patient and perhaps facilitate a therapeutic interaction.

Cognitive-behavioral approaches that focus on acquiring social skills may also help patients change. Because patients with schizoid personality disorder lack interest in other people, they may not be motivated to change.

NOTE: This is the Professional Version. CONSUMERS: View Consumer Version

What is the main difference between avoidant and schizoid personality disorders?

Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

What is the main difference between avoidant and schizoid personality disorders?

Which mental illness is most comorbid with avoidant personality disorder?

AVPD is often comorbid with depression and substance abuse, and is likely to be associated with increased odds of suicidal ideation and attempts,2,6,9 explaining, perhaps in part, why AVPD may be a significant predictor of chronic depression.

What are the two hallmark features of schizoid personality disorder?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the essential feature of schizoid personality disorder is a persistent detachment from social relationships and limited emotional expression in social settings.

What personality disorder is similar to schizoid?

Although a different disorder, schizoid personality disorder can have some similar symptoms to schizotypal personality disorder and schizophrenia, such as a severely limited ability to make social connections and a lack of emotional expression. People with these disorders may be viewed as odd or eccentric.

What is the difference between an avoidant style and avoidant personality?

The main difference between the fearful-avoidant attachment style and the dismissive-avoidant attachment style is that fearful avoidants tend to shy away from closeness because of fear, while dismissive avoidants do so because they disregard the importance of connections with others.