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Schizoid PD

Mnemonic. ?Sir Safe"SolitaryIndifferent to praise and criticismRelationships of little interestSexual experiences not of interestActivities preferred are solitaryFriendships are fewEmotionally cold and detached. DSM IV ? Essential Features. detachment from social relationshipsrestricted r

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Schizoid PD

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    1. Schizoid PD

    2. Mnemonic Sir Safe Solitary Indifferent to praise and criticism Relationships of little interest Sexual experiences not of interest Activities preferred are solitary Friendships are few Emotionally cold and detached

    3. DSM IV Essential Features detachment from social relationships restricted range of emotions

    4. DSM-V Very low base rates No stats in DSM on prevalence Prevalence rates vary (.5 to 7%) Not well-studied Eliminated from DSM-V?

    5. ICD-10 Criteria detachment, aloofness, coldness, solitude little interest in sexual relationships fondness for fantasy and introspection indifference to others lack of close friends insensitivity to social norms

    6. Schizoid Style Retiring (Millon, 1994) Solitary (Oldham and Morris, 1995)

    7. History Hoch (1910) - shut-in personality Kraepelin (1920s) comparison to autism Bleuler (1924) - coined schizoidie schizophrenia was characterized by 1) autistic thinking, 2) loose associations, 3) disturbed affect, 4) ambivalence if one of these characteristics - schizoid

    8. History Kretschmer (1925) two types overly sensitive (hyperaesthetic - AVD) insensitive (anesthetic - SZD) Hebebrand et al. (1997) found an association between body mass index and schizoid PD they are significantly underweight Hebebrand et al. (1997) found an association between body mass index and schizoid PD they are significantly underweight

    9. History SZD past was an amalgam of the schizoid, avoidant and schizotypal PDs DSM-III 3 parts avoidant (Millon) schizoid (Bleuler) schizotypal (Rado)

    10. Clinical Observations Compulsive masturbation Autistic thinking Fragmented self-identity Depersonalization/Derealization Primitive Defenses - splitting

    11. Associated Features do not desire emotional intimacy rarely marry (particularly men) activities involve intellectual abstraction bland, lack social graces still can function in society take jobs with little person contact

    12. Associated Features difficulty expressing anger lives seem directionless and a drift deficient motivation poor peer relations underachievement at school lacks interest in hobbies humorless might be creative

    13. Etiology debatable link to schizophrenia introversion is a highly inheritable trait lack the emotional equipment to display emotions? cold distant caregivers? overinvolved and overinvested parents? Hoek et al. (1996) found an association between 1st trimester famine and SZD

    14. 5 schizo disorders (1) schizophrenia (2) schizophreniform (3) schizoaffective (4) schizotypal (5) schizoid

    15. Comorbidity and Differential Diagnosis co-occurs with SZT, PAR, AVD Millon proposes 4 subtypes affectless (SZD with COM) depersonalized (SZD with SZT) languid (SZD with DPR) remote (SZD, AVD, SZT)

    16. Media Examples The Net Sandra Bullock Batman Mad Max Mel Gibson Clint Eastwood westerns Zero Effect Darrel Zero

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