CLUSTER A

 Schizotypal Personality Disorder

 Paranoid Personality Disorder
 Schizoid Personality Disorder
 What is Cluster A?

• Cluster A Personality Disorders:

 Characterized by odd or eccentric behavior
 Individuals may appear peculiar or eccentric to others
 Often experience social discomfort or isolation
 Includes Paranoid, Schizoid, and Schizotypal Personality
Disorders
 How disorders are classified in
cluster A?

• Disorders in this cluster share common

features:
 Social withdrawal
 Peculiar thought patterns
 Anxious or paranoid tendencies
 Schizotypal
Personality Disorder
What is Schizotypal Personality Disorder?

 Schizotypal personality disorder: Social deficits,

eccentric behaviors, odd beliefs; distinct from
schizophrenia but shares some traits, milder
symptoms, primarily affecting social functioning.
 Diagnostic Criteria

 The diagnostic criteria for Schizotypal Personality Disorder

according to the DSM-5 (Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition) include:
1. Pervasive pattern of social and interpersonal deficits,
characterized by discomfort with, and reduced capacity for,
close relationships, as well as cognitive or perceptual
distortions and eccentricities of behavior, beginning by early
adulthood and present in a variety of contexts.
Cont…

1. Cognitive or perceptual distortions and eccentricities of behavior,

including odd beliefs or magical thinking, unusual perceptual
experiences, and peculiar thinking and speech.
2. Interpersonal deficits, such as excessive social anxiety that does
not diminish with familiarity, paranoid ideation, or inappropriate or
constricted affect.
3. Exclusion of schizophrenia or other psychotic disorders.
 These criteria must be met for the diagnosis of Schizotypal
Personality Disorder.
 Characteristics

 Social and interpersonal deficits

 Eccentric behaviors
 Odd beliefs or magical thinking
 Unusual perceptual experiences
 Difficulty forming close relationships
 Eccentric speech patterns
 Tendency towards social isolation
 Comorbidity

 Comorbidity of Schizotypal Personality Disorder often includes:

• Major depressive disorder
• Anxiety disorders (e.g., social anxiety disorder)
• Substance use disorders
• Other personality disorders (e.g., borderline, avoidant)
• Paranoid personality disorder
 Risk factor and Prognosis
 Risk Factors:
• Genetics: Family history of schizophrenia or schizotypal personality
disorder can increase the risk.
• Environmental Factors: Early childhood trauma, neglect, or abuse can
contribute.
• Neurobiological Factors: Differences in brain structure and function may
play a role.
• Personality Traits: Certain personality traits, such as introversion or
unusual thinking patterns, may predispose individuals.
 Prognosis

•Chronicity: Schizotypal personality disorder tends to be

chronic, but symptoms may fluctuate in severity over time.
•Social Impairment: Difficulties in social and interpersonal
functioning often persist.
•Risk of Psychosis: While not everyone with schizotypal
personality disorder develops psychosis, there is an increased
risk compared to the general population
Cont…

•Treatment Response: While treatment can help manage

symptoms, the response varies, and long-term therapy may be
necessary for sustained improvement.
•Functional Impairment: Despite treatment, individuals may
continue to experience significant functional impairment in various
areas of life.
 Differential Diagnosis

•Schizophrenia: Differentiated by the absence of

prominent delusions, hallucinations, disorganized speech,
or grossly disorganized or catatonic behavior.
•Schizoid Personality Disorder: Distinguished by the
lack of close relationships or desire for them, without the
cognitive or perceptual distortions present in schizotypal
personality disorder.
 Cont…

•Borderline Personality Disorder: Differentiated by the

presence of unstable self-image, intense interpersonal
relationships, and impulsivity, which are less characteristic of
schizotypal personality disorder.
•Avoidant Personality Disorder: While both disorders involve
social anxiety, schizotypal personality disorder is distinguished
by eccentricities in behavior, odd beliefs, and perceptual
distortions.
Paranoid Personality
Disorder
TABLE OF CONTENTS
 01
Major characteristic cluster
Paranoid personality
disorder is a mental
disorder characterized
by paranoia and a
pervasive, long-standing
suspiciousness and
generalized mistrust of
others.
Individuals with this
personality disorder may be
hypersensitive, easily feel
slighted and habitually relate
to the world by vigilant
scanning of the environment
for clues and suggestions
that may validate their fears
and biases.
 Preoccupied with doubts about loyalty, trustworthiness, or
fidelity of friends, associates, and family members.
 Individuals with this disorder are reluctant to confide in or
become close to others. They may refuse to answer personal
questions, saying that the information is "nobody’s
business".
Individuals are often rigid,
critical of others and unable
to collaborate, although
they have great difficulty
accepting criticism
themselves.
 Holds grudges and is unforgiving of perceived slights
or insults.
 They are quick to counter attack and react with anger
to perceived insults.
 Individuals with this disorder may be pathologically
jealous, often suspecting that their spouse or sexual
partner is unfaithful without any adequate justification.
 Diagnostic criteria
.

A pervasive distrust and suspiciousness of others such that

their motives are Interpreted as malevolent, beginning by early
adulthood and present in a variety of contexts, as indicated by
four (or more) of the following
1. Suspects without sufficient basis.
2. Preoccupied with unjustified doubts.
3. Reluctant to confide in others because of unwarranted fear.
4. Reads demeaning into benign remarks.
5. Persistently bear grudges.
6. Perceives attacks on character or reputation that are not
apparent and is quick to react angrily.
7. Recurrent suspicions without justification regarding fidelity
of spouse or partner.
 Does not occur exclusively during the course of schizophrenia,
a bipolar disorder or depressive disorder with psychotic
features, or another psychotic disorder and is not attributable,
to the physiological effects of another medical condition.
 comorbidity

1. Common co-occuring personality disorders include

narcissistic, avoidant, borderline, schizotypal, and schizoid
personality disorders.
2. Comorbid disorders include major depressive disorder,
alcohol use disorder, substance use disorders, agoraphobia,
and obsessive-compulsive disorder.
Differential diagnosis
Personality change due to another
medical condition
 Paranoid personality disorder must be distinguished from
personality change from a medical condition (e.g. - traumatic
brain injury) involving the central nervous system.
Substance use disorders

 Paranoid personality
disorder must be
distinguished from
symptoms that may
develop in association
with persistence
substance use.
 Environmental factors

 Exposure to social stressors such as socioeconomic inequality,

marginalization and racism.2. Childhood trauma is also
another risk factor, and individuals are more likely to have
physical abuse (but not sexual abuse) in childhood and
adolescence.
Genetic factors

 Individuals with relatives who have schizophrenia and

delusional disorder, persecutory type are at greater risk.
SCHIZOID Personality
Disorder
 SCHIZOID Personality Disorder

 Schizoid personality disorder is a condition where a

person shows very little, if any, interest and ability to form
relationships with other people. It's very hard for the
person to express a full range of emotions. If you have
schizoid personality disorder, you may be seen as keeping
to yourself or rejecting others.
Diagnostic criteria

A. A pervasive pattern of the attachment from social

relationships and a restricted range of expression of
emotions in interpersonal settings, beginning by early
adulthood and present invite your contacts, as indicated by 4
or more of the following:
1. Neither desires not enjoys close relationships.
2. Almost always choses solitary activities
3. Has little, if any, interest in having sexual experiences with
another person.
4. Takes played in few, if any, activities.
5. Lacks close friends or confidants other than first degree
relatives.
6. Appears indifferent to the praise or criticism to others.
7. Shows emotional coldness, detachment, or flattened
effectivity.
B. Does not occur exclusively doing the course of schizophrenia,
bipolar disorder or depressive disorder with psychotic features
or autism spectrum disorder and is not a attributable to the
physiological effects of another medical condition.
Risk and prognostic factors

GENETIC AND PSYCHOLOGICAL

Schizoid personality disorder may have increased prevalence in
the relatives of individuals with schizophrenia or schizotypal
personality disorder.
CULTURE -RELATED DIAGNOSTIC ISSUES
Individuals from a variety of cultural backgrounds sometimes
exhibit defensive behaviours and interpersonal styles that may
be erroneously labelled as "schizoid". For example, those who
have moved from rural to metropolitan environments may react
with "emotional freezing" that may last for several months and
manifest as solitary activities, constricted affect, and deficits
in communication
SEX AND GENDER RELATED DIAGNOSTIC ISSUES:
While some research suggests that schizoid personality disorder
may be more common in men, other research suggests that there
is no gender difference in prevalence.
Differential diagnosis

OTHER MENTAL DISORDERS WITH PSYCHOTIC

SYMPTOMS:

Schizoid personality disorder can be distinguished from

delusional disorder, schizophrenia, and a bipolar or depressive
disorder with psychotic features because these disorders are all
characterized by a period of persistent psychotic symptoms (e.g,
delusions and hallucinations).
 To give an additional diagnosis of schizoid personality
disorder, the personality disorder must have been present
before the onset of psychotic symptoms and must persistent
when the psychotic symptoms are in remission. When an
individual has a persistent psychotic disorder ( e.g,
schizophrenia) that was preceded by schizoid
personality disorder.
AUTISM SPECTRUM DISORDER:
There may be great difficulty differentiating individual with
schizoid personality disorder from individuals with autism
spectrum disorders, particularly with milder forms of either
disorder, as both include a seeming indifference to
companionship with others. However autism spectrum disorder
may be Differentiated by stereotyped behaviour and interests.
PERSONALITY CHANGE DUE TO ANOTHER MEDICAL
CONDITION:
Schizoid personality disorder must be distinguished from
personality change due to another medical condition, in which
the traits that emerge are a direct physiological consequences of
another medical condition
SUBSTANCE USE DISORDER:
Schizoid personality disorder must also be distinguished from
symptoms that may develop in association with
persistent substance use.
comorbidity

 Particularly in response to stress, individuals with this

disorder may experience very brief psychotic episodes
( lasting minutes to hour's. In some instances schizoid
personality disorder may appear as the premorbid antecedent
of delusional disorder or schizophrenia.
 Individuals with this disorder may sometimes develop major
depressive disorder, schizoid personality disorder most often
co-occurs with schizotypal, paranoid, and avoidant
personality disorder.