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.