Cognitive clinical intervention in a patient with schizoid personality disorder: Case report. / Intervención clínica cognitiva en paciente con trastorno esquizoide de personalidad: reporte de caso.

The present case report describes a 19-year-old male patient whose main symptoms were emotional coldness, absence of close relationships, difficulty experiencing pleasure with other people, and lack of motivation to work or to continue his studies. A schizoid personality disorder was diagnosed as a product of early maladaptive patterns such as inhibition, emotional deprivation, social isolation, and inadequacy. Likewise, a rigid and fragmented family context was evidenced, with an affective absence of parents and a focus on strict behavioral rules. The study aimed to intervene, from a cognitive clinical approach, the early maladaptive patterns and symptoms that maintained the features of schizoid personality disorder in the patient. For this purpose, cognitive behavioral therapy was carried out, with techniques such as debates, images to reparentalize, assignment of tasks, use of humor, and social skills training, among others. In conclusion, it can be stated that the early maladaptive patterns maintained the schizoid personality symptomatology. Finally, it was demonstrated through clinical and psychometric criteria that cognitive behavioral therapy decreased schizoid personality behaviors in the patient.

El presente reporte de caso describe a un paciente varón de 19 años, que presentaba como principales síntomas frialdad emocional, ausencia de relaciones cercanas, problemas para experimentar placer con otras personas y carencia de motivación para trabajar o retomar sus estudios. Se diagnosticó un trastorno de personalidad esquizoide, producto de esquemas maladaptativos tempranos como inhibición, privación emocional, aislamiento social e inadecuación. Asimismo, se evidenció un contexto familiar rígido y fragmentado, con ausencia afectiva de padres y direccionado hacia normas estrictas en la conducta. El objetivo del estudio fue intervenir desde un enfoque clínico cognitivo los esquemas maladaptativos tempranos y síntomas que mantenían los rasgos de trastorno esquizoide de la personalidad en el paciente. Para esto se realizó una terapia cognitiva conductual, con técnicas como debates, imágenes para reparentalizar, asignación de tareas, uso del humor, entrenamiento de habilidades sociales, entre otros. Como conclusión se puede manifestar que los esquemas maladaptativos tempranos mantenían la sintomatología de personalidad esquizoide. Por último, se demostró a través de un criterio clínico y psicométrico que la terapia cognitiva conductual disminuyo las conductas de personalidad esquizoide en el paciente.

Conceptualizing a less paranoid schizophrenia.

Schizophrenia stands as one of the most studied and storied disorders in the history of clinical psychology; however, it remains a nexus of conflicting and competing conceptualizations. Patients endure great stigma, poor treatment outcomes, and condemnatory prognosis. Current conceptualizations suffer from unstable categorical borders, heterogeneity in presentation, outcome and etiology, and holes in etiological models. Taken in aggregate, research and clinical experience indicate that the class of psychopathologies oriented toward schizophrenia are best understood as spectra of phenomenological, cognitive, and behavioral modalities. These apparently taxonomic expressions are rooted in normal human personality traits as described in both psychodynamic and Five Factor personality models, and more accurately represent explicable distress reactions to biopsychosocial stress and trauma. Current categorical approaches are internally hampered by axiomatic bias and systemic inertia rooted in the foundational history of psychological inquiry; however, when such axioms are schematically decentralized, convergent cross-disciplinary evidence outlines a more robust explanatory construct. By reconceptualizing these disorders under a dimensional and cybernetic model, the aforementioned issues of instability and inaccuracy may be resolved, while simultaneously opening avenues for both early detection and intervention, as well as for more targeted and effective treatment approaches.

Commentary about social avoidance and its significance in adolescents and young adults.

Social avoidance in young patients is a clinically worrisome phenomenon that characterizes impending schizophrenia, but that also constitutes a core phenomenon in avoidant personality disorder (AvPD), schizoid personality disorder (ScPD), and in autism spectrum disorder (ASD). Especially in the absence of any other clinically relevant phenomena, understanding the origins of social avoidance may be one the most challenging tasks in assessing whether adolescents and young adults are at risk for developing schizophrenia. Descriptive and psychometric assessments only allow to comment on the absence or the presence of this phenomenon, but do not capture the origins and the meaning of social avoidance. Based on a narrative review, we highlight the importance of a phenomenological approach to unveil the Gestalt of social avoidance in these mental disorders, including and appraisal of the underlying mental structures and attachment styles. The phenomenological approach allows to distinguish the Gestalt of social avoidance between AvPD, ScPD, ASD, and beginning schizophrenia, to ensure correct diagnostic labelling and optimal treatment, and to avoid unwarranted stigmatization.

Development and preliminary psychometric evaluation of the dimensional clinical personality inventory - Schizoid Personality Disorder Scale / Desenvolvimento e avaliação psicométrica preliminar do inventário dimensional clínico da personalidade - Escala transtorno da personalidade esquizoide / Desarrollo y evaluación psicométrica preliminar del inventario dimensional clínico de personalidad - Escala del trastorno esquizoide de la personalidad

A new dimensional-based framework was proposed, the Hierarchical Taxonomy of Psychopathology (HiTOP). This study aimed to develop a specific version of the Dimensional Clinical Personality Inventory 2 (IDCP-2), focused on the assessment of the schizoid personality disorder (SZPD) according to the HiTOP. In stage 1, we developed a new factor to cover all SZPD traits, as presented in the HiTOP. Six factors (one new and five from the IDCP-2) composed the IDCP-SZPD. In stage 2, 434 adults from the community, aged from 18 to 67 years (M=31.6, SD=9.7), completed factors from three self-report measures: the IDCP-SZPD, PID-5, and FFaVA. The IDCP-SZPD factors and total score presented high reliability. Correlations and a bootstrap two-sample t-test comparison corroborated the expectations. Although we found evidence supporting the use of the IDCP-SZPD for the measurement of SZPD traits, further research is needed to verify the replicability of the present findings in samples composed of SZPD patients. (AU)

Um novo framework dimensional foi proposto, o Hierarchical Taxonomy of Psychopathology (HiTOP). O objetivo deste estudo foi desenvolver uma versão específica do Inventário Dimensional Clínico da Personalidade 2 (IDCP-2), com foco na avaliação do transtorno da personalidade esquizoide (TPE) de acordo com o HiTOP. No estágio 1, foi desenvolvido um novo fator, buscando cobrir todos os traços do TPE apresentados no HiTOP. Compuseram o IDCP-SZPD seis fatores (um novo e cinco do IDCP-2). No estágio 2, 434 adultos da população geral, com idade entre 18 e 67 anos (M = 31.6; DP = 9,7), completaram fatores de três medidas de autorrelato: IDCP-SZPD, PID-5 e FFaVA. Os fatores do IDCP-SZPD e o escore total apresentaram alta precisão. Correlações e comparações via bootstrap two-sample t teste corroboraram as expectativas. Embora evidências favoráveis tenham sido observadas para o uso do IDCP-SZPD, na avaliação de traços do TPE, estudos futuros devem verificar a replicabilidade dos achados em amostras de pacientes com TPE. (AU)

Un nuevo framework dimensional fue propuesto, el Hierarchical Taxonomy of Psychopathology (HiTOP). El objetivo fue el de desarrollar una versión específica del Inventario Dimensional Clínico de Personalidad 2 (IDCP-2), centrado en la evaluación del trastorno esquizoide de la personalidad (TPE) según el HiTOP. En la etapa 1 se desarrolló un nuevo factor para cubrir todos los rasgos del TPE presentados en el HiTOP. Seis factores (uno nuevo y cinco del IDCP-2) compusieron el IDCP-SZPD. En la etapa 2, 434 adultos de la comunidad, con edades comprendidas entre 18 y 67 años (M =31,6, DS=9,7), completaron los factores de tres medidas de auto-informe: IDCP-SZPD, PID-5 y FFaVA. Los factores del IDCP-SZPD y el puntaje total mostraron una alta confiabilidad. Las correlaciones y la comparación del bootstrap two-sample t test corroboraron las expectativas. Aunque se observaron evidencias favorables para el uso de la IDCP-SZPD para la medición de rasgos de TPE, los estudios posteriores deberían verificar la replicabilidad de los presentes hallazgos en muestras compuestas por pacientes con TPE. (AU)

On the Continuity Between Autistic and Schizoid Personality Disorder Trait Burden: A Prospective Study in Adolescence.

Although widely conceived as distinct conditions, higher-functioning autism spectrum disorder (ASD) and schizoid personality disorder (schizoid PD) share similar clinical symptomatology. This study explored the relationship between the two disorders by collecting extensively validated measures of autistic trait burden (Social Responsive Scale, Second Edition) and schizoid PD affectation (Diagnostic Interview for Genetic Studies) from clinically ascertained verbal males with and without autism ages 12 to 25 years (N = 72) via parent, teacher, and self-report. Although only a small minority of adolescents with ASD met full diagnostic criteria for schizoid PD, participants with ASD endorsed a continuous distribution of schizoid PD traits that reflected a pronounced pathological shift in comparison with those in the control group, with one half of ASD males experiencing three or more Diagnostic and Statistical Manual of Mental Disorders, 4th Edition schizoid PD criterion items "often" or "almost always." Results suggest significant amplification of schizoid PD trait burden in adolescents with ASD. ASD-specific interventions should be considered for patients with schizoid PD with premorbid histories of ASD.

A developmentally-stable pattern of premorbid schizoid-schizotypal features predicts psychotic transition from the clinical high-risk for psychosis state.

BACKGROUND: Despite the extensive research performed on prediction of psychosis from a Clinical High Risk for Psychosis state (CHR-P), the positive predictive value of the CHR-P designation remains unsatisfactory and further models including additional clinical and biological variables are required. Existing studies indicate that schizotypy assessed at baseline in "at-risk" individuals may be considered a predictor of transition from CHR-P to psychosis. This approach, however, is burdened with bias resulting from a possible overlap between current psychopathology and schizotypal features. No studies so far have assessed schizotypy in CHR-P from a developmental perspective. AIM: The aim of the study was to identify associations between a long-standing, parent-reported premorbid level of schizoid-schizotypal traits and the probability of psychotic transition in individuals with CHR-P. METHODS: The mothers of 107 individuals diagnosed as presenting CHR-P with the use of Comprehensive Assessment of At Risk Mental States12/2006 were interviewed with the Scale for the Assessment of Premorbid Schizoid-Schizotypal Traits (PSST). RESULTS: A high level of enduring schizotypy was found to be significantly associated with psychotic transition from CHR-P (HR: 1.78, 95% CI: 1.40-2.27, p < 0.0001), as indicated by the proportional hazards model, adjusted for age, sex and clinical covariates potentially related to the outcome. PSST items comprising negative schizotypy appeared to be the strongest predictors of transition. CONCLUSIONS: The assessment of parent-reported, present early in the development premorbid schizoid-schizotypal traits, which can be easily performed in clinical settings, may be of value in estimating the probability of transition from an "at risk" state to psychotic disorder.

Beyond the mental pain: A case-control study on the contribution of schizoid personality disorder symptoms to medically serious suicide attempts.

BACKGROUND: Clinical and research findings have highlighted the role of interpersonal factors in suicidal behavior with high levels of intent and lethality. Schizoid personality disorder (SPD) is at the extreme end of interpersonal difficulties. Thus, we aimed to understand the contribution of SPD symptoms to suicide behavior and specifically to more lethal suicide attempts. METHOD: Four groups were investigated (N = 338): medically serious suicide attempters, medically non-serious suicide attempters, psychiatric and healthy controls. SPD symptoms, mental pain variants, and clinical characteristics were assessed. RESULTS: Overall, attempters were characterized by higher levels of most SPD symptoms. Solitary lifestyle and emotional detachment were higher among medically serious suicide attempters relative to less-serious attempters. Emotional detachment doubled the risk for high lethality, beyond mental pain variables. CONCLUSIONS: SPD symptoms of interpersonal difficulties and low levels of emotional expressions are important risk factors for more severe suicidal behavior. Implications for identification of at-risk groups for suicide are discussed.

Subjective quality of life in recent onset of psychosis patients and its association with sociodemographic variables, psychotic symptoms and clinical personality traits.

AIM: There is lack of research on the study of clinical personality traits in recent onset of psychosis (ROP) patients. The aims of this research were to study the relations among psychosocial, personality and clinical characteristics in ROP patients and also the effect that significant variables had on the different domains of Quality of Life (QoL). METHODS: Data for these analyses were obtained from 81 ROP patients. The Millon Clinical Multiaxial Inventory, the Positive and Negative Syndrome Scale and the World Health Organization Quality of Life Brief Scale were used to assess personality, symptoms and QoL. RESULTS: Correlations between the negative symptoms and the physical, psychological and social domains of QoL, and the disorganized symptoms and physical domain, were found. Furthermore, the physical, psychological and social relationship domains of QoL were lower in patients with schizoid traits and the psychological domain was lower in patients with depressive traits. In contrast, the psychological and social domains were higher in patients with histrionic traits, while the physical domain was higher for patients with narcissistic traits. Multiple linear regressions demonstrated that negative symptoms and narcissistic and depressive traits explained 16.9% of the physical domain. Narcissistic and depressive traits explained 15% of the psychological domain. Finally, the negative symptoms and histrionic traits explained 13.7% of the social domain. CONCLUSIONS: QoL seems to be better explained by negative psychotic symptoms and some clinical personality traits. Our results support the importance of integrated intervention approaches that consider personality.

[The concept of schizoidia in psychiatry : From schizoidia to schizotypy and cluster A personality disorders]. / Das Schizoidie-Konzept in der Psychiatrie : Von der Schizoidie über die Schizotypie zu den Cluster­A­Persönlichkeitsstörungen.

From a perspective of conceptual evolution schizoidia was initially considered to describe features both of the premorbid personality of schizophrenic patients and of the personalities of non-psychotic family members (Bleuler, Kahlbaum, Kraepelin). On a psychopatholocial level a close link to the complex basic symptom of autism was stressed. From the very beginnings of modern psychiatry schizoidia was discussed within a conceptual frame of schizophrenia spectrum disorders (Kretschmer, Hoch, Polatin). Approaches to operationalize these conceptual works laid the basis for the cluster A personalities in DSM-III. Due to the prominent concept of schizotypy (Kety, Rado, Meehl) three split up diagnostic categories of schizotypal, schizoid and paranoid personality disorders resulted. Cluster A personality disorders are frequent in community-based epidemiological studies. Health-care seeking behaviour due to primary personality-related problems, however, seems to be less paramount compared to cluster B and C personality disorders. Many family- and twin-based genetic studies convincingly stress a close link between schizotypal personality disorder and schizophrenia. This link is less pronounced for paranoid personality disorder, and even vanishingly low for schizoid personality disorder. From a perspective of schizophrenia spectrum disorders a vast amount of data from molecular genetic, neurobiological, neuropsychological and psychosocial research has impressingly confirmed this link for schizotypal personality disorder. Major research deficits, however, have to be noticed for paranoid and schizoid personality disorder.

Schizophrenia spectrum personality disorders in psychometrically identified schizotypes at two-year follow-up.

Earlier (Bolinskey et al., 2015), we reported that psychometrically identified schizotypes displayed greater symptom levels and higher incidences of schizophrenia spectrum (schizotypal, schizoid, paranoid, and avoidant) personality disorders (PDs). In this study, 49 schizotypes and 39 matched controls participated in follow-up assessments after two years. Participants were previously identified as schizotypes or controls based on scores on the Chapman Psychosis Proneness Scales (CPPS), and were interviewed at baseline and follow-up with the Personality Disorder Interview for DSM-IV (PDI-IV). At follow-up, schizotypes displayed significantly higher symptom levels compared to controls, with medium to large effects, and appeared to meet criteria for diagnosis of each PD more often than controls, although significant differences were only observed for paranoid PD. Overall, schizotypes were more likely to have met criteria for a diagnosis at either baseline or follow-up. Finally, we observed a widening disparity over time between schizotypes and controls in avoidant and schizoid PDs. These results suggest that schizophrenia spectrum PDs, as well as subthreshold symptoms of these disorders, can represent a greater liability for schizophrenia in individuals identified as at-risk on the basis of psychometric means only. Furthermore, these findings demonstrate that such differences persist, and in some cases increase, over time.

A Case Study of Paternal Filicide-Suicide: Personality Disorder, Motives, and Victim Choice.

Although evidence with respect to its prevalence is mixed, it is clear that fathers perpetrate a serious proportion of filicide. There also seems to be a consensus that paternal filicide has attracted less research attention than its maternal counterpart and is therefore less well understood. National registries are a very rich source of data, but they generally provide limited information about the perpetrator as psychiatric, psychological and behavioral data are often lacking. This paper presents a fully documented case of a paternal filicide. Noteworthy is that two motives were present: spousal revenge as well as altruism. The choice of the victim was in line with emerging evidence indicating that children with disabilities in general and with autism in particular are frequent victims of filicide-suicide. Finally, a schizoid personality disorder was diagnosed. Although research is quite scarce on that matter, some research outcomes have showed an association between schizoid personality disorder and homicide and violence.

Alcohol-Dependent Subjects Show Different Personality Traits Compared With Subjects With Multiple Substance Dependence: Preliminary Data.

METHODS: We compared personality traits of 27 persons with multiple substance dependence with personality data of 52 alcohol-dependent persons regarding their personality traits and disorders (obtained by using SCID-II, TCI and NEO FFI). Both patient groups were free of any other mental disorder. RESULTS: In SKD-II, we found significant differences in the male group in dependent and scizotypic personality disorder. There were no significant differences in the female group, but sample was very small. We also found significant differences between alcohol-dependent and multiple substance-dependent persons in extraversion and novelty seeking. CONCLUSIONS: We detected significant differences in personality disorders evaluated by SCID-II. Temperament and character items­as evaluated by NEO FFI and TCI­showed also significant differences in personality traits. Given the limited number of subjects, the data should be regarded as preliminary until replicated in a larger sample. Nevertheless, the findings may be of clinical relevance with respect to prognosis or individualized treatment. These findings should be treated with caution until replicated.

Poor Validity of the DSM-IV Schizoid Personality Disorder Construct as a Diagnostic Category.

This study sought to evaluate the construct validity of schizoid personality disorder (SZPD) by investigating a sample of 2,619 patients from the Norwegian Network of Personality-Focused Treatment Programs by a variety of statistical techniques. Nineteen patients (0.7%) reached the diagnostic threshold of SZPD. Results from the factor analyses indicated that SZPD consists of three factors: social detachment, withdrawal, and restricted affectivity/ anhedonia. Overall, internal consistency and diagnostic efficiency were poor and best for the criteria that belong to the social detachment factor. These findings pose serious questions about the clinical utility of SZPD as a diagnostic category. On the other hand, the three factors were in concordance with findings from previous studies and with the trait model for personality disorders in DSM-5, supporting the validity of SZPD as a dimensional construct. The authors recommend that SZPD should be deleted as a diagnostic category in future editions of DSM-5.

Above and beyond short-term mating, long-term mating is uniquely tied to human personality.

To what extent are personality traits and sexual strategies linked? The literature does not provide a clear answer, as it is based on the Sociosexuality model, a one-dimensional model that fails to measure long-term mating (LTM). An improved two-dimensional model separately assesses long-term and short-term mating (STM; Jackson and Kirkpatrick, 2007). In this paper, we link this two-dimensional model to an array of personality traits (Big 5, Dark Triad, and Schizoid Personality). We collected data from different sources (targets and peers; Study 1), and from different nations (United States, Study 1; India, Study 2). We demonstrate for the first time that, above and beyond STM, LTM captures variation in personality.

Cluster A maladaptive personality patterns in a non-clinical adolescent population.

BACKGROUND: The prevalence and expression of Cluster A personality disorders in adolescence is poorly analyzed and understood. The main goal was to analyze the rate of Cluster A traits and maladaptive personality patterns in adolescents. In addition, the underlying dimensional structure and the possible influence of sex and age in its phenotypic expression were examined. METHOD: The final sample was comprised of a total of 1,443 participants (M = 15.9 years, SD = 1.2). The instrument used was the Personality Diagnostic Questionnaire-4+ (PDQ-4+). RESULTS: Cluster A maladaptive personality traits are common among adolescents. According to the PDQ-4+, 13.1% (n = 189) of the sample reported a Cluster A maladaptive personality pattern. Analysis of the internal structure yielded two interrelated factors, namely Paranoid and Schizotypal-Schizoid. Males, compared with females, obtained higher scores on the schizotypal subscale when the score was dimensional and on the schizotypal and schizoid subscales when items were dichotomized. CONCLUSIONS: These data yield new clues that improve the understanding of Cluster A traits in this sector of the population, and advance in early detection of adolescents at risk of personality disorders.

Measuring IPDE-SQ personality disorder prevalence in pre-sentence and early-stage prison populations, with sub-type estimates.

Understanding the prevalence and type of personality disorder within prison systems allows for the effective targeting of resources to implement strategies to alleviate symptoms, manage behaviour and attempt to reduce re-offending. This study aimed to determine the prevalence of personality disorder (PD) traits within a local urban high-turnover adult male prison with a remand/recently sentenced population in London, UK. The International Personality Disorder Examination - Screening Questionnaire (IPDE-SQ) self-administered questionnaire (ICD-10 version) was completed by 283 prisoners (42% completion rate). 77% of respondents reached the threshold for one or more PDs. The most common PD types were Paranoid PD (44.5%), Anankastic PD (40.3%), Schizoid PD (35%) and Dissocial PD (25.8%). These results confirm and extend existing knowledge regarding the prevalence of PD in prison populations into a high-turnover, urban, remand population. The stark comparison with community samples indicates that a more equitable standard of service delivery within the criminal justice system, focussing on preventive and early intervention services, is now required.

Are alexithymia and schizoid personality disorder synonymous diagnoses?

Relationships among alexithymia, personality disorders, and higher-order psychopathological and interpersonal dimensions were examined in 199 college students and a close relative of each. Alexithymia, the difficulty to express and identify emotions, was measured by the Observer Alexithymia Scale (OAS; [Haviland, M. G., Warren, W. L., & Riggs, M. L. (2000). An observer scale to measure alexithymia. Psychosomatics, 41, 385-392]), which was completed by each student's relative. Each student completed three self-report measures: the Coolidge Axis II Inventory (CATI; [Coolidge, F. L. (2000). Coolidge Axis II Inventory: Manual. Colorado Springs, CO: Author.), the Five Dimensional Personality Test (5DPT; [van Kampen, D. (2009). Personality and psychopathology: A theory-based revision of Eysenck's PEN model. Clinical Practice and Epidemiology in Mental Health, 5, 9-21]), and the Horney-Coolidge Tridimensional Inventory (HCTI; [Coolidge, F. L. (1998). Horney-Coolidge Tridimensional Inventory: Manual. Colorado Springs, CO: Author]). Results indicated that higher levels of alexithymia are associated with personality disorders and their traits, such as schizoid, avoidant, and paranoid. With regard to the issue of the similarity and difference between alexithymia and schizoid personality disorder, there was sufficient evidence across all of the measures to suggest that they are not synonymous entities. Finally, alexithymic traits were associated with concurrent depressive traits even in a non-clinical sample.

[Neuropsychological syndromes of non-psychotic mental disorders of youthful age].

Seventy male patients with non-psychotic mental disorders of youthful age (mean age 19.2±3.7), were studied using A.R. Luria neuropsychological syndrome analysis. Patients were stratified into 3 groups by diagnosis: cyclothymia (20 patients), pubertal decompensation of schizoid personality disorder (30 patients) and schizotypal personality disorder (20 patients). It has been shown that the neuropsychological changes indicate the dysfunction of the amygdale/temporal region in patients of the first group and frontal/thalamic/parietal connections in the patients of two other groups. There were interhemispheric differences between patients with personality disorder and schizotypal personality disorder: left hemisphere dysfunction was characteristic of schizotypal disorder and right hemisphere deficit (neurocognitive deficit) was found in patients with personality disorder.

Taxometric analyses of paranoid and schizoid personality disorders.

There remains debate about whether personality disorders (PDs) are better conceptualized as categorical, reflecting discontinuity from normal personality; or dimensional, existing on a continuum of severity with normal personality traits. Evidence suggests that most PDs are dimensional but there is a lack of consensus about the structure of Cluster A disorders. Taxometric methods are adaptable to investigating the taxonic status of psychiatric disorders. The current study investigated the latent structure of paranoid and schizoid PDs in an epidemiological sample (N=43,093) drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) using taxometric analyses. The current study used taxometric methods to analyze three indicators of paranoid PD - mistrust, resentment, and functional disturbance - and three indicators of schizoid PD - emotional detachment, social withdrawal, and functional disturbance - derived factor analytically. Overall, taxometrics supported a dimensional rather than taxonic structure for paranoid and schizoid PDs through examination of taxometric graphs and comparative curve fit indices. Dimensional models of paranoid and schizoid PDs better predicted social functioning, role-emotional, and mental health scales in the survey than categorical models. Evidence from the current study supports recent efforts to represent paranoid and schizoid PDs as well as other PDs along broad personality dimensions.

Schizoid personality disorder.

Schizoid personality disorder (ScPD) is one of the "odd cluster" or "cluster A" personality disorders in DSM-IV. In the present article, the authors review information pertaining to the psychometric characteristics of ScPD as gleaned from a search of relevant publications as well as from databases of personality disorder study groups. Comparatively little evidence exists for the validity and reliability of ScPD as a separate, multifaceted personality disorder. Some authors, moreover, have contended that the group of patients termed "schizoid" actually fall into two distinct groups--an "affect constricted" group, who might better be subsumed within schizotypal personality disorder, and a "seclusive" group, who might better be subsumed within avoidant personality disorder. The research-based justification for retaining ScPD as an independent diagnosis is sufficiently sparse for it to seem reasonable to remove ScPD from the list of personality disorders in DSM-V, and instead to invite clinicians to code for schizoid traits using a dimensional model.