Internet Mental Health

SCHIZOID PERSONALITY DISORDER






Internet Mental Health Quality of Life Scale (Client Version)

Internet Mental Health Quality of Life Scale (Therapist Version)

Big 5 Factors Of Mental Illness And Code For This Disorder
(The "6th Big Factor" of Mental Health, "Physical Health", Is Coded Normal or Green)

Onset:

Schizoid Personality Ddisorder occurs in between 3.1% to 4.9% of the U.S. population. Individuals with this disorder have a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. This disorder is characterized by moderate to severe detachment (social withdrawal, intimacy avoidance, restricted emotions). For this diagnosis to be given, the individual must be at least in early adulthood. This disorder is only diagnosed when these behaviors become persistent and very disabling.

Treatment:

There is insufficient evidence to justify using any psychological intervention or medication for adults with this disorder. Lacking such evidence, it would be prudent to only offer short-term crisis intervention, rather than long-term psychotherapy.

Prognosis:

Schizoid Personality Disorder may last years or a lifetime. Individuals with this disorder often seem directionless, and they appear to drift in their goals. These individuals often react passively to adversity and have difficulty responding appropriately to important life events.

Problems

Occupational-Economic Problems:

  • Works best when alone

Detached (Detachment):

    Social Withdrawal:
  • Neither desires nor enjoys close relationships, including being part of a family
  • Almost always chooses solitary activities
  • Has little, if any, interest in having sexual experiences with another person
  • Lacks close friends or confidants other than first-degree relatives

  • Constricted Range of Emotions:
  • Shows emotional coldness, detachment, or flattened affectivity
  • Appears indifferent to the praise or criticism of others
  • Takes pleasure in few, if any, activities


SAPAS Personality Screening Test

Individuals with this disorder would answer "Yes" to the red questions:

      In general, do you have difficulty making and keeping friends?
      Would you normally describe yourself as a loner?
      In general, do you trust other people?
      Do you normally lose your temper easily?
      Are you normally an impulsive sort of person?
      Are you normally a worrier?
      In general, do you depend on others a lot?
      In general, are you a perfectionist?

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Click Here For Free Diagnosis

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment

Schizoid Personality Disorder 301.20

This diagnosis is based on the following findings:

  • Neither desires nor enjoys close relationships, including being part of a family (still present)
  • Almost always chooses solitary activities (still present)
  • Has little, if any, interest in having sexual experiences with another person (still present)
  • Takes pleasure in few, if any, activities (still present)
  • Lacks close friends or confidants other than first-degree relatives (still present)
  • Appears indifferent to the praise or criticism of others (still present)
  • Shows emotional coldness, detachment, or flattened affectivity (still present)
  • This disorder does not exclusively occur during the course of a psychotic mental disorder
  • This disorder is not due to a Pervasive Developmental Disorder
  • This disorder is not due to the direct physiological effects of a general medical condition

Treatment Goals:

  • Goal: develop closer relationships, especially with own family.
    If this problem persists: She will become indifferent to her family and lose the desire to enjoy close relationships.

  • Goal: join in more social activities.
    If this problem persists: She will socially isolate herself, becoming a "loner" involved in only solitary activities or hobbies.

  • Goal: increase interest in having sexual experiences with another person.
    If this problem persists: She will totally avoid having sexual experiences with another person.

  • Goal: increase involvement in pleasurable activities.
    If this problem persists: She will accept living a life devoid of pleasure.

  • Goal: have more close friends.
    If this problem persists: She will live a life lacking close friends or confidants.

  • Goal: become more aware of the approval or criticism of others.
    If this problem persists: She will become totally indifferent to the approval or criticism of others. She would then become oblivious to the normal subtleties of social interaction and often fail to respond appropriately to social cues so that others would see her as being socially inept or superficial and self-absorbed.

  • Goal: show more emotional expression.
    If this problem persists: To others, she will appear cold and aloof, rarely displaying emotional reactivity and reciprocating gestures or facial expressions (such as smiles or nods). To others, she will appear to rarely experience strong emotions such as anger or joy.


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Schizoid Personality Disorder F60.1 - ICD10 Description, World Health Organization

Schizoid Personality Disorder is characterized by withdrawal from affectional, social and other contacts with preference for fantasy, solitary activities, and introspection. There is a limited capacity to express feelings and to experience pleasure.

ICD-10 International Personality Disorder Examination Screening Questions

  • I usually get fun and enjoyment out of life (False).

  • I almost never get angry about anything.

  • People think I'm cold and detached.

  • When I'm praised or criticized I don't show others my reaction.

  • I have little or no desire to have sex with anyone.

  • I prefer activities that I can do by myself.

  • Most people think that I am a strange person.

  • Everyone needs a friend or two to be happy (False).

  • I'm more interested in my own thoughts than what goes on around me.

ICD-10 Diagnostic Criteria (For Research)

    A. The general criteria of personality disorder must be met:

    • Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range (or 'norm').

    • The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e. not being limited to one specific 'triggering' stimulus or situation).

    • There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior.

    • There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.

    • The deviation cannot be explained as a manifestation or consequence of other adult mental disorders.

    • Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation.

    B. At least four of the following must be present:

    • Few, if any, activities provide pleasure.
        (E.g., "I seldom get fun or enjoyment out of life.")

    • Displays emotional coldness, detachment, or flattened affectivity.
        (E.g., "People think I'm cold and detached.")

    • Limited capacity to express warm, tender feelings for others as well as anger.
        (E.g., "I almost never get angry about anything.")

    • Appears indifferent to either praise or criticism of others.
        (E.g., "When I'm praised or criticized I don't show others my reaction.")

    • Little interest in having sexual experiences with another person (taking into account age).
        (E.g., "I have little or no desire to have sex with anyone.")

    • Almost always chooses solitary activities.
        (E.g., "I prefer activities that I can do by myself.")

    • Excessive preoccupation with fantasy and introspection.
        (E.g., "I'm more interested in my own thoughts than what goes on around me.")

    • Neither desires, nor has, any close friends or confiding relationships (or only one).
        (E.g., "I don't need a friend to be happy.")

    • Marked insensitivity to prevailing social norms and conventions; if these are not followed this is unintentional.
        (E.g., "Most people think I'm a strange person.")

Schizoid Personality Disorder - Diagnostic Criteria, American Psychiatric Association

A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by 4 (or more) of the following:

  • Neither desires nor enjoys close relationships, including being part of a family.

  • Almost always chooses solitary activities.

  • Has little, if any, interest in having sexual experiences with another person.

  • Takes pleasure in few, if any, activities.

  • Lacks close friends or confidants other than first-degree relatives.

  • Appears indifferent to the praise or criticism of others.

  • Shows emotional coldness, detachment, or flattened affectivity.

  • This enduring pattern of inner experience and behavior must deviate markedly from the expectations of the individual's culture.

  • This enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

  • This enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • Empirically Derived Taxonomy for Personality Diagnosis: Schizoid Personality Disorder

    (This section uses an alternative classification system to that of the American Psychiatric Association)

    How Schizoid Personality Disorder Differs From Other Personality Disorders

    Summary statement: Individuals with Schizoid Personality are characterized by pervasive impoverishment of interpersonal relationships and emotional experience.

    These individuals:
    • Lack close relationships and appear to have little need for human company or contact, often seeming detached or indifferent.
    • Lack social skills and tend to be socially awkward or inappropriate.
    • Have little insight into their own motives and behavior, and have difficulty giving a coherent account of their lives.
    • Appear to have a limited or constricted range of emotions and tend to think in concrete terms, showing limited ability to appreciate metaphor, analogy, or nuance. Consequently, they tend to elicit boredom in others.
    • Despite their apparent emotional detachment, they often suffer emotionally: They find little satisfaction or enjoyment in life's activities, tend to feel life has no meaning, and feel like outcasts or outsiders.


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    Diagnostic Features

    Individuals with Schizoid Personality Disorder have a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. This disorder is characterized by moderate to severe detachment (social withdrawal, intimacy avoidance, restricted emotions). This disorder is only diagnosed if: (1) it begins no later than early adulthood, (2) these behaviors occur at home, work, and in the community, and (3) these behaviors lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. This disorder should not be diagnosed if its symptoms occur exclusively during the course of a Psychotic Disorder, Autism Spectrum Disorder, or if it is attributable to Substance Use Disorder another medical condition.

    Individuals with Schizoid Personality Disorder display a restricted range of emotions, and rarely experience strong emotions such as anger or joy. They rarely reciprocate gestures or facial expressions, such nods or smiles. They appear cold and aloof. Individuals with Schizoid Personality Disorder often appear to be socially isolated and almost always choose solitary activities or hobbies. They have little interest in having sex with another person. They seem indifferent to the praise or criticism of others. They often seem socially inept or superficial and self-absorbed.

    Like all personality disorders, Schizoid Personality Disorder is a deeply ingrained and enduring behavior pattern, manifesting as an inflexible response to a broad range of personal and social situations. This behavior represents an extreme or significant deviation from the way in which the average individual in a given culture relates to others. This behavior pattern tends to be stable.

    Course

    Schizoid Personality Disorder may be first apparent in childhood and adolescence with solitariness, poor peer relationships, and underachievement in school, which may attract teasing from their peers. The course of this disorder is chronic.

    Complications

    The lives of individuals with Schizoid Personality Disorder often seem directionless, and they appear to drift in their goals. These individuals often react passively to adversity and have difficulty responding appropriately to important life events.

    Comorbidity

    Some other disorders frequently occur with this disorder:

      Non-Personality Disorders:

              Schizophrenia Spectrum and Other Psychotic Disorders:
        • This disorder may be a premorbid antecendent of a psychotic disorder. In response to stress, individuals with this disorder may experience very brief psychotic episodes (lasting minutes to hours). If the psychotic episode lasts longer, this disorder may actually develop into delusional disorder or schizophrenia.
              Depressive Disorders:
        • Major depressive disorder

      Personality Disorders:

              Avoidant personality disorder
              Schizotypal personality disorder

    Associated Laboratory Findings

    No laboratory test has been found to be diagnostic of this disorder.

    Prevalence

    The prevalence of schizoid personality disorder is 3.1%-4.9% of the general population. This disorder occurs slightly more commonly in males.

    Familial Pattern

    Schizoid Personality Disorder is more common among biological relatives of those with Schizophrenia or Schizotypal Personality Disorder.

    Controlled Clinical Trials Of Therapy

    Click here for a list of all the controlled clinical trials of therapy for this disorder.

    Psychotherapy

    The effectiveness of psychotherapy for Schizoid Personality Disorder is unknown because there are no randomized controlled trials. Lacking such evidence, it would be prudent to only offer short-term crisis intervention, rather than long-term psychotherapy. Individuals with this disorder seldom voluntarily present for treatment.

    Pharmacotherapy

    There are currently no medications approved by the FDA to treat this disorder. Vitamins and dietary supplements are ineffective for all Personality Disorders.

    A Dangerous Cult: Videos


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    Stories

    Rating Scales

    Lack Of Social Skills In Personality Disorders

    There are certain social skills that are essential for healthy social functioning. Individuals with Schizoid Personality Disorder lack the essential social skills of intimacy, sociability, and emotional expressiveness.

      Social Skills That Are Lacking In Schizoid Personality Disorder

      SOCIAL SKILL SCHIZOID PERSONALITY NORMAL
      Intimacy Intimacy avoidance Wanting close friendships or intimate romantic relationships
      Sociability Social withdrawal Friendly; interested in social contacts and activities
      Emotional Expressiveness Lack of emotional expression Normal range of emotional experience and expression

    Schizoid and Schizotypal Personality Disorder are so closely related that some researchers refer to them as the Schizoid-Schizotypal Personality Disorder. Schizoid Personality Disorder appears to be a subset of Schizotypal Personality Disorder. Schizoid Personality Disorder lacks the eccentricity, odd beliefs, perceptual distortions, and paranoia seen in Schizotypal Personality Disorder.

      Social Skills That Are Lacking In Schizoid vs. Schizotypal Personality Disorders

      PERSONALITY DISORDER LACKING LACKING LACKING
      Schizoid Personality Intimacy (instead has intimacy avoidance) Sociability (instead has social withdrawal) Emotional expressiveness (instead has lack of emotional expression)
      Schizotypal Personality Normal Behavior (instead has eccentricity) Normal Beliefs (instead has odd beliefs) Normal Perception (instead has perceptual distortions)

    Is Schizoid Personality Disorder A Valid Diagnostic Category?

    Research has shown that schizoid personality disorder has poor validity as a diagnostic category. Other research has shown that individuals diagnosed with schizoid personality disorder 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. Thus it seems reasonable to remove schizoid personality disorder from the list of personality disorders in DSM-V.

    It should be noted that the symptoms of schizoid personality disorder are essentially those of the "negative symptoms" of schizophrenia. Thus is schizoid personality disorder a mild, arrested or premorbid form of Schizophrenia? Thus it is argued that schizoid personality disorder should be declassified as a personality disorder, and instead be classified as a subclinical presentation of schizophrenia. However, the ICD-10 and DSM-5 still classify this disorder as a distinct personality disorder.

    A Good Life

    How does one live a good life?

    One approach to answering this question is to study the behavior of individuals who live troubled lives. Could the opposite of their maladaptive behavior define how to live a good life?

    Consider the troubled lives of people with schizoid personality disorder. Individuals with schizoid personality disorder socially withdraw because of their emotional detachment.

    Could the opposite of the maladaptive behaviors seen in schizoid personality disorder be a clue to how to live a good life? Many religions teach that we should love each other. This is the opposite of the social withdrawal and emotional detachment seen in schizoid personality disorder.


      Schizoid Personality Disorder The Opposite Of Schizoid Personality Disorder
      Social Withdrawal: Sociability:
      Neither desires nor enjoys close relationships, including being part of a family Enjoys close relationships, including being part of a family
      Almost always chooses solitary activities Almost always chooses social, rather than solitary, activities
      Has little, if any, interest in having sexual experiences with another person Has interest in having sexual experiences with another person
      Lacks close friends or confidants other than first-degree relatives Has a number of close friends or confidants (other than first-degree relatives)
      Emotional Flatness: Emotional Expressiveness:
      Shows emotional coldness, detachment, or flattened affectivity Shows emotional depth (wide range or depth of feelings)
      Appears indifferent to the praise or criticism of others Responds appropriately to the praise or criticism of others
      Takes pleasure in few, if any, activities Takes pleasure in many activities

    Primate Evolution

    There appears to be three different ways in which primates have evolved socially:
    • The chimpanzees have evolved to be socially antagonistic, competitive, callous, and manipulative. Chimpanzees are the only primates (apart from humans) that wage organized war. Thus chimpanzee social behavior most closely mirrors the antagonistic behavior of the antisocial-narcissistic-borderline-histrionic cluster of personality disorders.

    • In contrast, the bonobos have evolved to be socially anxious, peaceful, cooperative, and loving. Thus bonobo social behavior most closely mirrors the negative emotion (anxious) behavior of the avoidant-dependent cluster of personality disorders.

    • Another separate evolutionary path was followed by the orangutans. They evolved to become solitary hermits. Thus orangutan social behavior most closely mirrors the detached behavior of the paranoid-schizoid-schizotypal cluster of personality disorders.

    Core Behaviors Of Schizoid And Schizotypal Personality Disorders

    Religious Hermit

    History is filled with thousands of stories of religious hermits who withdrew to a solitary place for a life of religious seclusion.

    The core feature of Schizoid and Schizotypal Personality Disorders is detachment. Individuals with these disorders are socially and emotionally withdrawn; thus prefer a solitary life.

      Detachment: The Core Feature Of Schizoid And Schizotypal Personality Disorders

      • social withdrawal:
        In the past week, did you mostly prefer to be alone?
      • intimacy avoidance:
        In the past week, did you avoid close friendships (outside of your family) or romantic relationships?
      • inability to feel pleasure:
        In the past week, did few things in life give you pleasure?
      • restricted emotional expression:
        In the past week, did you seldom smile or show much emotion?

    Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder

    Research has shown that genetic, environmental, and prenatal factors all play important roles in the development of personality disorder. Research has also shown that low parental affection and harsh parenting increase the risk of a child later developing a personality disorder.

    "Low affection" was defined as: low parental affection, low parental time spent with the child, poor parental communication with the child, poor home maintenance, low educational aspirations for the child, poor parental supervision, low paternal assistance to the child's mother, and poor paternal role fulfillment. "Harsh parenting" was defined as: harsh punishment, inconsistent maternal enforcement of rules, frequent loud arguments between the parents, difficulty controlling anger toward the child, possessiveness, use of guilt to control the child, and verbal abuse.


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    Treatment Guidelines

    Treatment

    Setting Goals In Therapy

      Questions To Ask When Setting Goals

      In The Past Week:
      • WHO: was your problem?
      • EVENT: what did he/she do?
      • RESPONSE: how did you respond to that event?
      • OUTCOME: did your response help?
      • TRIGGER: what did you do that could have triggered this problem?
      • GOAL: what life skill(s) do you have to work on? (from checklist)

      Example Of Setting Goals In Interviewing A Person With Schizoid Personality Disorder

      In The Past Week:
      • WHO: was your problem?
        "My female neighbors."

      • EVENT: what did he/she do?
        "These neighbors always want to talk to me, or sit next to me when I go out for coffee."

      • RESPONSE: how did you respond to that event?
        "I try to avoid these neighbors, but we live in a small apartment where this is almost impossible."

      • OUTCOME: did your response help?
        "No. These women still are very talkative and want to socialize whenever we meet."

      • TRIGGER: what did you do that could have triggered this problem?
        "Ever since I was discharged from hospital, my neighbors have been keeping in closer contact with me. I guess they are trying to help me."

      • GOAL: what life skill(s) do you have to work on? (from checklist)
        "I want to work on: (1) Sociability ("being friendly; interested in social contacts and activities"), and (2) Gratitude ("being thankful for the good things in life; expressing thanks to others")."

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    Self-Help Resources

    Improving Positive Behavior

    Philosophers for the past 2,500 years have taught that it is very beneficial to start the day with goal-setting, and end the day with a brief review.

    This habit of planning your day in the morning, and reviewing your day in the evening, is a time-proven technique for more successful living.

    Note: When each of the following videos finishes; you must exit YouTube (by manually closing the window) in order to return to this webpage.



    Morning Meditation (5-Minute Video)



    Afternoon Meditation (Learn How To Have Healthy Relationships)



    Evening Meditation (5-Minute Video)



    Life Satisfaction Scale (Video)



    Healthy Social Behavior Scale (Video)



    Mental Health Scale (Video)



    Click Here For More Self-Help



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      "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

      Lord Kelvin (1824 – 1907)


    • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

    • Canadian researchers who commit scientific fraud are protected by privacy laws: There are criminals in every community - even in the scientific research community (especially if a lot of money is at stake). Criminal researchers can hide their fraud behind outdated privacy laws.

    • The power of asking "what if?"

    • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

    • Criteria For High Quality Research Studies

    • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

      • Randomized Controlled Trial:
        Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

      • Representative Sample:
        Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

      • Single Blind Trial:
        Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

      • Double Blind Trial (Better Than Single Blind Trial):
        Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

      • Baseline Comparability:
        Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

      • Confounding Factors:
        Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

      • Intervention Integrity:
        Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

      • Statistical analysis:
        Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

        Ask: Are the results both statistically significant and clinically significant? The results should be both statistically significant (with a p-value <0.05) and clinically significant using some measure of Effect Size such as Standardized Mean Difference (e.g., Cohen's d >= 0.33). The summary statistics should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention). In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

          Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

          Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

          Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

        Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

      • Completeness of follow-up data:
        Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

      • Handling of missing data:
        Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

      • Replication of Findings:
        Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

      • Fraud:
        Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size (n), mean (M) and standard deviation (SD) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

        • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean (M) is defined as "the sum (Sum) of the values of each observation divided by the total number (n) of observations". So: M = Sum/n. Thus: (Sum) = (M) multiplied by (n). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate (M) multiplied by (n). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean (M) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value, and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

        • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible.

        • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

        • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

        • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

        • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

        • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

        • If the research study's data contradicts the study's own conclusions - surprisingly, this often occurs.

    • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

    • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

    • Not All Scientific Studies Are Created Equal - video

    • The efficacy of psychological, educational, and behavioral treatment

    • Estimating the reproducibility of psychological science

    • Psychologists grapple with validity of research

    • Industry sponsorship and research outcome (Review) - Cochrane Library

    • 'We've been deceived': Many clinical trial results are never published - (text and video)

    • Junk science misleading doctors and researchers

    • Junk science under spotlight after controversial firm buys Canadian journals

    • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

    • When Evidence Says No, But Doctors Say Yes


    • Cochrane Collaboration - the best evidence-based, standardized reviews available


    Research Topics

    Schizoid Personality Disorder - Latest Research (2016-2017)


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    Which Behavioral Dimensions Are Involved?

    Research has shown that there are 5 major dimensions (the "Big 5 Factors") of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Big 5 dimensions of personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

    This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", but our discussion will focus on the first 5 major dimensions.)

    These 5 major dimensions of human behavior seem to represent 5 major dimensions whereby our early ancestors chose their hunting companions or spouse. To maximize their chance for survival, our ancestors wanted companions who were agreeable, conscientious, intelligent, sociable, and calm.

    Dimensions of Human Behavior That Are Impaired in Schizoid Personality Disorder

    THE POSITIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THE NEGATIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THIS DISORDER
    Agreeableness Antagonism       Agreeableness
    Conscientiousness Disinhibition       Conscientiousness
    Intellect Decreased Intellect       Intellect
    Sociability (Extraversion) Detachment       Detachment
    Emotional Stability Negative Emotion       Emotional Stability

    The 5 Major Dimensions of Mental Illness

    The Big 5 Factors or dimensions of mental illness each has a healthy side and an unhealthy side. Thus the Big 5 Factors are: (1) Agreeableness vs. Antagonism, (2) Conscientiousness vs. Disinhibition, (3) Intellect vs. Decreased Intellect, (4) Sociability (Extraversion) vs. Detachment (Introversion), and (5) Emotional Stability vs. Negative Emotion.

    The Following Will Only Discuss The Dimension of Mental Illness That Is Abnormal In This Disorder

    The problems that are diagnostic of this disorder are highlighted in   Pink  . Other problems that are often seen in this disorder are highlighted in   Yellow  .



    Treatment Goals for Schizoid Personality Disorder

    SOCIABILITY (EXTRAVERSION) VS. DETACHMENT
    .
    SOCIABILITY
    .
    Description: Sociability (Extraversion) is synonymous with being enthusiastic and assertive. Assertiveness encompasses traits relating to leadership, dominance, and drive. Enthusiasm encompasses both sociability and the tendency to experience and express positive emotion. Extraverts tend to engage in social interaction; they are enthusiastic, risk-taking, talkative and assertive. The Extraversion dimension measures the behaviors that are central to the concept of SOCIABILITY - seeking and enjoying companionship. High sociability is associated with better: longevity, leadership, job [sales] performance. (This dimension appears to measure the behaviors that differentiate approach from avoidance.)
    Descriptors: Sociable, gregarious, reward-seeking, talkative.
    Language Characteristics: Many topics, higher verbal output, think out loud, pleasure talk, agreement, compliment, positive emotion words, sympathetic, concerned about hearer (but not empathetic), simple constructions, few unfilled pauses, few negations, few tentative words, informal language, many swear words, exaggeration (e.g. "I'm really smart" ), many words related to humans (e.g. "man", "pal"). poor vocabulary.
    Research: Higher scores on Sociability (extraversion) are associated with greater happiness and broader social connections. *MRI research found that Sociability (extraversion) was associated with increased volume of medial orbitofrontal cortex, a region involved in processing reward information.
    "I'm talkative"
    "I'm not reserved."
    "I'm full of energy."
    "I generate a lot of enthusiasm."
    "I'm not quiet."
    "I have an assertive personality."
    "I'm not shy or inhibited."
    "I am outgoing and sociable."
    "I make friends easily."
    "I warm up quickly to others."
    "I show my feelings when I'm happy."
    "I have a lot of fun."
    "I laugh a lot."
    "I take charge."
    "I have a strong personality."
    "I know how to captivate people."
    "I see myself as a good leader."
    "I can talk others into doing things."
    "I am the first to act."
    .
    Attention Seeking
    .
    "I like to draw attention to myself."
    "I crave attention."
    "I do things to make sure people notice me."
    "I do things so that people just have to admire me."
    "My behavior is often bold and grabs peoples' attention."
    .
    DETACHMENT
    .
    Description: Detachment is synonymous with being reserved and quiet.
    Descriptors: Withdrawn, anhedonic (pleasureless), intimacy avoiding, detached, shy, passive, solitary, moody
    Language Characteristics: Single topic, doesn't think out loud, problem talk, dissatisfaction, negative emotion words, not sympathetic, elaborated sentence constructions, many unfilled pauses, formal language, many negations, many tentative words (e.g. maybe, guess), few swear words, little exaggeration, few words related to humans, rich vocabulary.
    .
    * Social Withdrawal:
    "I don’t like to get too close to people."
    "I don't deal with people unless I have to."
    "I'm not interested in making friends."
    "I don’t like spending time with others."
    "I say as little as possible when dealing with people."
    "I keep to myself."
    "I am hard to get to know."
    "I reveal little about myself."
    "I do not have an assertive personality."
    "I lack the talent for influencing people."
    "I wait for others to lead the way."
    "I hold back my opinions."
    .
    * Intimacy Avoidance:
    "I steer clear of romantic relationships."
    "I prefer to keep romance out of my life."
    "I prefer being alone to having a close romantic partner."
    "I'm just not very interested in having sexual relationships."
    "II break off relationships if they start to get close."
    .
    * Loss of Interest or Pleasure:
    "I often feel like nothing I do really matters."
    "I almost never enjoy life."
    "Nothing seems to make me feel good."
    "Nothing seems to interest me very much."
    "I almost never feel happy about my day-to-day activities."
    "I rarely get enthusiastic about anything."
    "I don't get as much pleasure out of things as others seem to."
    .
    * Restricted Emotions:
    "I don't show emotions strongly."
    "I don't get emotional."
    "I never show emotions to others."
    "I don't have very long-lasting emotional reactions to things."
    "People tell me it's difficult to know what I'm feeling."
    "I am not a very enthusiastic person."
    .
    ("Sociability vs. Detachment" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
    *MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.


    The "Big 5 Factors" of Personality as Shown In Dogs

    The same "Big 5 Factors" of personality found in humans can be found in dogs. This makes sense because dogs, like humans, are a social species.



    AGREEABLENESS VS. ANTAGONISM
    .
    Agreeableness ("Friend")
    .
    Dog is friendly towards unfamiliar people.
    Dog is friendly towards other dogs.
    When off leash, dog comes immediately when called.
    Dog willingly shares toys with other dogs.
    Dog leaves food or objects alone when told to do so.
    .
    Antagonism ("Foe")
    .
    Dog is dominant over other dogs.
    Dog is assertive with other dogs (e.g., if in a home with other dogs, when greeting).
    Dog behaves aggressively towards unfamiliar people.
    Dog shows aggression when nervous or fearful.
    Dog aggressively guards coveted items (e.g., stolen item, treats, food bowl).
    Dog is quick to sneak out through open doors, gates.

    CONSCIENTIOUSNESS VS. DISINHIBITION
    .
    Conscientiousness ("Self-Controlled")
    .
    Dog works at tasks (e.g., getting treats out of a dispenser, shredding toys) until entirely finished.
    Dog works hard all day herding or pulling a sleigh (if a "working dog" on the farm or in the snow).*
    Dog is curious.
    .
    Disinhibition ("Disinhibited")
    .
    Dog is boisterous.
    Dog seeks constant activity.
    Dog is very excitable around other dogs.

    INTELLECT VS. DECREASED INTELLECT
    .
    Open To Experience ("Open-Minded")
    .
    Dog is able to focus on a task in a distracting situation (e.g., loud or busy places, around other dogs).
    .
    Closed To Experience ("Closed-Minded")
    .
    Dog is slow to respond to corrections.
    Dog ignores commands.
    Dog is slow to learn new tricks or tasks.

    SOCIABILITY (EXTRAVERSION) VS. DETACHMENT
    .
    Sociability ("Approach")
    .
    Dog is attention seeking (e.g., nuzzling, pawing or jumping up on family members looking for attention and physical contact).*
    Dog seeks companionship from people.
    Dog is affectionate.
    .
    Detachment ("Avoidance")
    .
    Dog is aloof.
    Dog gets bored in play quickly.
    Dog is lethargic.

    EMOTIONAL STABILITY VS. NEGATIVE EMOTION
    .
    Emotional Stability ("Safety")
    .
    Dog tends to be calm.
    Dog is relaxed when greeting people.
    Dog is confident.
    Dog adapts easily to new situations and environments.
    .
    Negative Emotion ("Danger")
    .
    Dog is anxious.
    Dog is shy.
    Dog behaves fearfully towards unfamiliar people.
    Dog exhibits fearful behaviors when restrained.
    Dog avoids other dogs.
    Dog behaves fearfully towards other dogs.
    Dog behaves submissively (e.g., rolls over, avoids eye contact, licks lips) when greeting other dogs.
    .
    Modified from Jones, A. C. (2009). Development and validation of a dog personality questionnaire. Ph.D. Thesis. University of Texas, Austin.

    * New items added by Phillip W. Long MD


    Personality Difference Between Dogs and Humans

    Dogs and humans are strikingly similar on 4 of the "Big 5 Factors" of personality. However, dogs and humans are quite different on the "Conscientiousness" factor - because the canine brain is designed for hunting, not building. That's why dogs don't build dog houses.

    The Brain and the "Big-5 Factors" of Personality In A Social Species

    The "Big-5 Factors" of personality represent basic brain functions in social species. For example, when a male approaches a female, the female must: (1) decide whether the male is friend or foe ["Agreeableness"], (2) decide if this represents safety or danger ["Emotional Stability"], (3) decide whether to approach or avoid him ["Sociability"], (4) decide whether to be self-controlled or disinhibited ["Conscientiousness"], and (5) learn from this experience ["Openness to Experience"].

    The "Big-5 Factors" of Human and Cat Personality

    Cats are a social species, but less social than dogs. Nevertheless, cats also show the "Big 5 Factors" of personality.



    The "Big 5" Dimensions of Personality and Personality Disorders

    There are two free online personality tests that assess your personality in terms of the "Big 5" dimensions of personality. The following diagram shows the relationship between the "Big 5" dimensions of personality and personality disorders. This diagram is based on the research of Sam Gosling, Jason Rentfrow, and Bill Swann, Gerard Saucier, Colin G. DeYoung, and Douglas Samuel and Thomas Widiger.


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    "Big-5" Personality Dimension of Low Extraversion (Introversion)

    Schizoid and Schizotypal Personality Disorders don't seem to fit into a classification of personality disorders using the "Big 5" personality dimensions. On personality testing, neither of these two personality disorders scores abnormally on the "Big 5" personality dimensions. At best, they score low on Extraversion, but not significantly low.


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    "High Extraversion"

    The (BFAS) "Big-5" personality dimension of "High Extraversion" is associated with:
    • Make friends easily
    • Warm up quickly to others
    • Show my feelings when I'm happy
    • Have a lot of fun
    • Laugh a lot
    • Take charge
    • Have a strong personality
    • Know how to captivate people
    • Can talk others into doing things
    • See myself as a good leader
    • Am the first to act

    "Low Extraversion (Introversion)"

    The (BFAS) "Big-5" personality dimension of "Low Extraversion (Introversion)" is associated with:
    • Am hard to get to know
    • Keep others at a distance
    • Reveal little about myself
    • Rarely get caught up in the excitement
    • Am not a very enthusiastic person
    • Lack the talent for influencing people
    • Wait for others to lead the way
    • Hold back my opinions
    • Do not have an assertive personality

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