Toward resolution of a longstanding controversy in personality disorder diagnosis: Contrasting correlates of schizoid and avoidant traits |
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| Affiliation: | 1. Laboratory of Cell and Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, United States;2. Biomembrane Lab, Department of Biochemistry, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620 024, Tamil Nadu, India;1. Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands;2. Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania;3. Psychology & Digital Mental Health Care, Department of Health Sciences, Technical University Munich, Munich, Germany;4. Department of Clinical Psychology & Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany;5. Department of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany;6. WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Italy;7. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA;1. University of Detroit Mercy, Department of Psychology, 4001 W. McNichols Road, Detroit, MI 48221, United States;2. University of Kansas School of Medicine – Wichita, Department of Psychiatry and Behavioral Sciences, United States |
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| Abstract: | Although the construct validity and clinical utility of separate schizoid and avoidant personality disorder (PD) categories has been controversial since avoidant PD was first introduced in DSM-III, few studies have compared individuals with schizoid versus avoidant features on variables relevant to their contrasting personality dynamics. Those few investigations that exist have yielded inconclusive results. In this study a mixed-sex sample of nonclinical participants (N = 123) completed the International Personality Disorder Examination Screening Questionnaire (IPDE-SQ) and self-report measures of attachment style, defense style, empathy, internalized shame, need to belong, rejection sensitivity, and social anhedonia. High levels of social anhedonia were uniquely predictive of schizoid features; high levels of need to belong and internalized shame were uniquely predictive of avoidance. These findings support retaining the two PD categories in future versions of the DSM. Supplementary analyses revealed that among women—but not men—schizoid and avoidant traits were positively and significantly intercorrelated; it may be that women show more of a blended schizoid–avoidant profile, whereas men display the more prototypical categorical profile where either schizoid or avoidant features predominate. |
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| Keywords: | DSM-5 Personality disorder Schizoid Avoidant Differential diagnosis |
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