Isn't schizoid and avoident personality disorder Autism?

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25 Mar 2014, 6:28 am

Schizoid PD of childhood onset is probably the same thing as AS for the most part, but that label seems to have vanished.

Schizoid PD could probably be seen as an adolescent onset ASD of some kind, albeit usually milder.

Anyway, Wing put it as this in the penultimate AS paper in the west:

Quote:

Schizoid personality

The lack of empathy, single-mindedness, odd communication, social isolation and over-sensitivity of people with Asperger syndrome are features that are also included in the definitions of schizoid personality (see review by Wolff & Chick, 1980). Kretschmer (1925) outlined some case histories of so-called schizoid adults, one or two of which were strongly reminiscent of this condition, although he did not provide sufficient detail to ensure the diagnosis. For example, one young man had no friends at school, was odd and awkward in social interaction, always had difficulty with speech, never took part in rough games, was oversensitive, and very unhappy when away from home. He thought out fantastic technical inventions and, together with his sister, invented a detailed imaginary world.

There is no question that Asperger syndrome can be regarded as a form of schizoid personality. The question is whether this grouping is of any value. This will be discussed below in the section on classification.

She didn't put Avoidant PD as a differential.

Sweetleaf
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25 Mar 2014, 2:28 pm

beneficii wrote:

Callista wrote:

Oh, no, it won't be destroyed; it'll just be recognized as a kind of autism. The only change is in name, so there's actually no reason to be upset.

Personality disorders have very little to do with autism. Autism is a neurological disorder, for one thing. Personality disorders are the extremes of the normal personality traits, diagnosed when they begin to cause problems. Unlike autism, they don't affect thinking, learning, or perception to a huge extent.

Personality disorders do not involve repetitive behaviors, obsessive interests, sensory integration difficulties, delayed/odd language, or social skills delays; and they do not begin in childhood (personality disorders can only be diagnosed in adults or at the most older teens).

There are some minor similarities between the personality disorders and autism; but that's all they are--minor, very minor.

How do you mean to "get yourself diagnosed with" avoidant personality disorder? I thought the psychologist was supposed to make that decision! I mean, it's not like you just go up to a diagnosis-R-Us and place your order.

Keep in mind, though, that schizotypal (personality) disorder is 1.) disputed as a personality disorder and 2.) does have large effects on thinking. It is considered to be related to schizophrenia and may be used to diagnose what appear to be mild manifestations of schizophrenia that fall just short of the criteria (like when I was diagnosed with it at age 14). This is but one piece of evidence for the connection to schizophrenia:

http://schizophreniabulletin.oxfordjour ... bt239.long

From what I have read it certainly does have a large effect on thinking and perception.

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25 Mar 2014, 5:51 pm

Sweetleaf wrote:

beneficii wrote:

Callista wrote:

From what I have read it certainly does have a large effect on thinking and perception.

It does - ideas of reference, magical thinking, formal thought disorder - which itself causes odd speech are all associated with schizotypal personality disorder. In addition, it has several traits in common with autism. The similarity with autism is actually significant, and the subject of much study.

Eloa
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25 Mar 2014, 6:36 pm

In my first assessment report was written that per DSM-IV and ICD-10 I fulfil criteria to get assessed with schizoid disorder, schizotypal disorder, avoidant personality disorder (but it was written, that "not all difficulties patient has to face are merely explained by it") and the other difficulties are explained by autistic disorder (my axis 2 diagnosis) and I did not grow up in healthy environment what makes me believe that the other disorders may play into it as well,
because I do not like the thought that an autistic person has no personality or is completely unaffected by pathological circumstances.
In the later assessments there were no assessments for other disorders anymore, they were only directed on the autism, that were the formal assessments for disability, though severe complex PTSD was mentioned as well and severe executive dysfunction (but I am not assessed with ADHD, executive dysfunction is due to autism).

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TPE2
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26 Mar 2014, 7:20 am

schizophrenia / schizotypal - social isolation + distortion of reality
schizoid (ICD) - social isolation + daydreaming
schizoid (DSM) - social isolation
PDD/NOS - several possibilities, but social isolation without narrow interests could be one
Autism/Asperger - social isolation + narrow interests

Probably there are many misdagnosis between all - after all, the fantasies of the schizo- could easily be considered a kind of narrow interests. Put it in other way, a person in the schizophrenia spectrum that knows that his fantasies are not real and a person in the autistic spectrum with a narrow interest of the intelectual type could be virtually undistingueble (both will be of the "absent-minded thinker" type).

And I had read somewhere that the ASD where is more common the appearence of schizophrenia or other type of psychosys is PDD/NOS; well, attending that the symptoms of schizoid personality in a child or a pre-adolescent will probably be identical to the symptoms needed for a diagnosis of PDD/NOS, there is a good reason to think that many people "with PDD/NOS" are in reality mis-diagnosed schizoids.

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26 Mar 2014, 3:31 pm

TPE2 wrote:

PDD/NOS - several possibilities, but social isolation without narrow interests could be one

TPE2 wrote:

And I had read somewhere that the ASD where is more common the appearence of schizophrenia or other type of psychosys is PDD/NOS; well, attending that the symptoms of schizoid personality in a child or a pre-adolescent will probably be identical to the symptoms needed for a diagnosis of PDD/NOS, there is a good reason to think that many people "with PDD/NOS" are in reality mis-diagnosed schizoids.

I think you are a bit stereotyping PDD-NOS here. In general, according to the (now obsolete) DSM IV-TR, enough symptoms in one of the communication or RRB areas are needed besides the mandatory social. Some studies suggest that it is often the RRB that is left out, or where only subtreshold symptoms are present. PDD-NOS is also a way to say 'We are not sure of the exact label'. In fact, according to the ADOS and ADI-R that had been used in the evaluation I scored sufficiently high on the RRB scale but just fell short of the minimum score for both social and communication scales. The diagnosis was given due to the psychs thinking I need help anyway. Manifestation of ASDs can greatly differ in adulthood from what they were like in childhood. Besides, not all evidence is accessible when diagnosing adults.

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26 Mar 2014, 4:06 pm

This thread reminded me that I was almost DXed with Schizoid PD before I was DXed with an ASD.

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Acedia
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27 Mar 2014, 2:35 am

XFilesGeek wrote:

This thread reminded me that I was almost DXed with Schizoid PD before I was DXed with an ASD.

From what you have described of yourself I think a diagnosis of Schizoid PD would be more accurate.

No I don't think they're the same. Schizoid PD is probably an avoidant attachment style/personality type. Autism is a developmental disability that causes poor social integration. One is choice/circumstance and the other is involuntary/constitutional/congenital.

People with Schizoid PDs know how to socialize and can do so well, but they prefer their own company, and refrain from being social. It doesn't sound like people with autism who have great difficulty with socializing.

Quote:

Descriptions of the schizoid personality as "hidden" behind an outward appearance of emotional engagement have been recognized as far back as 1940 with Fairbairn's description of "schizoid exhibitionism," in which the schizoid individual is able to express a great deal of feeling and to make what appear to be impressive social contacts yet in reality gives nothing and loses nothing. Because he is only "playing a part," his own personality is not involved. According to Fairbairn, "the person disowns the part which he is playing and thus the schizoid individual seeks to preserve his own personality intact and immune from compromise."

http://en.wikipedia.org/wiki/Schizoid_p ... chizoid.27

Maybe personalities have a biological component to them, but I'd say it's so slight. I would take Schizoid PD out of the DSM, as I think it's a personality that doesn't need to be pathologized. Reading a book about autism, one author says that Schizoid traits can be exhibited by people with Asperger Syndrome, but there are people with Asperger's who exhibit no traits of Schizoid personalities.

Last edited by Acedia on 28 Mar 2014, 3:53 am, edited 2 times in total.

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27 Mar 2014, 3:19 am

Acedia wrote:

From what you have described of yourself I think a diagnosis of Schizoid PD would be more accurate.

This may be why she was considered for a diagnosis, but with a more thorough evaluation autism was deemed more appropriate.

As far as schizoid PD goes, it also presents with impairments that cause serious difficulties in life, which is why it's a diagnosis in the first place. The diagnosis isn't saying "Being a loner is bad" but that a schizoid personality experiences severe difficulties because of their schizoid ways.

As far as etiology goes, at least some people do think schizoid PD has biological elements/causes. Sula Wolff says there are constitutional, probably genetic basis (got the quote from wiki, at least).

Acedia
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27 Mar 2014, 3:29 am

Verdandi wrote:

As far as etiology goes, at least some people do think schizoid PD has biological elements/causes. Sula Wolff says there are constitutional, probably genetic basis (got the quote from wiki, at least).

Do you think there is a genetic basis? And in some cases they can socialize to a normal degree?

Are Schizoid people the transition between autism and neurotypicality?

alwaysnow
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27 Mar 2014, 12:14 pm

What's with all this nonsense. Yes schizoid pd shares many features/symptoms with AS, but many things can share similar symptoms without having any of the same reasons behind it. I was also close to being diagnosable with schizoid pd, but it was clear that most of that was explained by symptoms from my AS.

Schizoid pd is a personality disorder, something which develops in a person not earlier than the teens due to some form of maladaption or troubled life experience.

AS means being born with an abnormal brain, and have numerous other symptoms that do not appear in schizoid pd.

One thing I've learned from WP at least is that there's an abundance of aspie pseudo-scientists.

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27 Mar 2014, 3:02 pm

alwaysnow wrote:

What's with all this nonsense. Yes schizoid pd shares many features/symptoms with AS, but many things can share similar symptoms without having any of the same reasons behind it.

But the big problem here is that nobody really knows what are the reasons behind both AS-like behaviour and behaind schizoid-like behaviour, then we only have the behaviour itself to make a diagnosis - and the behaviours could be very similar.

Quote:

Schizoid pd is a personality disorder, something which develops in a person not earlier than the teens due to some form of maladaption or troubled life experience.

Afaik, there is not an "official" explanation about the causes of PDs - some authors tend more to "nurture", others more to "nature".

And the age of onset of PDs seems to be also a contentious thing - the DSM says after 18 y.o., unless the symptoms are present for more than one year (and Anti Social Personality Disorder is always after 18 ); in contrast, the ICD say "late childhood or adolescence".

And, about SPD, the old version of the DSM said:

Quote:

The essential feature of Schizoid Personality Disorder is a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. This pattern begins by early adulthood and is present in a variety of contexts. (...)

Schizoid Personality Disorder may be first apparent in childhood and adolescence with solitariness, poor peer relationships, and underachievement in school, which mark these children or adolescents as different and make them subject to teasing.

There seems to be much confusion (in the same page of the same book..) about at age SPD is supposed to appear (or probably a confusion between two different thing: the age when symptoms of SPD are supposed to appear; and the age when these symptoms should be diagnosed with SPD)

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27 Mar 2014, 3:07 pm

Schizophrenia spectrum symptoms can appear as early as childhood, albeit often in a more subtle form than those of ASD.

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27 Mar 2014, 4:01 pm

Acedia wrote:

Verdandi wrote:

Do you think there is a genetic basis? And in some cases they can socialize to a normal degree?

Are Schizoid people the transition between autism and neurotypicality?

I would say that the assumption that the axis II category of personality disorders exists as it is believed to exist may be inaccurate. Looking at research based on multiple PDs, it seems that they don't actually fit all that well into one specific model. The primary thing that seems to connect them is that the people who have them tend be all "ego syntonic" about those traits, meaning they don't see anything wrong with them. Schizophrenia often has this feature too, although in SZ it's called anosognosia, which is a lack of insight into one's own mental state.

And about PDs being personalities taken to extremes - many axis I disorders are traits taken to extremes, which is what makes them a problem.

I guess I am just dubious about the view of personality disorders being a matter of choice or circumstance. I don't think it's wrong to say that they are a pattern of maladaptive behaviors because they totally are, just that I am skeptical of the way they're explained - usually in a manner that basically blames people for having developed them.

Oh and I couldn't begin to say if schizoid people are a transition between autism and NT. It may be some kind of "some negative symptoms from schizophrenia with no positive symptoms" or it could be some other thing. I don't have enough information.

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27 Mar 2014, 4:20 pm

alwaysnow wrote:

Schizoid pd is a personality disorder, something which develops in a person not earlier than the teens due to some form of maladaption or troubled life experience.

Can you cite the findings that clearly demonstrate this?

This study places schizoid (and schizotypal) into the schizophrenia spectrum, which doesn't seem to be very PD-like as they are commonly described:

http://www.ncbi.nlm.nih.gov/pubmed/11533862

If you look at various websites they say that no one really knows what causes these PDs, so to confidently claim what you did seems a bit inaccurate.

Also, per Theodore Millon in Personality Disorders in Modern Life pp 78-79:

Quote:

That characteristics of anatomic morphology, endocrine physiology, and brain chemistry would not be instrumental in shaping the development of personality is inconceivable. Biological scientists know that the central nervous system cannot be viewed as a simple and faithful follower of what is fed into it from the environment; it not only maintains a rhythmic activity of its own but also plays an active role in regulating sensitivity and controlling the amplitude of what is picked up by peripheral organs. Unlike a machine, which passively responds to external stimulation, the brain has a directing function that determines substantially what, when, and how events will be experienced.

Each individual’s nervous system selects, transforms, and registers objective events in accord with its distinctive biological characteristics. Unusual sensitivities in this delicate orienting system can lead to marked distortions in perception and behavior. Any disturbance that produces a breakdown in the smooth integration of functions, or a failure to retrieve previously stored information, is likely to create chaos and pathology. Normal psychological functioning depends on the integrity of certain key areas of biological structure, and any impairment of this substrate will result in disturbed thought, emotion, and behavior. However, although biogenic dysfunctions or defects may produce the basic break from normality, psychological and social determinants almost invariably shape the formof its expression. Acceptance of the role of biogenic influences, therefore, does not negate the role of social experience and learning (Eysenck, 1967; Meehl, 1962, 1990b; Millon, 1981, 1990; Millon, Blaney, & Davis, 1999; Millon & Davis, 1996).

Although the exact mechanisms by which biological functions undergird personality disorders will remain obscure for some time, the belief that biogenic factors are intimately involved is not new. Scientists have been gathering data for decades, applying a wide variety of research methods across a broad spectrum of biophysical functions. The number of techniques used and the variety of variables studied are legion. These variables often are different avenues for exploring the same basic hypotheses. For example, researchers focusing on biochemical dysfunctions often assume that these dysfunctions result from genetic error. However, the methods they employ and the data they produce are different from those of researchers who approach the role of heredity through research comparing monozygotic with dizygotic twins. This chapter proceeds to subdivide the subject of development into several arbitrary (but traditional) compartments,beginning first with heredity.

I won't add more because this is one of the wordiest books I've ever read*. But basically it appears there is an understanding that there is more to personality disorder formation than environment.

AS means being born with an abnormal brain, and have numerous other symptoms that do not appear in schizoid pd.

Quote:

One thing I've learned from WP at least is that there's an abundance of aspie pseudo-scientists.

One thing I've learned from people is that if two things are at least superficially similar, they often want to know if that similarity extends more deeply. This is why autism and schizoid PD have been researched in relation to one another. For example:

http://www.gnc.gu.se/digitalAssets/1349 ... utism-.pdf

That covers potentially all personality disorders, although cluster A and C are emphasized. The point being that asking "is there a connection between these externally similar disorders?" is not actually pseudoscience. It's the point at which research begins.

* Seriously, shortly after the quoted section there is a four and a quarter page sidebar on gender and personality disorders.

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27 Mar 2014, 7:48 pm

Acedia wrote:

Well, I'm not going to argue, but I would note that I, in fact, have difficultly socializing (even when I want to).

I got an ASD DX because my psychologist claimed my manner reminded him of adolescent boys he previously treated with Aspergers, and that I do care about people once you get past my non-labile face.

In any case, the process of diagnosis isn't terribly "scientific," so I'm open to the possibility of other labels may apply, and I appreciate the feedback.

Quote:

Heh. I don't have "impressive social contacts."

Quote:

Maybe personalities have a biological component to them, but I'd say it's so slight. I would take Schizoid PD out of the DSM, as I think it's a personality that doesn't need to be pathologized. Reading a book about autism, one author says that Schizoid traits can be exhibited by people with Asperger's Syndrome, but there are people with Asperger's who exhibit no traits of Schizoid personalities

I'm sure there are Schizoid individuals who suffer no ill-effects from their disorder, but I'm not one of them.

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