What Are Cluster A Personality Disorders?

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The Diagnostic and Statistical Manual of Mental Disorders, DSM-5, identifies 10 unique personality disorders, each belonging to one of three groups known as "clusters." Cluster A contains paranoid, schizoid, and schizotypal disorders. These are personality disorders characterized by odd, eccentric thinking or behavior.

Paranoid Personality Disorder

Paranoid personality disorder is a condition marked by excessive distrust and suspiciousness of others. This disorder is only diagnosed when these behaviors become persistent and very disabling or distressing.

• Distrust and suspicion of others
• Believing that others are trying to harm you
• Emotional detachment
• Hostility

Individuals with this disorder are often difficult to get along with and often have problems with close relationships because of their excessive suspiciousness and hostility. Their combative nature may elicit a confrontational response in others, which then serves to confirm their original expectations. Individuals with this disorder have a need for control over those around them. They are often rigid, critical of others, and unable to collaborate, and they may have great difficulty accepting criticism themselves.

They may exhibit thinly hidden, unrealistic grandiose fantasies, are often attuned to issues of power and rank, and tend to develop negative stereotypes of others, particularly those from population groups distinct from their own. More severely affected individuals with this disorder may be perceived by others as fanatics and form tightly knit cults or groups with others who share their paranoid beliefs.

Schizoid Personality Disorder

Schizoid personality disorder is a condition in which affected people avoid social activities and consistently shy away from interaction with others. They often have little concept of how to connect with others to form personal relationships.

• Limited range of emotional expressions
• Inability to pick up normal social clues
• Appearing dull or indifferent to others

To others, the schizoid personality may appear dull or humorless. Because they don't tend to show emotion, they may appear as though they don't care about what's going on around them. However, they may actually feel extremely sensitive and lonely. People with schizoid personality disorder are seen as loners and have little motivation for sexual relationships. They often prefer being alone, value independence, have few close friendships, and feel confused about how to respond to normal social cues.

These tendencies may first become noticeable in childhood. Because they feel so anxious around other people, they may not learn how to form friendships, so they give up and turn inward. Schizoid personalities can underperform at school or work due to lack of motivation and are more comfortable in the role of follower rather than leader.

Although schizoid personality disorder is considered part of the "schizophrenic spectrum" of disorders, which includes schizotypal personality disorder and schizophrenia, it is distinct in the sense that they are in touch with reality and are less likely to experience hallucinations associated with schizophrenia.

Schizotypal Personality Disorders

People with classic schizotypal personalities are apt to be loners. They may feel extremely anxious in social situations, but they're likely to blame their social failings on others. They view themselves as alien or outcast, and this isolation causes pain as they avoid relationships and the outside world.

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People with schizotypal personalities may ramble oddly and endlessly during a conversation. They may dress in peculiar ways and have very strange ways of viewing the world around them. Often they believe in unusual ideas, such as the powers of ESP or a sixth sense. At times, they believe they can magically influence people's thoughts, actions, and emotions. Other symptoms may include:

• Incorrect interpretation of events, including feeling that external events have personal meaning
• Peculiar thinking, beliefs, or behavior
• Belief in special powers, such as telepathy
• Perceptual alterations, in some cases bodily illusions, including phantom pains or other distortions in the sense of touch
• Idiosyncratic speech, such as loose or vague patterns of speaking or tendency to go off on tangents
• Suspicious or paranoid ideas
• Flat emotions or inappropriate emotional responses
• Lack of close friends outside of the immediate family
• Persistent and excessive social anxiety that doesn't abate with time

Schizotypal personality disorder falls in the middle of the schizophrenia spectrum, with schizoid personality disorder on the milder end and Schizophrenia on the more severe end.

Seeking Help

Treatment for a personality disorder may be more effective if it begins as early as possible. If someone close to you has urged you to seek help for symptoms common to schizoid personality disorder, make an appointment, starting with a primary care physician or mental health professional. When someone chronically feels or behaves in an inappropriate way, that person may have a personality disorder. Treatment for personality disorders often includes a combination of medication and one or more types of therapy:

Psychotherapy. Building a trusting relationship with a therapist may help people with personality disorders begin to trust other interpersonal relationships.

Behavior therapy. People with personality disorders often need to learn specific social skills and behaviors. In behavior therapy, they might be taught to respond to social cues with appropriate words, tone of voice, or facial expressions.

Cognitive therapy. This type of therapy can help people identify and change distorted thought patterns. For example, this type of therapy may help a person uncover—and change—confused ideas about what goes on in interpersonal exchanges.

Family therapy. Treatment can be more effective when family members are involved. Seeking professional counseling as a group may help reduce fighting or emotional distance in the home. Family therapy may also offer the affected person a support structure and a boost in morale.

©2021 Kevin Bennett, Ph.D. All rights reserved.

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