MENTAL HEALTH

GROUP
MEMBERS:
ARETHA HECTOR
ASHA POMPEY
DENESHA
ALEXANDER
KEZIA WILLIAMS
APRIL JOB

PARANOID &
SCHIZOID
PERSONALITY TYPES
DISORDER

SCHIZOID & PARANOID PERSONALITY DISORDERS

TABLE OF CONTENTS
Introduction.. Page 3
What are Personality disorders?.................................................................. Page 4
Definition and Epidemiological Statistics
Paranoid Personality Disorder (PPD).page 5
Schizoid Personality Disorder (SPD)......page 5
Etiology
Paranoid Personality Disorder (PPD).page 6-7
Schizoid Personality Disorder (SPD)......page 6
Clinical Picture
Paranoid Personality Disorder (PPD).page 7
Schizoid Personality Disorder (SPD)......page 8
How is PPD Diagnosedpage 9
How is SPD Diagnosedpage 10
Symptoms
Paranoid Personality Disorder (PPD).page 11
Schizoid Personality Disorder (SPD)......page 11
Treatment:
Nursing Management
Paranoid Personality Disorder (PPD).page 12-13
Schizoid Personality Disorder (SPD)......page 13-14
Medical Management
Paranoid Personality Disorder (PPD).page 14
Schizoid Personality Disorder (SPD)......page 14-15
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SCHIZOID & PARANOID PERSONALITY DISORDERS

Complication
Paranoid Personality Disorder (PPD).page 15
Schizoid Personality Disorder (SPD)..page 16
Outlooks For Persons With PPD & SPD page 17
Prevention of PPD & SPDpage 18
Conclusion.......page19
References........page 20

SCHIZOID & PARANOID PERSONALITY DISORDERS

INTRODUCTION
Personality is vital in defining who we are as individuals. It involves a unique blend of traits,
attitudes, thoughts, behaviours and moods as well as how these traits affect the people around
us. Some characteristics of an individuals personality are inherited, and some are shaped by life
events and experiences. A personality disorder can develop if certain personality traits become
too rigid and inflexible. This research paper is going to focus on only two of the ten types of
personality disorders; schizoid & paranoid. Its going to educate our reader on what both
schizoid & paranoid personality disorders are, their causes, incidence rates, symptoms,
treatments and more.

SCHIZOID & PARANOID PERSONALITY DISORDERS

WHAT ARE PERSONALITY

DISORDERS?
Personality Disorders, also known previously as character disorders, is a broad term for a
class of personality types and behaviors that describe individuals who have problems dealing with
other people. The patient will typically tend to be rigid and inflexible, finding it harder than other
people to respond as easily to the changes and demands that occur in life. They are seen as
dysfunctional in the way they assess situations and relate to other people.

The American Psychiatric Association (APA) describes a personality disorder as: "An enduring
pattern of inner experience and behavior that deviates markedly from the expectations of the culture
of the individual who exhibits it."

A personality disorder is a mental illness. The patient can become distressed when having to
perform everyday functions in the workplace, school or situations involving other people.
(PsychCentral, 2014)

SCHIZOID & PARANOID PERSONALITY DISORDERS

Paranoid Personality Disorder (PPD)

Definition and Epidemiological Statistics
The DSM-IV-TR defines paranoid personality disorder as a pervasive distrust and
suspiciousness of others such that their motives are interpreted as malevolent beginning by early
adulthood and present in a variety of contexts. Sadock and Sadock (2007), identify the
characteristic feature as a longstanding suspiciousness and mistrust of people in general.
Prevalence is difficult to establish because individuals with the disorder seldom seek
assistance for their problem or require hospitalization. When they present themselves for
treatment because of the insistence of others, they may be able to pull themselves together
sufficiently so that their behaviour does not appear maladaptive. The disorder is more commonly
diagnosed in men than in women.(M. Townsend, 2007)

Schizoid Personality Disorder (SPD)

Definition and Epidemiological Statistics
Schizoid personality disorder is characterized primarily by a profound defect in the ability
to form personal relationships or to respond to others in any meaningful or emotional way
(Skodol& Gunderson, 2008). These individuals display a lifelong pattern of social withdrawal,
and their discomfort with human interaction is apparent.
The prevalence of schizoid personality disorder within the general population has been
estimated at between 3 and 7.5 percent. Significant numbers of people with the disorder are
never observed in a clinical setting. Gender ratio of the disorder is unknown, although it is
diagnosed more frequently in men.(M. Townsend, 2007)
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ETIOLOGY
SCHIZOID PERSONALITY DISORDER
Although the role of hereditary in the etiology of schizoid personality disorder is unclear,
the feature of introversion appears to be a highly inheritable characteristic. Further studies are
required before definitive statements can be made. (M. Townsend, 2007)
Psychosocially, the development of schizoid personality is probably influenced by early
interactional patterns that the person found to be cold and unsatisfying. The childhood of these
individuals have often been characterized as bleak, cold, and notably lacking empathy and
nurturing. A child brought up with this type of parenting may become a schizoid adult if that
child possesses a temperamental disposition that is shy, anxious, and introverted. According to
Skodol and Gunderson (2008), Clinicians have noted that schizoid personality disorder occurs
in adults who experienced cold neglectful and ungratifying relationships in early childhood,
which leads these persons to assume that relationships are not valuable or worth pursuing. (p.83)

PARANOID PERSONALITY DISORDER

Research has indicated a possible hereditary link in paranoid personality disorder. Studies
have revealed a higher incidence of paranoid personality disorder among relatives of clients with
schizophrenia that among control subjects (Sadock&Sadock, 2007).

SCHIZOID & PARANOID PERSONALITY DISORDERS

Psychosocially, people with paranoid personality disorder may have been subjected to
parental antagonism and harassment. They likely served as scapegoats for displaced parental
aggression and gradually relinquished all hope of affection and approval. They learned to
perceive the world as harsh and unkind, a place calling for protective vigilance and mistrust.
They entered the world with a chip-on the-shoulder attitude and were met with many rebuffs
and rejections from others. Anticipating humiliation and betrayal by others, the paranoid person
learned to attack first. (T. Basavanthappa, 2000)

CLINICAL PICTURE
PARANOID PERSONALITY DISORDER
Individuals with paranoid personality disorder are constantly on guard, hypervigilant, and
ready for any real or imagined threat. They appear tense and irritable. They have developed a
hard exterior and become immune or insensitive to the feelings of others. They avoid interactions
with other people, lest they be forced to relinquish some of their own power. They always feel
that others are there to take advantage of them.
They are extremely over sensitive and tend to misinterpret even minute cues within the
environment, magnifying and distorting them into thoughts of trickery and deception. Because
they trust no one, they are constantly testing the honesty of others. Their intimidating manner
provokes exasperation and anger in almost everyone with whom they come in contact.
Individuals with paranoid personality disorder maintain their self-esteem by attributing
their shortcomings to others. They do not accept responsibility for their own behaviours and
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feelings and project this responsibility on to others. They are envious and hostile toward others
who are highly successful and believe the only reason they are not as successful is because they
have been treated unfairly. People who are paranoid, are extremely vulnerable and constantly on
defense. Any real or imagined threat can release hostility and anger that is fueled by animosities
from the past. The desire for reprisal and vindication is so intense that a possible loss of control
can result in aggression and violence. These outbursts are usually brief, and the paranoid person
soon regains the external control, rationalizes the behaviour, and reconstructs the defenses central
to his or her personality pattern. (M. Townsend, 2007)

SCHIZOID PERSONALITY DISORDER

People with schizoid personality disorder appear cold, aloof, and indifferent to others. They
prefer to work in isolation and are unsociable, with little need or desire for emotional ties. They
are able to invest enormous affective energy in intellectual pursuits.
In the presence of others they appear shy, anxious, or uneasy. They are inappropriately
serious about everything and have difficulty acting in a lighthearted manner. Their behaviour and
conversation exhibit little or no spontaneity. Typically they are unable to experience pleasure,
and their affect is commonly bland and constricted. (M. Townsend, 2007)

SCHIZOID & PARANOID PERSONALITY DISORDERS

HOW IS PPD DIAGNOSED?

Family physicians and general practitioners are generally not trained or well-equipped to
make this type of psychological diagnosis. So while you can initially consult a family physician
about this problem, they should refer you to a mental health professional for diagnosis and
treatment. There is no laboratory, blood or genetic tests that are used to diagnose schizoid
personality disorder. (PsychCentral, 2014)
The psychiatrist or psychologist will conduct a psychological assessment. He or she may
ask about childhood, school, work, and relationships. He or she may also ask you several
hypothetical questions. This is to gauge how you react to certain situations. For example, he or
she may ask what you would do if you found somebodys wallet on the sidewalk. The
psychiatrist or psychologist will use your responses to make a diagnosis and form a treatment
plan. (Healthline, 2014)

SCHIZOID & PARANOID PERSONALITY DISORDERS

HOW IS SPD DIAGNOSED?

To be diagnosed with schizoid personality disorder, you must meet criteria in
the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the
American Psychiatric Association. Diagnosis of schizoid personality disorder includes
four or more of these characteristics: (Mayo Clinic, 2014)

You neither desire nor enjoy close relationships, including being part of a family.

You almost always choose solitary activities.

You have little, if any, interest in sexual experiences with another person.

You take pleasure in few, if any, activities.

You don't have any close friends or confidants other than first-degree relatives.

You seem not to care about praise or criticism.

You seem emotionally cold, detached or unexpressive.

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SYMPTOMS
PARANOID PERSONALITY DISORDER
A person with a paranoid personality disorder is extremely distrustful and suspicious. Other
symptoms include:

thinking other people are lying to them or trying to manipulate them

feeling they cannot really trust their friends and associates

worrying any confidential information shared with others will be used against them

thinking there are hidden meanings in remarks most would regard as innocent

worrying their spouse or partner is unfaithful, despite a lack of evidence

SCHIZOID PERSONALITY DISORDER

A person with a schizoid personality disorder may appear cold and detached, and avoid making
close social contact with others. Other symptoms include:

preferring to take part in activities that do not require interaction with others

having little desire to form close relationships, including sexual relationships

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SCHIZOID & PARANOID PERSONALITY DISORDERS

being uninterested when receiving criticism or praise

having a limited ability to experience pleasure or joy

TREATMENT
NURSING MANAGEMENT
(Paranoid Personality Disorder - PPD)
Psychotherapy or talk therapy is used by the nurse to treat persons with paranoid personality
disorders. It is a way to treat people with a mental disorder by helping them understand their
illness. It teaches people strategies and gives them tools to deal with stress and unhealthy
thoughts and behaviors (National Institute of Mental Health, 2012). To care for clients with
paranoid personality disorders is challenging for the nurse. The nurse understands that the client
is suspicious and that he has long standing patterns of interactions that will make him unable to
respond to him/her off of communication. Forming an effective working relationship with
suspicious persons is difficult. The nurse has to remember that these clients take everything
seriously and are particularly sensitive to the reactions and motivations of others. Therefore,
nurses approach these clients in a formal, business-like manner and refrain from social chit-chat
or jokes. Being on time, keeping commitments, and being particularly straight forward are
essential to the nurse-client relationships. (Basavanthappa, 2000)
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Since these clients need to feel control, it is important to involve them in formulating their
plan of care. The nurse should provide care and information to the clients in a non-emotional and
matter-of-fact manner. If the client agrees to treatment because his behavioural patterns are
making life too difficult; the nurse should focus on the behavior. For example, the client
frequently doesnt know how his actions come across to others so the nurse would provide clear
and honest feedback. As for clients who have paranoid delusions, the nurse wouldnt try to talk
to the client about founded fears. Such discussions will only lead to the client becoming
defensive. (Townsend, 2007)

(Schizoid Personality Disorder - SPD)

People with this personality disorder rarely seek treatment, because their thoughts and behavior
generally do not cause them distress. When treatment is sought, psychotherapy -- a form of
counseling -- is the form of treatment most often used. Treatment likely will focus on increasing
general coping skills, as well as on improving social interaction, communication, and selfesteem. This type of disorder is always marked by the inability to establish a nurse-client
relationship because people with schizoid personality disorder have difficulty forming
relationships with others. The client will be unable to respond in the way others do. Again, the
nurse must be aware of the fact that the client is unable to change his basic personality. He may
learn to change some behavioural characteristics, and care should be directed to changing
behavior that is causing the most disruption to the clients life without attempting to change the
clients personality. (Basavanthappa, 2000)

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Group Therapies would also be conducted by the nurse because it can help persons with
SPD to practice their social skills. This helps them to become more comfortable in social
situations.
Nursing interventions focus on improved functioning in the community. If a client needs
housing or a change in living circumstances, the nurse can make referrals to the social worker for
assistance.

MEDICAL MANAGEMENT
(Paranoid Personality Disorder - PPD)
Medications are usually contraindicated for this disorder, since they can arouse unnecessary
suspicion that will usually result in non-compliance and treatment dropout. Medications which
are prescribed for specific conditions should be given for the briefest time period possible to
bring the condition under management. (PschCentral, 2012)
An anti-anxiety agent, such as diazepam, is appropriate to prescribe if the client suffers from
severe anxiety or agitation where it begins to interfere with normal daily functioning. An antipsychotic medication decompensates into severe agitation or delusional thinking which may
result in self-harm or harm to others (PsychCentral, 2012).

(Schizoid Personality Disorder - SPD)

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There are no specific drugs to treat schizoid personality disorder, but certain drugs can help with
symptoms. For example, if you have symptoms of anxiety or depression, you doctor may
prescribe a selective serotonin reuptake inhibitor (SSRI). Or while antipsychotics are not a
routine part of treatment, they may be used to help with flattened emotions and social problems.
(Healthline, 2014)

COMPLICATIONS OF PPD
Any change or increase in stress can create complications, especially if occupational,
financial, or legal problems or personal relationships are involved. The paranoid personality
exaggerates even minimal problems. Examples of stress involving the workplace include a
change of supervisor, moving to another workspace, change in work hours, and / or a shift
change. (PsychCentral, 2014)
Substance abuse is often the individual's way of coping with the distress. Self-medication
can lead to abuse and dependence. Alcoholism, which is often associated with this disorder, leads
to a vicious cycle of paranoid perceptions becoming reality, as it leads to estrangement from
family members, co-workers, and friends. The presence of another personality disorder may also
complicate treatment. (PsychCentral, 2014)

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COMPLICATIONS OF SPD
A lack of social interaction is the main complication of schizoid personality disorder. People
with this personality disorder are rarely violent, as they prefer not to interact with people.
Persons with schizoid personality disorder are though, at an increased risk of:

Developing schizotypal personality disorder, schizophrenia or another delusional disorder

Major depression

Anxiety disorders

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OULOOK FOR PERSONS WITH

PPD
The outlook for people with PPD varies. It is a chronic disorder, which means it tends to last
throughout a person's life. Although some people can function fairly well with PPD and are able
to marry and hold jobs, others are complete disabled by the disorder. Because people with PPD
tend to resist treatment, the outcome often is poor. (WebMD, 2014)

OULOOK FOR PERSONS WITH

SPD
Although some of their behaviors might be odd, people with schizoid personality disorder
are generally able to function in everyday life. However, they might not form any meaningful
relationships or have families of their own. (WebMD, 2014)

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Prevention (PPD)
Although prevention of PDD might not be possible, treatment can sometimes allow a person
who is prone to this condition to learn more productive ways of dealing with situations.
(WebMD, 2014)

Prevention (SPD)
Schizoid personality disorder may be prevented if interventions occur early enough in life.
The disorder has both genetic and environmental origins. Obviously, you can't change your
genes. If your parents or another close relative have a schizophrenia-related illness, then you are
more likely to have a similar condition than the average person. To counteract this, adults can
shape the environment for their children, possibly reducing some of the risk factors for schizoid
personality disorder. When adults are warm, supportive, and responsive to their children's needs,
children are more likely to grow up seeking social support and healthy relationships. Those with
schizoid personality disorder often come from abusive upbringings and may have had cold and
distant parents. When parents avoid acting in these abusive ways, their children have a chance to
grow up with a healthier self-image. (WebMD, 2014)

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CONCLUSION
In relation to the Schizoid Personality and the Paranoid Personality Disorder, some
individuals may not realize that they have a personality disorder because the way they think and
behave may seem natural to them nor would they want to accept the condition due to its
classification with mental disorder, and the stigma attached.
However, these disorders are very common and most individuals with personality
disorders lead normal lives and often only seek psychotherapeutic treatment during times of
increased stress or social demands. Most people when talking about the signs and symptoms, can
relate to some or all of the personality traits; the difference is that it does not affect most people's
daily functioning to the same degree that it might affect someone who is diagnosed with one of
these disorders. Personality disorders tend to be an integral part of a person, and therefore, are
difficult to treat or "cure." By seeking out information you may come to recognize the signs and
symptoms of a personality disorder and therefore, help yourself or someone you know live a
healthier and fulfilling life.

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References
Mental Health: Paranoid Personality Disorder. (n.d.). Retrieved November 7, 2014, from
http://www.webmd.com/mental-health/paranoid-personality-disorder
Personality Disorders and Personality Traits. (n.d.). Retrieved November 7, 2014, from
http://psychcentral.com/personality/
SYNOPSIS. (n.d.). Retrieved November 7, 2014, from
http://www.mentalhealth.com/home/dx/schizoidpersonality.html
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SCHIZOID & PARANOID PERSONALITY DISORDERS

Schizoid Personality Disorder Symptoms, Causes, Treatments. (n.d.). Retrieved November 7,

2014, from http://www.webmd.com/mental-health/mental-health-schizoid-personalitydisorder
The DSM-IV Personality Disorders. (n.d.). Retrieved November 7, 2014, from
http://books.google.com/books?id=9AqPs9ootqoC&printsec=frontcover&dq=personalit
disorders&hl=en&sa=X&ei=pTZdVIDSMcPugwSxo4HoAw&ved=0CEAQ6AEwBg#v
=onepage&q=personalit disorders&f=false
Townsend, M. (2007). Essentials of Psychiatric Mental Health Nursing (4th ed.). Philadelphia:
F.A. Davis.

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