Introduction
The case study for week four involves a male client who seems to exhibit characteristics of Schizoid Personality Disorder.
Schizoid Personality
According to the Diagnostic and Statistical Manual, (5th ed.; DSM-5; American Psychiatric Association [APA], 2013), individuals with Schizoid Personality Disorder (PD) are usually detached from social relationships. Criteria for Schizoid PD are as follows (APA, 2013):
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.
A person may be diagnosed with Schizoid PD when at least four of these manifestations are observed.
The Client with Schizoid Personality Disorder based on the DSM-5
The male client in this week’s case study meets the criteria for Schizoid PD. He seemed to have a lack for close friends and confidants (Criteria 5; DSM-5; APA, 2013) as evidenced by his mom being concerned of his not having many friends. He did not seem to desire nor enjoy close relationships (Criteria 1; DSM-5; APA, 2013). He expressed indifference towards his father and sister when he was asked about his family and if he was close to them. He even explicitly stated that he only considers his mom as his family. In terms of friends, he stated that he did not have time to socialize or make friends in college.
He also chooses solitary activities (Criteria 2; DSM-5; APA, 2013) and mentioned that when he was in college, he spent most of his time studying. He believes that he did not need to learn with other students as they tended to be idiots. Moreover, he stated that he was able to learn more by teaching himself the things he needed to know. He expressed pleasure in a few activities (Criteria 4; DSM-5; APA, 2013), namely his job and playing World of Warcraft. He spends most of his time between these two activities. He even expressed much interest and enthusiasm when talking about World of Warcraft and how he is able to create his own fantasy world.
Lastly, he also displayed manifestations for little interest in sexual experiences with others (Criteria 3; DSM-5; APA, 2013). He mentioned that he has been alone for quite some time and explicitly stated that he does not want a relationship nor has he ever wanted a relationship. He is also aware that this was one of his mom’s concerns.
Other Information Helpful for A More Accurate Diagnosis
As evidenced through the DSM-5 (APA, 2013), five out of the seven criteria for Schizoid Personality Disorder were observed. This however is only based on the short transcript for the case study. It would be helpful to gather more information through the use of a Mental Status Exam (Martin, 1990). This would help in gaining insight on the client’s appearance, behavior, mood, and affect.
Further information on the client’s past experiences will also be helpful. Specifically, the client mentions a specific interaction with his dad who used to scream at him as a child. He also expressed some form of fear towards his dad. He stated “I was afraid just to come out of my room because I didn't know how he was going to be. Was I going to get a smile or the back of his hand?” (as cited in Larueate Education, 2013, p.2). These childhood experiences with his father may have been a source of trauma for the client. As he remembers, when his father shouts, no one was left outside playing except him. Such experiences may have contributed to the client’s lack of desire for close friends and relationships.
It is also possible to look further into past relationships. An assessment of these past relationships, if any, may help shed some light into why he has little interest in sexual experiences with others. The client mentioned that he has been alone for a long time but it is unsure if he has had past relationships. If he has, then information as to how the relationship was like, how he was towards his girlfriend and the emotions he experienced during the relationship will be helpful. Information from these may support that he really lacks interest in romantic or sexual relationships. It may also support a possible lack of emotion on his part. On the other hand, possible experiences from his past relationships may be a reason for his avoiding possible future relationships.
Finally, although the client considered his mom as his only family member, it would be beneficial to look into his relationship with his mom. Background on how his relationship with his mom was like as a child, an adolescent, and at present will be helpful. Through these, it may be possible to gain insights on his attachment style as a child. Such information may also help further shed some light into his present pattern of detachment.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: American Psychiatric Association.
Fritz, R. (n.d.). Schizoid personality disorder: Treatment, symptoms, and causes. Retrieved from
http://study.com/academy/lesson/schizoid-personality-disorder-treatment-symptoms-
causes.html
Martens, W. H. J. (2011). A schizoid man. The European Journal of Psychiatry 25(2),
pp. 111-113. Retrieved from http://dx.doi.org/10.4321/S0213-61632011000200006.
Martin D.C. (1990). The mental status examination. In: H. K. Walker, W.D. Hall, & J. W. Hurst
(Eds.), Clinical Methods: The History, Physical, and Laboratory Examinations (3rd ed.).
Boston: Butterworths. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK320/
Schizoid personality style and disorder. (n.d.). Retrieved from
http://maretwebproject.com/users/docs/schizoid.pdf
Vaknin, S. (n.d.). The schizoid patient - a case study. Retrieved from
http://samvak.tripod.com/personalitydisorders51.html
