Cluster A (Paranoid, Schizoid, Schizotypal) Personality Disorders (Memorable Psychiatry Lecture)

Let’s continue our discussion of personality pathology by talking about cluster A personality disorders which include paranoid, schizoid, and schizotypal personality disorders. Each has features that overlap with psychotic disorders making it easy to confuse them, so we’ll spend some time learning how to disentangle each from schizophrenia as well as reviewing how to diagnose them using mnemonics!

Learn more about cluster A personality disorders, including their diagnostic criteria and treatment strategies, in this high-yield talk intended for all healthcare providers, including doctors, medical students, psychologists, nurses, nurse practitioners, physician assistants, social workers, and more!

ATTRIBUTIONS
Licensed under Creative Commons: By Attribution 3.0 License

[catharinepizzarello]

People do misjudge me because I’m different. As I have gotten older, that’s come to matter much less. Mostly, folks’ behavior baffles me. I’m tired of explaining myself. I work as a housekeeper, gardener, and pet care specialist. I’m able to be a friendly, unobtrusive, efficient presence. There are very few people I take the trouble to try to get close to. I pull my own weight and don’t want to hurt myself or anyone else. I know I’m different in other’s eyes. I leave them to it, put them in their place if they try to push my buttons, and share myself with those few who care.

[Hannah-zcoe]

I had such a hard time understanding all the different disorders in cluster a, b, and c but this helped tremendously!! Thank you!!

[MikeHawkJuices]

When you were going over schizotypal and said they would hear their name randomly in an empty room that has me almost crying dude. That's happened to me since I was a kid

[Dolliemea]

Thank you so much for this video!!! I went through so many and this was wonderful!!!!

[destinywashington]

This was VERY helpful! Thank you! Happy I came across your video.

[kma-uxci]

I'm paranoid but agreeable, somewhat schizoid it gets lonely sometimes but I socialize more now and engage in social connection now, schizotypal yes, delusions of reference and auditory hallucinations but hope not to end up totally schizophrenic.

[shotorokis]

ohhhh im gonna love this channel so much u r going to help me pass my psych degree

[AdibKhan-vbcx]

It's helpful, would be more clear if explained with real life experience, or just any example

[DaughterOfTheKingdom]

What happens when a Schizoid person who is unaffected by praise or criticism meets someone with Histrionic or Narcissistic personality disorder who are highly affected by criticism or praise?

[Lemonz]

Can you have a mix of Cluster A disorders? I have a "friend" (she's so odd and hostile that it's difficult to call her a real friend) who ticks almost all of the boxes in paranoid personality disorder, but has a very odd speaking pattern and extreme "magical thinking" that are supposedly common in schizotypal. She truly believes tarot cards work, and does dozens of readings a day. She regularly removes her picture from her Facebook profile because she "feels" someone is using it to wish her ill intent and that's why her life is going so bad. She believes her aunt is using "Islamic magic" to bring her misfortune for some reason. She has a crush on a neighbor and "feels" it when he apparently thinks about her, and "feels his presence" when he's at home. They've hardly interacted at all and she has made a huge narrative of them having some special connection.

On the paranoid side, she thinks her dates/partners are always with some "wh*re" when they don't answer her messages fast enough. She has ruined every single relationship because she thinks they are all cheating on her. She thinks people are looking at her when she's out, which they aren't - I've been with her when she says this, and I don't see it. When she's at her worst, she thinks I want to "steal" her neighbor crush (I'm gay), even though I've only seen him 3 times in my life, and I've only said one word to him (I said "hi" when I met him once). I don't even think he is gay either, and she still thinks that we are together when she's at her most suspicious - it's so bizarre. She thought at one point I was partying with him, because I didn't answer her messages for one day due to me having a migraine. She thinks everyone is "false" or have malicious intentions based solely on them not using an emoji or setting a period at an "odd" place and so on in text messages.

It's exhausting...

[TheDiamondladyone]

I had to purchase your books for desk reference when I start practicing…thanks for the simplicity

[Katie-de]

My symptoms are
Sensing a presence in the room, even though there's nobody there, and sometimes having a full-blown conversation with somebodv who can't see but I feel that is there the presents in the room tells me I have to dress weird act weird I just be eccentric and I can't make friends.
Kids at school used to tease me because we would be in class, and I would look at the wall and have a conversation with the wall because I sent somebody was in the wall of the school it's kind of like having invisible friends that you can't control.
¡remember having this disease ever since I was in first grade, and in first grade I was very shy I didn't talk to anybody because I thought I was so different I didn't deserve to talk to anybody.

[VenessaThompson-hm]

Love your videos and books. I am learning so much and making NP school so much easier!!!

[Γιώργος-ΕυγένιοςΤζωρτζίνης]

My mother's childhood friend is very unusual. She exhibits heavily paranoid traits in regard with her ex-husbands, and often fantasizes that many people who don't even know him are in collusion with him and makes whole scenarios up which she believes. She doesn't try to harm them, though. As far as that guy is concerned, he has even forgotten her name and how she looks.

But with some other people, like us, she is calm, all-giving, empathetic, nurturing, she does only good for decades, even during whole months of co-habitation, not judgamental, and she helps even when she cannot.

She is a very unsual and contradictory character.

[aura.expanse]

hmm ive just recently began learning about personality disorders after always knowing something was up! when it got to schizotypal i started giggling bc i couldnt help but think "oh yes i believe im god do i win?!"

[jackchop]

I feel like I temporarily went schizoid during the covid lockdowns since I had a nasty breakup just before that and lost most of my friends.

[DaisyMoose]

Hello kind commenters, I’m looking for some insight and different opinions from the schizoid perspective. I just went through a painful process of figuring out what is going on with one of my family members and it seems like the search has landed me here. There may be other factors that play, but all the schizoid features line up with them perfectly. So here’s my question now. How do I go about interacting with this person? Do schizoids truly just wanna be left alone with not much interaction? This is very difficult for me to understand because I’m very much the opposite personally.

I just came to the realization that this person cannot meet the emotional needs of the family, the desired amount of closeness, and hang-out time. But I’m trying to figure out what to do next. I want to invite them to come around and reach out to them on occasion, but I’m not sure if this is welcome. I have tried discussing with them what I want/need but it just felt flat and maybe even got worse after that. When I try to state my wants/needs to this person it kind of seems like it makes them feel guilty and they push away even more.

I’m at a place where I accept that this is just the way things are but looking for perspectives on how to proceed with interacting with this person because it seems cruel and needless to just cut them out, almost did to be fully honest, but after researching this it seems like it would be mean to hold this condition against them.

For more context, this person is the sibling of my significant other and we recently had a child and moved across the country to be closer to family and have gotten very little reaction or response despite living very close by for their convenience. It’s been heartbreaking to realize that our child will not have a close and loving aunt/uncle figure but we just need a plan to move forward. Of course, this has also devastated my significant other who expected a tight bond with their sibling upon returning to their home turf after living away for many years. (Seems that this condition was much less back in the past, hence the shock.)

Sorry for the long post but felt that it would be good to clarify a few things to get the best answers possible from people. Also, I want to say that in no way am I judging people with this condition I’m just trying to be honest about the fact that it has been painful to deal with. It feels like grieving a loss but the person is still there. Trying to focus on the positive and still have a relationship without overburdening or having unrealistic expectations of this person.

They also might be in a toxic (at best) or abusive relationship (at worst) but it is difficult to figure it out considering how little we see them in the mixed messages that we’ve got. Even though we thought that was the main reason for their distance for a while, there is much more to this puzzle and schizoid personality seems to fit the bill so far. They both have unusual social behaviors, although their significant other is more hostile. Anyway, I guess that adds more context but it’s not really the main point.

I look forward to hearing and brainstorming some ways to help. How do we show we care and that we are always here for this person without pressuring them and making them feel worse about who they are? Right now the approach is to throw out invitations for family get-togethers once a month (or way less) for birthdays or holidays but not trying to pressure for more hangouts or time together. Some casual chatting online but again no pressure, not overly frequent, and typically about the topics that they seem to care about. Any insight helps. Thanks for taking the time to read this and for your comments if you feel so inclined to leave one.

[CatCambak]

I’ve been diagnosed with this, Schizotypal personality disorder is worse than schizophrenia my friends. Once a cloud is gone the sun shines on but when there is no sky there can be no sun and so we cannot be treated like others sadly this is my life. If I was a social butterfly I’d be a billionaire so maybe better I’m not. Cheers

[AA-mruy]

Yeah that's pretty much my sister.

[mn]

schrizotypal are just Buddhist monks or shamans with a lack of grounding (aka calmness). hence meditation to remove dear or anxiety to manifest heaven instead of hell on earth.