CLUSTER A PERSONALITY DISORDERS/ECCENTRIC-BIZARRE CLUSTER

Paranoid Personality Disorder and Its Characteristics

 Individuals with this diagnosis are people who do not like being close to “other” people, are intensely and unfairly suspicious of people, are very jealous and sensitive to criticism. Because of these features, they are generally not preferred by humans and lead an isolated life. These individuals do not need evidence to have doubts. They think that anyone can attack them at any time, even without any reason. Their belief that no one can be faithful constantly preoccupies them. They doubt the loyalty of everyone, regardless of spouse, friend or family. They interpret people's behavior and words negatively, and they are not forgiving individuals. Since they do not trust anyone, they need to trust themselves. They want to have control over their own and others' lives. These characteristics cause them to live stressful lives in their close relationships and working lives. Despite all these features, this disorder is not a psychotic disorder. What distinguishes paranoid personality disorder from psychotic disorders is the absence of psychotic features such as hallucinations and delusions.

 Its first symptoms may appear in childhood or adolescence, with poor relationships with peers, the presence of social anxiety, hypersensitivity, and unique thoughts. However, this diagnosis cannot be made in both periods because personality traits have not yet developed and matured, that is, they may develop and change.

What are the DSM-5 Diagnostic Criteria for Paranoid Personality Disorder?

• A. Starting in early adolescence and appearing in different environments, constantly interpreting other people as malicious, as well as general distrust and suspicion manifesting itself with four or more symptoms of the following (Güzel, 2022. p.561).

1. A person constantly suspects that other people are exploiting him/her or doing evil, even though he/she does not have enough evidence.

2. Dealing with intense doubts about the loyalty and reliability of the people around him/her.

3. Not to share private information with others in order to prevent it from being used against him/her in the future.

4. Inferring other meanings from normal words and events.

5. Unforgiveness, constantly holding grudges against others.

6. Perceiving a situation, words or behavior as an attack on himself/herself and his/her personality, even though nothing has happened, and suddenly reacting with anger.

7. Repeated and baseless doubts about the fidelity of his/her spouse or sexual partner.

• B. It cannot be attributed to the physiological effect of another health problem. For example; It does not occur during the course of schizophrenia, bipolar, psychotic depression disorder (Güzel, 2022. p.561).

Schizoid Personality Disorder and Its Characteristics

 Individuals with this personality trait stay away from social relationships. Starting from early adulthood, they do not like being with other people because they experience low levels of pleasure in these relationships. Individuals diagnosed with schizoid personality disorder also stay away from activities that involve sensory, physical and interpersonal experiences. Generally, these people enjoy dreaming by being alone and doing activities that they can do alone. For them, it does not matter what others praise or criticize or what they think of them. During communication, they do not care about the normal subtleties of social interaction and try to communicate by giving simple answers. These people do not have close friends or anyone they see regularly, and they do not get married. Aaron T. Beck stated that schizoid individuals see themselves as "observers" rather than "participants" in life (Güzel, 2022. p.564).

What are the DSM-5 Diagnostic Criteria for Schizoid Personality Disorder?

• A. Presence of four or more of the following symptoms, along with the fact that it is extremely common to avoid social relationships and show emotions as little as possible in interpersonal environments, which begins in adulthood and occurs in different environments (Güzel, 2022. p.563).

1. The person does not like or does not want to have close relationships, even with a family member.

2. Usually prefers activities done alone.

3. Rarely shows interest in sexual intimacy with someone else.

4. Too little enjoyment from activities.

5. Not having confidants or close friends other than first-degree relatives.

6. Not paying attention to praise or criticism.

7. Having an emotionally cold or monotonous affect.

• B. It cannot be attributed to the physiological effect of another health problem. These features do not occur only during schizophrenia, bipolar, psychotic depression or autism (Güzel, 2022. p.563).

Schizotypal Personality Disorder and Its Characteristics

 Among Cluster A personality disorders, it is the personality disorder that disrupts the individual's functionality the most. These people, who say they have intrapsychic experiences (inside the mind), have strange behaviors and thoughts.

 These people have eccentric (unlike others) behavior and perceptual distortions, along with paranoid thoughts and a tendency towards suspicion. They experience high levels of social anxiety and similar characteristics of the schizoid personality. For example, they have no confidants and are uncomfortable with social and interpersonal relationships. Their emotional expression is limited and they have a distorted sense of self-image. According to some researchers, this disorder is explained by genetic predisposition and shares the same genetic etiology with the schizophrenia spectrum. However, according to Aaron T. Beck, these people are strange people, different from others. They see the world as unimportant and tend to see themselves as supernatural individuals. According to them, the basic strategies are to have an unusual appearance, exhibit different behaviors, stay away from others, and use their special abilities and magical powers to protect themselves (Güzel, 2022. p.567).

What are the DSM-5 Diagnostic Criteria for Schizotypal Personality Disorder?

• A. Sudden discomfort in relationships that begins in early adulthood and occurs in different environments, lack of ability to establish close relationships, as well as cognitive/perceptual distortions and unusual behavior, as well as five or more of the following symptoms.

1. Having thoughts of resentment.

2. Having unusual beliefs that are incompatible with cultural values, affecting the individual's behavior, and magical thinking.

3. Experiencing unusual perceptual experiences.

4. Having strange thoughts and conversations.

5. Skepticism.

6. Having inappropriate or restricted affect.

7. Behaving unusually or appearing strange.

8. Not having any close friends or confidants other than first-degree relatives.

9. Experiencing extreme social anxiety that does not decrease even with close proximity, and intense paranoid fears of being evaluated negatively.

• B. These features do not occur only during schizophrenia, bipolar, psychotic depressive disorder or autism and cannot be explained by the physiological effect of another health condition (Güzel, 2022. p.563).

Treatment of Personality Disorders

 Methods in which the clinician plays a more active role and therapy sessions are more structured are generally preferred. Many treatment approaches have a theoretical basis. Research indicates that combined treatment is the most effective treatment for personality disorders, where psychoanalytic approach, dialectical behavior therapy, cognitive therapy, individual treatment, group therapy, and drug treatment are used when necessary. Combined treatment is a treatment in which different treatment approaches are brought together.

BIBLIOGRAPHY

H.Ş. Güzel (2022). Kişilik Bozuklukları. Tuna E. ve Ö. Öncül Demir (ed.) DSM-5’ E Göre Anormal psikoloji. (2;560-567. 591-595). Nobel Yayıncılık.