A client is admitted with a diagnosis of schizotypal personality disorder. Which signs would this client exhibit during social situations?
A. Aggressive behavior
B. Paranoid thoughts
C. Emotional affect
D. Independence needs
Correct Answer: B. Paranoid thoughts
Clients with schizotypal personality disorder experience excessive social anxiety that can lead to paranoid thoughts. Isolation is a salient feature in the history of a schizoid patient. Rarely do they have close relationships, and often they will choose to participate in occupations that are solitary in nature. They infrequently experience strong emotion, express little to no desire for sexual activity with a partner, and tend to be ambivalent to criticism or praise.
Option A: Aggressive behavior is uncommon, although these clients may experience agitation with anxiety. Schizotypal can be differentiated with its more pronounced “magical” and eccentric thought processes. Paranoid, avoidant, and obsessive-compulsive personality disorders are also often on the clinician’s list of differential diagnoses. Unlike the aloofness observed in schizoid, however, patients with paranoid personality disorder are often overly resentful and can demonstrate explosive anger.
Option C: Their behavior is emotionally cold with a flattened affect, regardless of the situation. Individuals afflicted with personality disorders tend to externalize their problems, viewing others as the etiology of any conflict. If, by chance, a person with schizoid personality disorder presents in the clinical setting, DSM V has outlined specific diagnostic criteria for the clinician to use for evaluation. A pronounced blunted affect will immediately be observable on presentation. The patient will be disengaged, aloof, and will most likely diminish symptomatology.
Option D: These clients demonstrate a reduced capacity for close or dependent relationships. It is unlikely that a person with a schizoid personality disorder will present in the clinical setting of his own volition unless prompted by family, or as a result of a co-occurring disorder, such as depression. As with most personality disorders, the behavior is in synchrony with the ego, and thus the patient does not acknowledge the need to adapt his or her behavior.