The ICD-11 (2022) doesn't have a specific schizoid diagnosis, but it's detachment trait domain in its personality disorder traits section is similar to SzPD:
From Zachary Wheeler, Treatment of Schizoid Personality [dissertation] (2013); the DSM-5-TR (2022), & the ICD-11 (2022).
Hey y’all, Andie here. We haven’t gotten any comments or questions about this yet, but I wanted to take the bull by the horns and say something first.
Yes Rylie is Autistic. By DSM-IV-TR standards, she would have either Asperger’s Syndrome or PDD-NOS. By DSM 5 standards, she would be diagnosed with Autism Spectrum Disorder, level 1 (most likely, I’m most comfortable with the revised fourth edition).
Autism is a very sensitive topic in media, I know. I know it’s a bold move to make her autistic, and there will be people who will try to say “you can’t write an autistic character because you’re not autistic!!!”
That’s where you’re wrong. I am autistic. I was diagnosed with PDD-NOS when I was young, back when they still used the DSM-IV-TR, and I was rediagnosed with Autism Spectrum Disorder (no level was specified, I checked) and an Unspecified Neurodevelopmental Disorder when I was 17, which was about four years ago now.
While Rylie’s diagnosis of autism differs from mine, I base a lot of her behaviors off of myself. And if there’s something I don’t know, I do my research and I ask my friends, who are also on the spectrum.
If you don’t like that Rylie is autistic, then there’s a simple thing you can do called stop reading.
Note: You cannot be diagnosed with this disorder, as it's not in any diagnostic manual; you would be diagnosed with Other Specified Personality Disorder instead.
Criteria from the DSM-IV-TR (2000):
A pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
passively resists fulfilling routine social and occupational tasks
complains of being misunderstood and unappreciated by others
is sullen and argumentative
unreasonably criticizes and scorns authority
expresses envy and resentment toward those apparently more fortunate
voices exaggerated and persistent complaints of personal misfortune
alternates between hostile defiance and contrition
Millon's subtypes:
(Millon, ed.).
About PA/NegPD
PA/NegPD is similar to histrionic, dependent, avoidant, depressive, borderline, antisocial, paranoid, masochistic, obsessive-compulsive and narcissistic PDs. It's part of what Millon & Bloom term the "Aggressive Personality Patterns", along with AsPD, NPD, & Sadistic PD.
Renamed Negativistic PD in the DSM-IV; Millon suggested renaming it “oppositional personality disorder” (Lane).
Differential diagnoses include mood disorders, anxiety disorders, somatic disorders, and Oppositional Defiant Disorder. Many children who are diagnosed with ODD will develop PA/NegPD (Millon).
The most common PD comorbidities with PA/NegPD are AvPD (22.78%), AsPD (22.64%), & Sadistic PD (15.36%). The least common was OCPD (0.94%). Less than 1 percent (0.81%) had only ("pure") PA/NEGPD [less than those who had comorbid OCPD] (Millon & Bloom).
Millon defines it on a spectrum from sceptical -> negativistic (Millon Personality Group); or alternatively from discontented [personality type] -> resentful [style] -> negativistic [disorder] (Millon).
In the first DSM, it “... consisted of three subtypes - passive-dependent type who are helpless, overly dependent, and indecisive; passive-aggressive type who express their aggressiveness through passive means like pouting, procrastination, and intentional inefficiency; and the aggressive subtype who react to frustration with irritability, temper tantrums, and overt destructive behaviours” (Coolidge & Segal).
In the DSM-II it was described as being “characterized by passivity and aggression through obstinate behavior, procrastination, stubbornness, and intentional inefficiency” (Coolidge & Segal).
The DSM focuses on its overt/external behaviours and therefore miss its "cardinal qualities"; "underlying the behavior characterizing this personality pattern are profound confusion and ambivalence about self", similar to OCPD but with different coping strategies (Millon & Bloom)
It was a Cluster C PD, but in the DSM-IV & IV-TR it was moved to the Conditions for Further Study section “[d]ue to poor reliability and questionable validity and usefulness” (Coolidge & Segal). It wasn't included in any capacity in later editions.
PA/NegPD has a long history of ‘questionable validity’, as it originated in US military documents about reluctant soldiers during WWII, and continued throughout its history in the various DSMs to have criteria that could theoretically apply to anyone (e.g. dissatisfaction with their job or “personal misfortunes”, feeling misunderstood or unappreciated, complaining too much, etc.) (Lane).
However, Millon says “[s]uch thoughts are normal, but they represent what negativists feel most of the time. To them, every request or expectation feels like a willful imposition. Meeting requests or honoring expectations feels like submission, and meeting demands feels like humiliation” (Millon, ed.).
References
Coolidge, Frederick L., & Segal, Daniel L., ‘Evolution of Personality Disorder Diagnoses in the Diagnostic and Statistical Manual of Mental Disorders’, Clinical Psychology Review, 1998, vol. 18, no. 5, pp. 585-599.
Lane, Christopher, ‘The Surprising History of Passive-Aggressive Personality Disorder’, Theory & Psychology, 2009, vol. 19, no. 1, pp. 55-70.
Millon, Theodore, & Bloom, Caryl, The Millon Inventories, 2008.
Millon, Theodore, Disorders of Personality, 2011.
Millon, Theodore, ed., Personality Disorders in Modern Life, 2004.
do you know the difference between
Hebephrenic schizophrenia/disorganized schizophrenia vs schizotypal PD ? let me know if you need more information on this question i am asking
Firstly, hebephrenic / disorganised schizophrenia isn't a diagnosis anymore.
This was the definition of hebephrenic / disorganised schizophrenia from the ICD-10:
"A form of schizophrenia in which affective changes are prominent, delusions and hallucinations fleeting and fragmentary, behaviour irresponsible and unpredictable, and mannerisms common. The mood is shallow and inappropriate, thought is disorganized, and speech is incoherent. There is a tendency to social isolation. Usually the prognosis is poor because of the rapid development of "negative" symptoms, particularly flattening of affect and loss of volition. Hebephrenia should normally be diagnosed only in adolescents or young adults."
and from the DSM-IV-TR:
"The essential features of the Disorganized Type of Schizophrenia are disorganized speech, disorganized behavior, and flat or inappropriate affect. The disorganized speech may be accompanied by silliness and laughter that are not closely related to the content of the speech. The behavioral disorganization (i.e., lack of goal orientation) may lead to severe disruption in the ability to perform activities of daily living (e.g., showering, dressing, or preparing meals). Criteria for the Catatonic Type of Schizophrenia are not met, and delusions or hallucinations, if present, are fragmentary and not organized into a coherent theme. Associated features include grimacing, mannerisms, and other oddities of behavior. Impaired performance may be noted on a variety of neuropsychological and cognitive tests. This subtype is also usually associated with poor premorbid personality, early and insidious onset, and a continuous course without significant remissions. Historically, and in other classification systems, this type is termed hebephrenic."
Essentially, it's a type of schizophrenic presentation characterised mostly by negative psychotic symptoms, especially formal thought disorder (disorganised thinking & speech).
The main difference between schizophrenia (SZA) and StPD is the presence of positive psychotic symptoms (delusions, hallucinations, thought disorder). But since hebephrenic schizophrenia is mostly about negative psychotic symptoms (avolition, anhedonia, alogia, flat affect/diminished emotional expression etc) & disorganised symptoms (thought disorder) we can't really use positive psychotic symptoms to differentiate the two. StPD can have some symptoms of thought disorder and negative psychotic symptoms, but not to a SZA degree (e.g. StPD speech can be weird, but SZA speech can be downright impossible to understand).
The other difference between SZA and StPD is persistent psychosis. So the symptoms of hebephrenic SZA are persistent, and aren't episodic or triggered by stress, while psychosis in StPD is episodic and often triggered by stress.
People with StPD also meet the general criteria for a personality disorder, while someone with SZA won't.
StPD can be premorbid (turn into) to SZA. StPD is relatively stable over a person's lifetime, while SZA is strongly associated with a decline in functioning.
Note: You cannot be diagnosed with this disorder, as it's not in any diagnostic manual; you would be diagnosed with Other Specified Personality Disorder instead.
Criteria from the DSM-IV-TR (2000):
A pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
usual mood is dominated by dejection, gloominess, cheerlessness, joylessness, unhappiness
self-concept centers around beliefs of inadequacy, worthlessness, and low self-esteem
is critical, blaming, and derogatory toward self
is brooding and given to worry
is negativistic, critical, and judgmental toward others
is pessimistic
is prone to feeling guilty or remorseful
Millon's subtypes:
(Millon, ed.).
About De/MePD
De/MePD is similar to avoidant, schizoid, masochistic / self-defeating, negativistic / passive-aggressive and borderline PDs. It's part of what Millon & Bloom term the "Reserved Personality Patterns", along with AvPD & SzPD.
Differential diagnoses include anxiety disorders, mood disorders, and somatic disorders.
The most common PD comorbidities with De/MePD are AvPD (19.53%), AsPD (14.06%), & Negativistic / Passive-Aggressive PD (13.02%). The least common was HPD (1.82%). Less than 6 percent (5.34%) had only ("pure") De/MePD [much higher than people with pure Ne/PAPD or SaPD] (Millon & Bloom).
Millon defines it on a spectrum from pessimistic -> depressive (melancholic) (Millon Personality Group); or alternatively from dejected [personality type] -> forlorn [style] -> depressive [disorder] (Millon).
"The depressive and masochistic are so similar that some authors view them as a single constellation" (Millon, ed.).
In the DSM-IV-TR it was described as being “characterized by a pervasive pattern of depressive cognitions and behaviors, low self-esteem, brooding, and pessimism." (Coolidge & Segal).
"Always in a dejected and gloomy mood, they see themselves as inadequate and worthless. They submerge themselves in criticism for even minor shortcomings and tend to blame themselves when things go wrong. A pervasive pessimism leads them to anticipate the worst - to expect that life will always go wrong and never improve. Their days are spent brooding and worrying, ignoring the good and dwelling on the bad. Saturated with guilt, they wish that life could be different, but instead of taking the initiative, they berate themselves for missed opportunities and feel powerless to change their destiny. Such individuals may indeed be depressed, but their depression emerges from a way of thinking, feeling, and perceiving - a depressive personality" (Millon, ed.).
De/MePD only ever appeared in the appendix of the DSM-IV & IV-TR, and it was dropped because it was "controversial whether the distinction between depressive personality disorder and Dysthymic [Persistent] Disorder [was] useful" (DSM-IV-TR).
However, "many dysthymics did not meet criteria for depressive personality. [...] In fact, the proportion of those with depressive personality disorder who had never met criteria for dysthymia was high", indicating that De/MePD is likely a separate disorder from persistent & major depressive disorders (Millon, ed.).
References
Coolidge, Frederick L., & Segal, Daniel L., ‘Evolution of Personality Disorder Diagnoses in the Diagnostic and Statistical Manual of Mental Disorders’, Clinical Psychology Review, 1998, vol. 18, no. 5, pp. 585-599.
Millon, Theodore, & Bloom, Caryl, The Millon Inventories, 2008.
Millon, Theodore, Disorders of Personality, 2011.
Millon, Theodore, ed., Personality Disorders in Modern Life, 2004.
My fist was shaking in fervor at the airplane that buzzed me too close to my naked head while I was merely hanging around as a typical slouch performing within known boundaries no suspicious acts. Even the majestic redwood trees towering above me were bent out of shape. If there is a new natural law against asymmetry, no one told me.
The airplane not only buzzed, but twisted, flipped, and…
When there is no beginning and no end, as there was, is, and will be, where does the time go to get credit for dues paid off? Does it ever double down to sweeten the pot? When do late fees stop kicking in stalls? Are hands ever wiped clean? Under what sticky table employing how many greased palms? Paid doctors just say no.
The epic war against the clueless human enablers of venal cats who murder beautiful birds, in which I had enlisted as a Benedict Arnold to my species early on, or as early as it was when I received a clue, which was only early to me, had been raging for nearly nine months. That can be a fuck of a long time for any dirty human traitor to wait while sitting idly by. I had endured a harsh,…
