Toward resolution of a longstanding controversy in personality disorder diagnosis: Contrasting correlates of schizoid and avoidant traits

Abstract

Although the construct validity and clinical utility of separate schizoid and avoidant personality disorder (PD) categories has been controversial since avoidant PD was first introduced in DSM-III, few studies have compared individuals with schizoid versus avoidant features on variables relevant to their contrasting personality dynamics. Those few investigations that exist have yielded inconclusive results. In this study a mixed-sex sample of nonclinical participants (N=123) completed the International Personality Disorder Examination Screening Questionnaire (IPDE-SQ) and self-report measures of attachment style, defense style, empathy, internalized shame, need to belong, rejection sensitivity, and social anhedonia. High levels of social anhedonia were uniquely predictive of schizoid features; high levels of need to belong and internalized shame were uniquely predictive of avoidance. These findings support retaining the two PD categories in future versions of the DSM. Supplementary analyses revealed that among women—but not men—schizoid and avoidant traits were positively and significantly intercorrelated; it may be that women show more of a blended schizoid–avoidant profile, whereas men display the more prototypical categorical profile where either schizoid or avoidant features predominate.