in the last video we talked about the basics of personality as well as the process by which extreme and inflexible personality traits can become a source of distress and disability for our patients now we will turn our attention to the individual personality disorders in each cluster as listed in the dsm as we cover this material you'll likely notice that there aren't a lot of mnemonics in the style of sigicaps or dig fast that's because using a cookbook style algorithmic approach to diagnosing personality disorders is largely a waste of time as the specific criteria are often just descriptions of behavior that naturally result from the core personality pathology for this reason it's more important to focus on the process by which the inflexible disabling and extreme personality trait leads to the specific pattern seen in each disorder going off the personality disorder party mnemonic from the last video we'll focus first on cluster a which is the group that will pass on the party this will help you remember that cluster a consists of paranoid schizoid and schizotypal personality disorders in actual practice cluster a disorders rarely come to clinical attention as each of the disorders has features that make people less likely to seek care these disorders have the highest chance of being misdiagnosed with psychotic disorders due to the overlap in their symptoms for this reason we'll take a moment to compare each of the three disorders to schizophrenia in order to help you better understand any similarities or differences between them let's go over each of these one by one first paranoid personality disorder is characterized by a persistent pattern of fear mistrust and suspiciousness of other people people with this disorder tend to believe that others are deceiving or exploiting them and will doubt the loyalty of family or friends including harboring suspicions that their partners are being unfaithful to them for this reason they tend to avoid confiding in others for fear of being betrayed we'll interpret other people's statements as hostile or threatening can bear long-lasting grudges and often show a high sensitivity to attacks on their character importantly these patterns are not specific to any one person but are directed at most if not all of the people in their lives accordingly people with paranoid personality disorder tend to become quite socially isolated although given that they think that everyone else is only out to get them they say they don't mind too much when considered through the lens of the ocean model the culprit and paranoid personality disorder is an extreme and inflexible trait of low agreeableness as long as you understand the concept of agreeableness as a personality trait involving trust in others it's not hard to see how paranoid personality disorder would result from that pattern while the word paranoia may make you think of schizophrenia these are distinct disorders that should not be mistaken for each other while the delusions seen in schizophrenia are often paranoid in nature they typically involve a complex but stable delusional belief system in contrast people with paranoid personality disorder are constantly jumping between various paranoid ideas without sticking to any one belief for too long this constant stream of new paranoid thoughts differs from the fixed and enduring delusional belief system seen in schizophrenia which should help you differentiate between these two disorders next schizoid personality disorder is characterized by a consistent lack of interest in social relationships this manifests through a preference for solitary activities a disinterest in seeking new relationships difficulty with experiencing pleasure a lack of close confidence an indifference to praise or criticism from others an emotional coldness or aloofness when interacting socially and often an estrangement from family and friends unlike an avoidant personality disorder a cluster c disorder which we'll talk about in a later video this lack of close contact doesn't appear to bother patients with schizoid personality disorder this isn't to say that people with this disorder don't get lonely sometimes they do but they generally find that being alone is preferable to the constant demands for connection and intimacy that others put upon them you can remember this key pattern of schizoid personality disorder by thinking that schizoid avoids schizoid personality disorder maps to the ocean trait of extremely and inflexibly low extroversion again as long as you understand the concepts of extroversion and introversion there is no need to memorize long lists of diagnostic criteria like other cluster a personality disorders schizoid personality disorder overlaps with schizophrenia with asociality being one of the five a's in the negative symptoms mnemonic while patients with both diagnoses will generally avoid socializing with others in schizoid personality disorder this a sociality is more conscious and intentional with the person actively going out of their way to avoid others and often reporting a lack of desire to engage socially if asked about it in contrast someone with schizophrenia tends to avoid social connection due to a lack of motivation and an inability to connect with others due to their other negative symptoms like effective flattening so while the end result of social isolation is the same the underlying pattern is quite different between these two conditions finally schizotypal personality disorder is defined by the presence of odd beliefs and difficulty relating to other people the odd beliefs can range from magical or supernatural thinking such as believing in telepathy being obsessed with paranormal experiences or having many superstitions all the way to ideas of reference and even frank delusions that border on those seen in schizophrenia people with schizotypal personality disorder also tend to have unusual perceptual experiences such as hearing their name called in an empty room although these generally fall short of the classic running commentary auditory hallucinations heard in schizophrenia in addition people with schizotypal personality disorder often have difficulty relating to other people which leads to loneliness and isolation however in contrast to schizoid personality disorder in this disorder the avoidance is often out of fear that others will judge them for their odd ways of thinking their often unconventional manner of clothing their eccentric behaviors and their unusual ways of expressing emotion unlike paranoid and schizoid personality disorders schizotypal personality disorder does not map to an extreme of any specific trait in the ocean model in addition studies have shown that schizotypal personality disorder is more than just superficially similar to schizophrenia with many genetic links existing between the two furthermore about a third of these patients will end up progressing to a full diagnosis of schizophrenia over time based on these facts it seems reasonable to conclude that schizotypal personality disorder is not really a personality disorder and is more accurately thought of as a low-grade schizophrenia that at least in some cases has not yet declared itself you can remember this by thinking that schizotypal is a typo schizo with clear links to schizophrenia rather than a disorder of personality so those are the three cluster a personality disorders in the next video we'll touch on cluster b personality disorders which are the most likely of the three to come to clinical attention if you learned something from this video consider hitting the like button leaving a comment below or subscribing to the channel you can also read more about psychiatry and neurology in my books on amazon see you again soon