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- Personality Disorders
Autism and Schizoid Personality Disorder
One of the interesting aspects about mental health is the overlap of symptoms between conditions. A quick perusal of the Diagnostic Statistical Manual (DSM) will show entries where just about every condition is mentioned as needing to be differentiated from another condition due to similarities in presentation.
One of the more intriguing similarities is between Autism and Schizoid Personality disorder. The similarities are such that there are various fields of thoughts which speculate whether Schizoid Personality Disorder is actually part of Autism. The DSM also notes the difficulty between differentiating the two disorders.
For ease of writing, the variants of Autism - Classical Autism, Asperger's Syndrome and Pervasive Developmental Disorder - Not Otherwise Specified - will be collectively mentioned as "Autism", or as Autism Spectrum Disorder (ASD).
Autism is a diagnosis that has received growing attention and recognition in current years. It is a condition from childhood (sometimes identified in early childhood) where there are qualitative impairments in three major areas - communication, social interaction and imagination/theory of mind. People with autism tend to find communication with others difficult, as well as such things as interpreting verbal and non-verbal cues. People with autism also tend to find understanding other's perspectives difficult, or to anticipate the emotional needs of others. These impairments are expressed in ways such as social withdrawal or an apparent lack of interest in interpersonal relationships, a preference for solitary pursuits, limited body language, obsessional interests on narrow topics, and repetitive behaviour (known as "stimming").
Schizoid Personality Disorder (SPD) is a disorder that usually manifests around adolescence or early adulthood. Here are the characteristics of SPD from the DSM criteria:
Neither desires nor enjoys relationships or human interaction, including being part of a family
Almost always chooses solitary activities
Has little, if any, interest in having sexual experiences with another person
Takes pleasure in few, if any, activities
Lacks close friends or confidants other than first-degree relatives
Appears indifferent to praise or criticism by others
Shows emotional coldness, detachment, or flattened affect
People with SPD tend to demonstrate circumscribed interests as well as impairments in interpersonal relationships. They may also find it difficult to interpret non-verbal cues and they may also show a limited range of non-verbal behaviour.
Thus, there are multiple similarities between Autism and SPD. Aside from the ones already mentioned, both show a tendency towards solitary pursuits. So it is not surprising that there is speculation about the relationship between the two conditions and whether or not SPD is an alternative expression of an ASD.
However, a deeper examination shows that the mechanics behind the behaviour is quite different.
Much of Autism's external presentation involves two main areas - an inability to filter the external environment which causes disorientation and confusion, and a need to control the immediate environment in order to function.
In the mind of the autistic person, the world is a very confusing place. Every aspect of the external environment is amplified, some more than others. For some, certain textures are distressing. For others, it may be certain lights, or sounds, or a combination. There is an impaired ability to build walls around input from the external environment, which then makes the world disorientating and distressing.
In the mind of the autistic person, there is too much stimuli in any given situation to be able to focus. For instance, in a social situation, an autistic person would be attempting to decipher conversations and non-verbal cues, judging what may or may not be socially appropriate responses from them, coupled with attempting to filter (to the best of their ability) sounds, colours, and lights.
Therefore, a controlled environment acts as a buffer for the confusion of the outside world. Focusing on narrow topics is one way of creating control. A perseverance towards inanimate objects offers the autistic mind a way to focus on a solid item, rather than the constantly shifting environment of the outside world. Stimming is another predictable behaviour that can shut out external stimuli.
On the other hand, a person with SPD operates from the core belief that they are vulnerable to being hurt by the world. The withdrawal, therefore, stems from the need to protect themselves from being hurt. Forming interpersonal connections with people runs the risk of pain, so the person with SPD attempts to avoid such things. Becoming more involved with the world in general also runs the risk of pain, so the person with SPD attempts to prevent this by inoculating themselves from the outside world.
This fear of pain from the outside world leads to the feeling of general detachment from the world and their circumscribed interests. Having too deep of an attachment to an activity can also open the person to hurt.
People with SPD tend to have a rich inner fantasy life. Again, this is the result of the fear of being hurt, because in this fantasy life, they have full control over the environment and the characters. That way, they can minimise the chances of being hurt because they can control the variables.
The similarities between SPD and ASD can be a fascinating area of study. However, a deeper examination reveals that there are very real differences between the two conditions, as the mechanisms for their traits come from unrelated sources.