Eccentric, detached, and distrustful are characteristics of cluster A personality disorders, which include paranoid, schizoid, and schizotypal personalities.
The Diagnostic and Statistical Manual of Mental disorders, 5th edition, text revision (DSM-5-TR) lists 10 personality disorders. These are conditions defined by long-standing impairing or distressing patterns of behaviors, thoughts, and personality traits.
Grouped together by defining similarities, these personality disorders fall into three clusters:
Cluster A personality disorders are conditions that often involve characteristic behaviors or traits that are considered eccentric, distrustful, and detached. Emotional unavailability may also be a sign.
The DSM-5-TR lists three cluster A personality disorders:
- Paranoid personality disorder: Persistent behaviors and thoughts that center on suspiciousness, doubt, and mistrust of others.
- Schizoid personality disorder: Persistent patterns of social detachment and limited emotional expression.
- Schizotypal personality disorder: Persistent paranoid or suspicious thoughts, avoidance of close relationships, and distortions of thought or perception.
Globally, a 2019 systematic review and meta-analysis spanning several decades found approximately 3.8% of people around the world live with a cluster A personality disorder, compared to cluster B disorders at 2.8% and cluster C disorders at 5.0%.
Only a mental health professional can accurately diagnose a cluster A personality disorder, because these conditions go beyond a specific set of simple behaviors or attitudes.
What is a personality trait?
A personality trait is an enduring pattern in your thoughts, perceptions, and ability to relate to the environment around you.
It’s not your capacity to run the fastest or jump the highest. It is, however, your determination to train the hardest or your drive to learn the best techniques.
Paranoid personality disorder involves a persistent mistrust of the people around you and a suspicious attitude.
The DSM-5-RT diagnostic criteria for paranoid personality disorder involve the presence of four or more of the following symptoms:
- unwarranted suspicion that others are being deceptive, exploitative, or deliberately harmful
- persistent doubts about the loyalty or trustworthiness of friends or peers
- a reluctance to confide in others out of fear that information could be used against you
- tendency to take innocent remarks or actions as masked threats
- unforgiveness of perceived slights
- constant perception of character attacks and tendency to retaliate or react
- recurring, unjustified suspicions about partner infidelity
Living with paranoid personality disorder can mean you appear rigid, unable to collaborate, or are quick to develop negative stereotypes.
Schizoid personality disorder, a condition involving relationship detachment and limited emotional expression toward others, tends to begin by early adulthood, and has a variety of presentations.
The DSM-5-RT states that four or more of the following symptoms must be present to receive a schizoid personality disorder diagnosis:
- feeling no desire for, or enjoyment of, a close relationship, even among family members
- preference for solitary activity
- little or no interest in sexual experiences with others
- rarely, if ever, a need to seek pleasure from activities
- lacking friends and people to confide in beyond immediate relatives
- appearing emotionally detached, aloof, or unexpressive
- seeming indifferent to positive or negative input from others
People with schizoid personality disorder are typically called “loners.” You may rarely experience emotional extremes, like anger or elation, and you may be oblivious to typical social cues.
Schizotypal personality disorder is considered the most well-researched cluster A personality disorder.
It’s defined by features like a limited capacity to establish close relationships, eccentric behaviors, and ideas and perceptions that are atypical.
According to the DSM-5-RT, five or more of the following symptoms must be present to receive a schizotypal personality disorder diagnosis:
- false beliefs that worldly events or happenings are directly related to you
- magical beliefs or fantasies that directly influence behavior
- atypical perception of the surroundings
- persistent, paranoid, or suspicious thoughts
- uncommon speech and thinking patterns
- pervasive social anxiety regardless of relationship level
- diminished or inappropriate emotional expression
- eccentric behavior or appearance
- absence of close friends other than immediate relatives
Living with schizotypal personality disorder can mean you feel you have special powers or supernatural control over others. You might speak in riddles, rhymes, or a dialect you associate with otherworldly ability.
You may express using unique mannerisms or have an unkempt manner of dress.
Overall, all personality disorders can benefit from psychotherapy. The goal is to learn about the disorder and how your thoughts, feelings, and behaviors may be influenced by it.
As your understanding grows, your mental health team can help you identify how your actions affect those around you. You can learn new ways to manage and cope with the underlying factors in cluster A personality disorders.
Common forms of psychotherapy for personality disorders include:
- cognitive behavioral therapy (CBT)
- dialectical behavior therapy (DBT)
- psychodynamic therapy
- group therapy
- psychoeducation
There are no medications for cluster A personality disorders. However, if you live with overlapping symptoms of other conditions, like depression, medications can help.
Antipsychotics and other mood stabilizers, as well as antidepressants and anti-anxiety medications are typically used to treat overlapping symptoms.
Cluster A personality disorders are three conditions that share eccentric behaviors and a reluctance or inability to form close, trusting relationships.
Whether you live with paranoid, schizoid, or schizotypal personality disorder, symptoms can cause you significant distress or prevent you from everyday levels of function.
Symptoms of cluster A disorders can be managed, and psychotherapy is the go-to treatment in these cases.