Cluster A Personality Disorders: Schizotypal, Schizoid and Paranoid Personality Disorders in Childhood and Adolescence

Abstract

Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors. The DSM-IV-TR describes personality disorders as representing stable and enduring patterns of maladaptive traits, and much of what is understood about Cluster A personality disorders in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area.

Precursors of Personality Disorders in Children and Adolescents

“…Paranoid PD also comprises risk for schizophrenia spectrum disorders, although the risk is lower than in schizotypal PD (Esterberg et al 2010). Johnson et al(2000) de-monstrated that adolescents diagnosed as paranoid PD during the adolescence period are associated with increased risk for violence-and crime-oriented projection disorders…”

Measurement and Assessment of Child and Adolescent Personality Pathology: Introduction to the Special Issue

“…Personality pathology appears to be just as stable in childhood and adolescence as in adulthood (Tackett et al 2009). Another common criticism is that applying PD labels to youth will be stigmatizing, given the belief that PD constructs are stable and intractable to interventions (Cicchetti and Crick 2009;Esterberg et al 2010;Tackett et al 2009). On the other hand, recent efforts toward adolescent intervention have been found to reduce symptoms of personality pathology specifically by using an indicated prevention approach, which relies on identification of early risk factors to determine those adolescents who are most vulnerable to developing adult PDs (Chanen et al 2008).…”

“…Indeed, identification of early risk factors may be one of the most critical factors in the development and delivery of effective interventions. In addition, although stability is high, a small proportion of youth who meet criteria for a PD diagnosis fail to meet criteria 1 year later (Esterberg et al 2010). Thus, an adolescent PD diagnosis need not be seen as deterministic or untreatable.…”

Cluster A Personality Symptomatology in Youth

“…However, a concern common to both Esterberg et al (2010) andDe Clercq et al (2010) is that this distinction is at times rather fluid, if not lost entirely.…”

“…"Cluster A" includes the paranoid, schizoid, and schizotypal personality disorders. Esterberg et al (2010) and De Clercq et al (2010) provide very informative findings and discussions of the consideration of Cluster A personality disorder symptomatology within children and adolescents. This commentary is organized with respect to three main concerns that follow from these incisive papers: (1) the differentiation of personality from other mental disorders, (2) dimensional classification of Cluster A symptomatology, and (3) openness to experience.…”