Which Personality Disorders are in Cluster A?
Courtesy of Godoy Medical Forensics
The American Psychiatric Association organizes personality disorders by clusters. Cluster A is a category that describes individuals who are withdrawn and may engage in odd or eccentric behavior. The diagnoses include:
Paranoid Personality Disorder
An individual with this disorder suspects that others are exploiting, harming, or deceiving him or her. They often suspect without justification that their spouse or sexual partner is unfaithful. They may imagine threats or hidden meaning in communication from friends or co-workers. A client with a paranoid personality disorder may not be willing to trust and confide in his or her attorney.
Schizoid Personality Disorder
Individuals who have schizoid personality disorder have a pattern of detachment from relationships, even with family members. They prefer solitary activities, such as computer games. They may appear to be emotionally cold and detached. They may not respond to anger if provoked. They are indifferent to the praise or criticism of others. An individual with a schizoid personality may not respond appropriately if questioned by police.
Schizotypal Personality Disorder
Individuals with this disorder have symptoms that are similar to those of schizophrenia. They tend to be socially isolated and their behavior and appearance can be odd and eccentric. Their thinking may be positive for unusual beliefs and bizarre fantasies. An individual with schizotypal personality disorder could be suspected of drug abuse due to odd behavior and speech.
The following is a fictional case study about a client who is arrested and has been diagnosed with a personality disorder. As you read the case, think about what the diagnosis might be and the most effective way for the attorney to communicate with this client.
John is a 40-year-old divorced man who lives in a rural neighborhood with his dog. His closest neighbors are a family of two parents and three teenage boys. John reported to the police that his neighbors poisoned his dog. The investigation was concluded quickly after a call to the veterinarian who said that the dog was 12 years old and appeared to have expired from natural causes. John would not accept this conclusion. He called the police a few weeks later to report that his teenage neighbors were entering his house when he was at work. He said that nothing was missing but insisted that objects inside the house had been moved. When one of the boys chased a ball into John’s yard he shouted at him that he was trespassing. When the boy’s father walked over to the yard, John confronted him with a rifle and fired a shot into the air. John was arrested. His blood alcohol was 0.15. John met with his attorney and stated that he was being set up by the neighbors. He stated that he had been treated unfairly all of his life and this was another example.
The legal nurse advised the attorney that the best way to communicate with John was to be calm and matter-of-fact. She told the attorney that a warm and friendly approach would be likely to cause suspicion. She also advised the attorney to avoid joking and whispering in his presence.
An assessment was done by a psychologist who concluded that John had a paranoid personality disorder and wrote a report that was presented to the court. Mandatory counseling that included substance abuse treatment was ordered.
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