Cluster A and its treatment for professionals

Cluster A and its treatment

Cluster A personality disorder forms a part of the Personality Disorders. Personality disorders affect the individual way more than a normal individual can think of. It not only affects and effects the person’s social life but also hampers his interpersonal relationships with his family and might hamper his intrapersonal relationship.

Personality refers to relatively permanent characteristics that an individual has. People with personality disorders are more vulnerable to other mental health problems too such as depression, anxiety or substance use disorder.

Cluster A personality has the following characteristics:

  • Suspicious
  • Unforgiving
  • Cold and
  • Have difficulty maintaining relationships
  • Have an increased tendency to procreate sexual and physical violence

Cluster A personality disorders are as follows:

  1. Paranoid
  2. Schizotypal
  3. Schizoid

People in the working field who are diagnosed with Cluster A personality disorder have the following characteristics:

Paranoid: The individual is very suspicious, has huge doubt on other people and think the other individual will cheat me. They have very low level of interpersonal trust.

Schizoid: The individual tends to be socially detached with people and has a difficulty to interpret and showcase emotions.

Schizotypal: The person is generally out of sync with reality has distortions of thought or perception (Delusions or hallucinations)

Classification of Personality disorders and symptoms present in those disorders according to DSM5:

Personality disorders have the following clusters:

  1. Cluster A (Paranoid, schizoid and schizotypal)
  2. Cluster B (Anti-social, Borderline, Histrionic and Narcissist)
  3. Cluster C (Obsessive Compulsive, Avoidant Personality and Dependent)

Symptoms of Cluster A are:

  1. Paranoid Personality Disorder:
  2. Pervasive Distrust and subconscious interpretation that other people motives are malevolent. These are indicated by 4 or more of the following:
  3. Suspects that others are exploiting or harming
  4. Preoccupied by unjust doubts about loyalty
  5. Is reluctant to confide in others because the information may be used against him
  6. Reads and interprets demeaning and threatening meaning in remarks
  7. Bears grudges
  8. Perceives attacks on his/her character or reputation and is quick to react angrily
  9. Has recurrent suspicions without any evidence of spouse or sexual partner
  10. Doesn’t occur during the course of schizophrenia, Bipolar Disorder or Depressive disorder or any other psychotic illness and is not attunable to the use of any physiological effects of a medication or substance.

Paranoid personality acts as symptom to following disorders:

  1. Personality changes due to another medical condition
  2. Substance use disorder
  3. Paranoid traits related to people who are physically handicapped
  4. Other personality disorders


  1. Schizoid Personality Disorder:
  2. A pervasive pattern of detachment from social relationships and a limited range of emotions in interpersonal relationships.  These are indicated by 4 or more of the following:
  3. Neither desires nor enjoys close relationships including a part of a family.
  4. Choses solitary activity
  5. Has little or no interest in sexual activity with a person
  6. Takes pleasure in very few activities
  7. Lacks close friendships other than first-degree relatives
  8. seem indifferent to praise or criticism 
  9. Show flattened affect almost every day
  10. Does not occur during the course of schizophrenia, a bipolar or depressive disorder with psychotic features and is not a result of any physiological or medical condition.

Schizoid personality acts as symptom to following disorders:

  1. Autism Spectrum Disorder
  2. Personality changes due to any medical condition
  3. Substance use disorder
  4. Other personality disorders and personality traits
  1. Schizotypal Personality Disorder:
  2. Pervasive pattern of social and interpersonal deficits. Acute discomfort alongside reduced capacity for close relationships. Perceptual distortions. These are indicated by 5 or more of the following:
  3. reference idea (no reference delusion) 
  4. Odd beliefs that influence behaviour and is consistent with subcultural norms
  5. Unusual perceptual experiences
  6. Odd thinking or speech
  7. Subconsciousness or paranoid ideation
  8. Inappropriate affect
  9. Behaviour or appearance is odd, peculiar
  10. Lack of close friends
  11. Excessive social anxiety than do not diminish with familiarity.
  12. Does not occur exclusively during the course of schizophrenia, Bipolar or depressive disorder or is not a result of any psychotic features or autism spectrum disorder.

Schizotypal personality acts as symptom to following disorders:

  1. Neurodevelopmental Disorders
  2. Personality changes due to another illness 
  3. Substance use disorder
  4. Other personality disorder and personality traits

Risk Factors associated with Cluster A are as follows:

Genetic and Physiological: Increased risks for people to develop Paranoid Personality Disorder who have a relative suffering from schizophrenia. People with relatives of schizophrenia have a increased risk for developing schizoid personality disorder. The Schizotypal personality disorder incidence increases when the individual has first degree biological relatives who have schizophrenia.

Treatment for Individuals suffering from Cluster A personality disorder:

  1. Psychotherapies:
  1. Cognitive Behaviour Therapy: The therapeutic approach makes the individual become more aware of his/ her thoughts patterns. Helps to deal with the negative affects and turn them into positive ones by conditioning. Allowing the individual be in more control of behavioural patterns shown by the individual.
  2. Psychoanalytic Therapy: Focuses on uprooting buried emotions and resolving the conflicts between ID and Superego.
  1. Medications: Medications as such don’t help but help in reducing certain symptoms.
  • Antidepressants: treating symptoms of depression and also decrease the feelings of impulse
  • Mood Stabilizers: Prohibit mood swings and reduce irritability
  • Anti-Psychotics

Management of people with Paranoid Personality Disorder:

  1. Maintaining fair, non-intimate and supportive relationships will help the individual grow and increase trust on people. Increase in emotional stability can also be seen.
  2. Providing space for conversations: The manager should provide an individual with space where he can share his/her grievances without being judged alongside increasing the state of interpersonal trust.

Management of people with Schizoid Personality Disorder:

  1. Providing space: people with schizoid personality disorder are generally afraid of conflict. Providing them space where they can confide without being judged can help
  2. Alongside helping them maintain relationships that are not emotional in nature. These relationships should only be work related and no intimacy should be expected to grow

Management of people with Schizotypal Personality Disorder

  1. The person impulsive side should be undertaken by keeping complete transparency alongside taking care of all needs and wants of the individual.

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