Cluster A Personality DisordersSymptoms, Treatment, and Support

What are cluster A personality disorders?

Cluster A personality disorders are characterized by patterns of distorted thinking, odd behavior, and social awkwardness or detachment. Often, people with these disorders come off as loners, either because they are mistrusting of others or simply disinterested in relationships.

Despite their social difficulties, like everybody else, people with cluster A personality disorders need some degree of connection to lead healthy lives. Lack of connection can give way to loneliness and isolation, which can have real physical, mental, and emotional consequences, leading to an impaired immune system, depression, higher stress, and cognitive decline.

There are three personality disorders that are classified as cluster A:

Paranoid Personality Disorder (PPD)

Paranoid personality disorder (PPD) involves a pattern of extreme distrust. A person with PPD often lives in fear that other people are planning to harm or deceive them, even if there’s no evidence. Someone with PPD usually has a hard time confiding in others and tends to hold long grudges for perceived slights.

Schizoid Personality Disorder (SPD)

Schizoid personality disorder (SPD) involves a pattern of lonesome behavior and disinterest in relationships. A person with this personality disorder might also come across as emotionally cold and remain indifferent even if you shower them with compliments. Others maydeem this person “strange” or a “hermit.”

Schizotypal Personality Disorder (STPD)

Schizotypal personality disorder (STPD) involves a pattern of magical thinking, unusual speech and behaviors, and suspiciousness. They tend to routinely connect unrelated events, such as believing their choice of clothing affects weather patterns. In contrast with schizoid personality disorder, people with STPD tend to be loners due to their distrust of others, rather than disinterest or lack of desire for relationships.

Personality disorders involve inflexible and oftentimes extreme behaviors. However, they can be managed. It all starts with gaining a deeper understanding of the symptoms and then taking proactive steps to lessen their severity.

Cluster A personality disorder symptoms

Symptoms of cluster A personality disorders will vary based on the specific condition. However, in general, they tend to include some level of social detachment, distorted thinking, eccentric behaviors, and emotional withdrawal.

If you suspect that you or someone you love has a cluster A personality disorder, consider these symptoms:

Social detachment. Everyone likes a little space sometimes, but people with cluster A personality disorders might live in excessive isolation. For example, if you have paranoid personality disorder, you might be so suspicious of other people that you routinely avoid interactions with coworkers, family, or even people who see you as a friend. On the other hand, if you have schizoid personality disorder, you may stay in your home because the thought of social interactions simply isn’t appealing.

Odd or distorted thoughts. You may falsely believe that your neighbors are spying on you, or that you can read other people’s minds or predict the future. You might have a fixation with and firm belief in the paranormal, such as alien encounters.

Eccentric and behaviors. This might encompass subtle things, such as slow or flat speech patterns, or more disruptive actions, such as having accusatory outbursts. Others may say that you dress in an odd way or use unusual mannerisms, such as staring off into space instead of making eye contact.

Emotional withdrawal. Other people may note that you come across as detached or indifferent. Perhaps you hide emotions because you don’t trust others, or maybe you’re genuinely not emotional. You might also shy away from more intimate acts, whether that involves holding hands or having sex.

Cluster A vs. clusters C and B personality disorders

Personality disorders are categorized by how similar their symptoms seem. People with cluster A personality disorders may often (but not always) seem withdrawn, awkward, or eccentric.

Cluster B personality disorders are frequently defined by dramatic behaviors, such as the unpredictable emotional swings of someone with borderline personality disorder (BPD) or the grandiose bragging of someone with narcissistic personality disorder. Cluster C personality disorders, such as avoidant personality disorder (AVPD) and dependent personality disorder, tend to involve intense and chronic fear and anxiety.

Risk factors of cluster A personality disorders

Studies of twins indicate that cluster A personality disorders have a genetic component, meaning they might be, at least in part, hereditary. In addition, if you have relatives with schizophrenia, you are more likely to have traits found in cluster A personality disorders.

However, environmental factors, such as childhood experiences can also play a role. For example, some research shows that experiencing physical abuse as a child or having a parent with a substance abuse problem can increase the risk of schizoid personality disorder. Similarly, emotional abuse or emotional neglect in childhood is associated with paranoid personality disorder as well as schizotypal traits.

Diagnosing cluster A personality disorders

A thorough evaluation can help avoid misdiagnosis. For example, other conditions, such as autism, can come with unusual behaviors or communication differences. Meanwhile, people with avoidant personality disorder, a cluster C personality disorder, may have self-isolating behaviors that seem similar to cluster A personality disorders. An evaluation can also help identify co-occurring issues, such as anxiety or depression, that might also need to be treated.

To reach a diagnosis, a medical provider will likely take a look at your medical history, conduct interviews, use psychometric tools, and collect information from friends and family members. They’ll compare their findings to criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Treatment options for cluster A personality disorders

Professional treatment options do exist for cluster A personality disorders. However, evidence around their effectiveness is scarce, due to how unlikely it is for people with these disorders to seek help or maintain connections with medical providers.

Tailored therapy

Psychotherapy for cluster A personality disorder might involve a personalized approach. Treatment can be tailored to manage the specific issues. Some examples:

• Cognitive behavioral therapy (CBT) focuses on identifying how thought patterns affect behavior, and then making healthy adjustments. You may examine how anxious, automatic thoughts lead you to ruminate and self-isolate. Then, you can replace those habits with healthier steps, such as challenging negative thoughts.
• Someone with paranoid personality disorder might benefit from narrative reformulation, a technique that allows a person to reframe an internalized story, such as, “I can only stay safe if I remain vigilant and distant from other people.”
• Metacognitive reflection insight therapy, which involves enhancing self-awareness of thoughts and feelings, might be useful for people with schizoid or schizotypal personality disorder. During a session, you may reflect on how you want to deepen a relationship with someone close to you, for example. Through dialogue with a therapist, you can explore how negative self-talk blocks you from the goal and how to address it.
• Therapy that incorporates social skills training, such as learning how to express yourself more clearly, might be useful for someone with schizotypal personality disorder. For instance, in these sessions, a therapist might role-play as a stranger so you can practice talking with someone new and reading nonverbal cues.

Medication management

Medication might be prescribed to manage specific symptoms or co-occurring conditions. For example:

• Antipsychotics might be used to reduce paranoid thinking or cognitive distortions
• Selective serotonin reuptake inhibitors (SSRIs) might be used to treat co-occurring major depression and self-harm
• Anti-anxiety medication may be helpful in managing social anxiety, which commonly occurs alongside paranoia.

Getting help for cluster A personality disorders

Although personality disorders can’t be cured, their symptoms can be managed. Self-help strategies and professional treatment options can improve your mental health and help you lead a more fulfilling life. It all starts with recognizing your need for help. From there, you can take more proactive steps, such as addressing common roadblocks to treatment, building social support, and finding ways to manage stress.

Tip 1: Recognize your need for help

If you have a cluster A personality disorder, you may struggle to recognize how your symptoms impact your daily life and relationships. Those around you may have expressed their concern, but you might have a tendency to brush off your symptoms as “Just the way I am.” It’s important to recognize your capacity to make changes to improve your relationships and overall well-being.

Consider feedback from others. Other people might have noticed issues that you’ve overlooked. Has someone close to you mentioned how your actions impact your relationship? For example, they might have noted that your distrustful nature makes you difficult to work with.

Consider other ways in which you can improve your quality of life. For example, managing your paranoid thoughts may help you to ease your anxiety. Or learning to better engage with others could help you feel less lonely or depressed. You might even build a sense of connection and community by talking to others who share your condition.

Journaling can be a useful tool here. Consider freewriting a narrative about your ideal life or best possible self. What kind of relationships do you have? What’s your health, hobbies, and work life look like? This exercise can help you identify areas in which you can improve.

If you already have a diagnosis, read up on the condition. Perhaps you already have a personality disorder diagnosis, but don’t feel motivated to make the leap into treatment. Learning more about the symptoms and how they can disrupt your life might encourage you to seek help.

Tip 2: Overcome challenges in treating cluster A personality disorders

Distrust in others or reluctance to engage with others might lead you to avoid treatment. Here are some tips on progressing in your journey toward better health:

Consider researching how therapy works and what sessions are like. This insight might make the process seem less daunting and help you better understand what you have to gain. And remember that you can try out a single therapy session without having to commit to more.

Talk to trusted individuals about their experiences. Close friends or family members may have recommendations for therapists. Or perhaps they can share more insight into what you can expect.

Try a support group. If the thought of one-on-one therapy sessions makes you nervous, sit in on a support group. You might be able to listen in and see how sharing emotions is not just safe, but also therapeutic. You might even take comfort in hearing from others who experience similar social challenges.

Know that trust-building doesn’t happen overnight. If you do find a therapist, understand that it’s okay to go slow and build rapport over time. You shouldn’t feel pressured to immediately open up. If you feel uncomfortable, you can look for a new therapist, but be sure to give each one a chance.

Tip 3: Find support

Although people with cluster A personality disorders may be more withdrawn or hesitant to socialize, social support has a crucial role to play in your mental and physical health. For example, research shows that having healthy relationships can make you more resilient to stress—a concept known as social-buffering.

Start small. If you feel easily overwhelmed or anxious when socializing, focus on building a core group of trustworthy connections. Don’t feel pressured to share all of your deepest feelings with them or spend every moment with them. Instead, share what feels comfortable, and aim to see them at regular, predictable intervals, such as seeing a friend once a week for coffee. Prioritize in-person interactions, but if meeting face-to-face feels daunting, connect with a text or a phone call.

Combine socializing with hobbies. Not every meetup has to be heavy on conversation. You might find that you enjoy some light socializing as you hike, play video games, or ride a bike.

Improve your social skills. If you’re not used to connecting with others on more than a superficial level, you might want to build your social skills. In doing so, you’ll have an easier time communicating your needs and developing a deeper understanding of others. Some ways to start:

• Learn to recognize nonverbal cues in others. You can also practice using body language to complement your own words.
• Practice taking an interest in others and using open-ended questions to move through conversations. For instance, instead of asking, “How are you?” you might ask, “What was the best part of your day?”
• Use mindfulness in conversations. Mindfulness is about being present in the moment and reserving judgment. In conversation, it allows you to give your full attention to the other person and get out of your own head. If you feel your mind wandering from what’s being said to your own thoughts, practice bringing your attention back to the speaker, their words, and their body language to stay focused.

Tip 4: Manage stress

If you spend a lot of time by yourself or have a small social circle, it’s crucial to find ways to manage stress when you’re alone. Doing so might also help reduce personality disorder symptoms.

Create a list of go-to relaxation exercises. Start by experimenting with different relaxation techniques and determine which ones seem to work best for you. Practices such as mindful breathing can calm your central nervous system and can be done anywhere. Other techniques, such as yoga and meditation, require a little more time or a dedicated space.

Improve sleep hygiene. Poor sleep can amplify your stress levels, but some studies also find that it may worsen paranoia. Most adults need at least seven hours of sleep each night. Good sleep hygiene practices, such as having a regular bedtime and keeping your room dark and quiet, can increase your odds of restful sleep.

Stay active. Exercise is very effective for stress management, as it triggers the release of mood-boosting hormones. It might be helpful to find a physical activity you enjoy doing alone, such as biking or jogging, so you can stick to your exercise routine even if you aren’t feeling social.

Consider the link between stress and nutrition. Fibrous foods and fermented foods may help to reduce anxiety, while alcohol and caffeine (especially in high amounts) can make it worse. Omega-3 fatty acids–-which you find plenty of in the Mediterranean diet—are known to decrease stress. Omega-3 fatty acids also appear to reduce schizotypal traits in children.

Supporting loved ones with cluster A personality disorders

Supporting someone who has a cluster A personality disorder can be challenging. Some days, you might be on the receiving end of their paranoia, discomforted by their odd behavior, or frustrated by their solitary disposition. These tips may help.

Offer compassionate understanding

Your emotional support can make a big difference in your loved one’s life. It can make them feel less isolated, less anxious, and more likely to seek treatment.

Educate yourself. Learning as much as you can about personality disorders can help you avoid misunderstandings or taking their actions personally. Through research, you can also learn how best to help your loved one manage their symptoms.

Be patient and understanding. A loved one with a personality disorder might be hard to deal with but recognize that their behaviors stem from deeply ingrained patterns and not personal choices. For example, you might feel like you need to simply force a relative with schizoid personality disorder to get out of the house and meet new people. Try to understand that their motivation to socialize is lower than your own.

Don’t berate them or be dismissive. If your loved one holds strange or mistaken beliefs—such as the idea that someone is plotting against them—you don’t need to argue with them. In fact, doing so can make things worse.

Address their discomfort and anxiety. This doesn’t necessarily mean you need to agree with their strange beliefs in order to placate them. Instead, focus on exploring their feelings and offer comfort if needed. You might say something like, “I see why you would feel that way. It sounds tough.” Ask them what you can do to make them feel comfortable and safe.

Encourage professional support

Although your support is valuable, it’s not a substitute for professional treatment. Here’s how you can encourage your loved one to seek more help.

Make the case for professional help. Give some concrete examples of how their disorder is affecting their life and how therapy might be helpful. Even if they won’t acknowledge they might have a personality disorder, you can point out how it can be a tool for managing challenges. For instance, you could say, “A therapist can help you figure out how to handle anxiety.”

Share your experiences. If you’ve been in therapy, consider sharing your experiences. What did you like, and what didn’t you like? How did you benefit? Giving a personal account might help make them feel more comfortable, especially if they put a lot of trust in you.

Anticipate setbacks. Even if your loved one starts therapy, they might stop after a few sessions—especially if they’re grappling with paranoia or low motivation to open up to a new person. You can encourage them to try again later. However, remember that you’re not responsible for their decision-making.

Prioritize your well-being

Helping your loved one will require time and energy. If you’re not careful, the endeavor can leave you drained and frustrated. Use the following tips to protect your own mental health.

Prioritize self-care. Make time to relax, enjoy hobbies, and pursue your own interests. Know what activities help you unwind, and allow yourself to indulge in them. Self-care practices allow you to show up more fully for your loved one later.

Set boundaries. If a loved one with paranoid personality disorder feels the need to be controlling, for example, point out what behaviors make you feel uncomfortable or unsafe. Let them know how you’ll respond if your boundaries are crossed. But only state consequences that you’re ready to enforce.

Stay social. If your loved one has a small social circle, they likely rely on you for a lot. However, that doesn’t mean you need to narrow or withdraw from your own support network. Remember to take time to nurture other relationships.

Understanding cluster A personality disorders

People with cluster A personality disorders are often viewed as eccentric loners. Their distrust or disinterest often gets in the way of meaningful social connections. However, change is possible. A combination of self-help steps and professional treatment can help you or a loved one manage the symptoms of a personality disorder.

Last updated or reviewed on March 24, 2025