Schizotypal personality disorder, or simply schizotypal disorder, is a personality disorder that is characterized by a need for social isolation, odd behavior and thinking, and often unconventional beliefs.

The schizotypal individual develops a fear of, strong objection to, or incapacity for social interaction, due to the sum of their past social experiences being negative in nature. As infants they do not learn how to interact with others, and as children and adults this inability quickly makes them a target for other people. Eventually, the individual learns (most often unconsciously) to see people as harmful and a source of negativity, suffering and ostracization. This leads to the development of "ideas of reference," in which the schizotypal individual believes that events are of special relevance to them or that benign events are somehow related to them (e.g., sees two people laughing and believes that the people are laughing at them). The individual may realize that their ideas of reference are irrational, but maintains them nonetheless. This exacerbates the individual's social anxiety, causing them to skew away from society and withdraw into their own world.

Diagnostic criteria (DSM-IV-TR)

The American Psychiatric Association's DSM-IV-TR, a widely used manual for diagnosing mental disorders, defines Schizotypal personality disorder as "A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Ideas of reference (excluding delusions of reference)
2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or "sixth sense"; in children and adolescents, bizarre fantasies or preoccupations)
3. Unusual perceptual experiences, including bodily illusions
4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
5. Suspiciousness or paranoid ideation
6. Inappropriate or constricted affect
7. Behavior or appearance that is odd, eccentric, or peculiar
8. Lack of close friends or confidants other than first-degree relatives
9. Social anxiety that tends to be associated with paranoid fears rather than negative judgments about self

Link with other mental disorders

There is a high rate of comorbidity with other personality disorders. McGlashan et al. (2000) stated that this may be due to overlapping criteria with other personality disorders, such as avoidant personality disorder and paranoid personality disorder.

Causes

Genetic

Although listed in the DSM-IV-TR on Axis II, schizotypal personality disorder is widely understood to be a "schizophrenia spectrum" disorder. If you look at the relatives of individuals who have been diagnosed with schizophrenia, rates of schizotypal PD will be much higher in those individuals than in the relatives of people with other mental illnesses or in the relatives of community controls with no mental illness. Technically speaking, schizotypal PD is an "extended phenotype" that helps geneticists track the familial or genetic transmission of the genes that are implicated in schizophrenia There are dozens of studies showing that individuals with schizotypal PD look similar to individuals with schizophrenia on a very wide range of neuropsychological tests. Cognitive deficits in patients with schizotypal PD are very similar to, but somewhat milder than, those for patients with schizophrenia.

Social / Environmental

People with schizotypal PD, like patients with schizophrenia, may be quite sensitive to interpersonal criticism and hostility, and there is now evidence to suggest that parenting styles, early separation and early childhood neglect can lead to the development of schizotypal traits

Similarities with Schizoid personalities

There are many similarities between the Schizotypal and Schizoid personalities. Most notable of the similarities is the inability to initiate or maintain relationships (both friendly and romantic). The difference between the two seems to be that those labeled as Schizotypal avoid social interaction because of a deep-seated fear of people. The Schizoid individual simply feels no desire to form relationships, because they quite literally see no point in sharing their time with others.

References

2. Fogelson, D.L., Nuechterlein, K.H., Asarnow, R.F., et al., (2007). Avoidant personality disorder is a separable schizophrenia-spectrum personality disorder even when controlling for the presence of paranoid and schizotypal personality disorders: The UCLA family study. Schizophrenia Research, 91, 192-199.

3. Matsui, M., Sumiyoshi, T., Kato, K., et al., (2004). Neuropsychological profile in patients with schizotypal personality disorder or schizophrenia. Psychological Reports, 94(2), 387-397.

4. Deidre M. Anglina, Patricia R. Cohenab, Henian Chena (2008) Duration of early maternal separation and prediction of schizotypal symptoms from early adolescence to midlife, Schizophrenia Research Volume 103, Issue 1, Pages 143-150 (August 2008)

5. Howard Berenbaum, Ph.D., Eve M. Valera, Ph.D. and John G. Kerns, Ph.D. (2003) Psychological Trauma and Schizotypal Symptoms, Schizophrenia Bulletin

See also

• Paranoid personality disorder
• Schizoid personality disorder
• Schizophrenia
• Schizotypy

External links

• DSM-IV TR diagnostic criteria for Schizotypal Personality Disorder
• ICD-10 diagnostic criteria for Schizotypal Disorder
• Link collection for resources on Schizotypal Disorder