Schizotypal personality disorder (StPD), or simply schizotypal disorder, is a cluster A personality disorder that is characterized by a need for social isolation, and illogical behavior and thought patterns, often resulting in false beliefs.
The schizotypal individual develops a fear of social interaction, because of constant teasing and bullying. As infants, they do not learn how to interact with others, and as children, this inability quickly makes them a target for other children. Eventually, the individual learns (unconsciously) to see people as harmful, and the source of humiliation 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. The most pervasive symptoms do not develop until adulthood, so it is rarely diagnosed in individuals under the age of 18.
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 3 (or more) of the following:
- Ideas of reference (excluding delusions of reference).
- 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).
- Unusual perceptual experiences, including bodily illusions.
- Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).
- Suspiciousness or paranoid ideation.
- Inappropriate or constricted affect.
- Behavior or appearance that is odd, eccentric, or peculiar.
- Lack of close friends or confidants other than first-degree relatives.
- Excessive anxiety that does not diminish with familiarity and 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.
As with any other personality disorder, the roots of the schizotypal individual's pathology is believed to stem from early childhood, particularly the first or second year of development. The child is subject to inadequate care, usually in the form of emotional/social neglect more than outright abuse. A child can be well-fed, kept clean and safe at all times, but without the constant social stimulation of the mother and/or father, the child (unwittingly) learns to withdraw into itself, and not to seek pleasure from the outside world.
Similarities with Schizoid personalities
There are many similarities between the schizotypal and schizoid personalities. Most notable of the similarities is a mistrust of others, and an inability to initiate or maintain relationships (both friendly and romantic). The difference between the two seems to be that those labelled 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.
- M - magical thinking that influences behavior, superstitiousness or the paranormal
- E - eccentric behavior or appearance
- P - paranoid ideation
- E - experiences unusual perceptions
- C - constricted affect
- U - unusual thinking & speech
- L - lacks friends
- I - ideas of reference
- A - anxiety (socially)
- R - rule out psychotic disorders & pervasive developmental disorder
- McGlashan, T.H., Grilo, C.M., Skodol, A.E., Gunderson, J.G., Shea, M.T., Morey, L.C., et al. (2000). The collaborative longitudinal personality disorders study: Baseline axis I/II and II/II diagnostic co-occurrence. Acta Psychiatrica Scandinavica, 102, 256-264.
- Pinkofsky HB. Mnemonics for DSM-IV personality disorders. Psychiatr Serv. 1997 Sep;48(9):1197-8. PMID 9285984.
- Personality Disorders. www.personalityresearch.org. URL: http://www.personalityresearch.org/pd.html. Accessed May 2, 2006.
- DSM-IV TR diagnostic criteria for Schizotypal Personality Disorder.
- ICD-10 diagnostic criteria for Schizotypal Disorder.
- Extensive link collection for Schizotypal Disorder.
- Paranoid personality disorder
- Schizoid personality disorder
|Personality disorder | Psychopathy|
|Cluster A (Odd) - Schizotypal, Schizoid, Paranoid|
|Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic|
|Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant|
|Personality disorder not otherwise specified|
|Assessing Personality Disorder|
|MCMI | MMPI | Functional assessment|
|Treating Personality Disorder|
|DBT | CBT | Psychotherapy |Mindfulness-based Cognitive Therapy|
|Prominent workers in Personality Disorder|
|Millon | Linehan
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