Schizotypal Personality Disorder
Madison R. Amos
I have neither given nor received help on this work, nor am I aware of any infraction of the Honor Code.
Schizotypal Personality Disorder
Schizotypal personality disorder, also known as SPD, is categorized as a Cluster A personality disorder in the DSM-IV. There is a total of three clusters that a personality disorder can fall under, Cluster A, Cluster B, and Cluster C. Cluster A personality disorders are described as behaviors that are eccentric, odd, and sometimes quirky. Cluster B personality disorders are described as erratic, emotional, as well as dramatic. Finally, Cluster C personality disorders are recognized as personalities and behaviors that are fearful and anxious. With schizotypal personality disorder being relatively new to the field of psychology, there is not much on the history of it besides the fact that even though the name schizotypal personality disorder is new, psychologist have seen this personality disorder for years but diagnosed it as something else because it did not have its own category in the Diagnostic and Statistical Manual of Mental Disorders. Symptoms of schizotypal personality disorder have been around and have been constant throughout the years even though the symptoms people experience may vary. Over the years, diagnosing this personality disorder has evolved. In order to be diagnosed with schizotypal personality disorder, a person must show at least five symptoms. Treating schizotypal personality disorder is a complex process. This can be because a symptom of this personality disorder is paranoia. People with this disorder may become paranoid of people and have a hard time trusting so getting someone to trust their therapist can be difficult.
Schizotypal personality disorder became an official personality disorder when it was listed into the DSM-III, but it has been around since the late 1970s and possibly earlier. Before it was announced in the DSM-III, those individuals who currently meet the criteria for schizotypal personality disorder could have been diagnosed with ambulatory schizophrenia, pseudoneurotic schizophrenia, psychotic character, schizophrenic phenotype, or schizotype (Ridenour, 2014). This misdiagnosis made by many psychologists is because that the DSM did not define and characterize personality disorders in depth.
Since schizotypal personality disorder is a Cluster A personality disorder, most of the symptoms are odd and eccentric. This odd and eccentric behavior pattern can also be seen in the way that individuals dress as well as their personal hygeine. People with schizotypal personality disorder behave in ways that are against the social norm. Some of the symptoms include extreme social anxiety, paranoid thoughts and beliefs, struggle to form friendships as well has having trouble interacting with people and perceptual/cognitive distortions. Perceptual and cognitive distortions can be described as a person who may see or experience things that are not actually happening. Other symptoms include eccentric or odd thought patterns, magical thinking, ideas of reference (which means people who suffer with schizotypal personality disorder truly believe that everything that occurs in their life has significant meaning, and odd speech). There are different ways to describe odd speech, people with this disorder can be vague, overelaborate, and even speak in only metaphors so it can be difficult to comprehend what they are trying to say. People diagnosed with schizotypal personality disorder exhibit similar social skills deficits to individuals with schizophrenia, such as difficulties labeling positive emotions and difficulty understanding the difference between appropriate and inappropriate social behaviors (Ridenour, 2014). The symptoms are prevalent in many different settings, meaning that it does not only happen in social settings but all the time. Although schizotypal personality disorder and schizophrenia are closely related, the diagnostic process is different. To be diagnosed with schizotypal personality disorder, people usually experience brief psychotic symptoms while with schizophrenia, people must experience active positive psychotic symptoms for at least a month as well as show signs of disturbances for six months (Ridenour, 2014). Ridenour (2014) stated that individuals with positive schizotypal tendencies (psychotic-like traits of SPD, such as off beliefs) paid greater attention to their emotions than controls, yet they lacked the psychological resources to understand and identify their feelings. “Individuals with schizotypal tendencies who are unclear about their emotional experiences might falsely attribute the source of their emotional discomfort to other people” (Ridenour, 2014).
Many questions have been raised about the cause of personality disorders such as who is more likely to develop these types of disorders? Are they more common among males or females? Does socioeconomic status or psychological trauma play a role? Few studies have been conducted on whether or not socioeconomic status effects the development of personality disorders. Cohen, Chen, Gordon, Johnson, Brook, and Kasen (2008) found that there is no clear connection between socioeconomic status and personality disorders, including schizotypal personality disorder. In a study conducted by Berenbaum, Thompson, Milanak, Boden, and Bredemeier (2008), they wanted to examine the relationship between psychological trauma and schizotypal symptoms. For one study, the researchers conducted telephone interviews looking at childhood maltreatment and injury or life-threatening events and for the second study, they completed face to face assessments looking at posttraumatic stress disorder Criterion A and childhood maltreatment. The results showed that men and women did not differ appreciably in their total childhood maltreatment scores, however, they did differ in the kinds of maltreatment they experienced- women experiencing more sexual abuse while men experienced more physical neglect and physical abuse (Berenbaum, Thompson, Milanak, Boden, & Bredemeier, 2008). They also found that men and women did not differ in their levels of schizotypal symptoms and that regardless of sex, higher levels of schizotypal symptoms were associated with higher forms of childhood maltreatment (Berenbaum et. al, 2008). The difference between male and female with schizotypal symptoms had no significant differences between them, however, in a survey conducted by Pulay et. al (2009), they found that there were significantly greater rates of schizotypal personality disorder in men than in women.
In a study conducted by Anglin et.al (2012), it demonstrated prospectively that early use of cannabis is related to later schizotypal symptoms. This is the only study that has been conducted that looks at the potential interaction between cannabis use and schizotypal symptoms (Anglin et. al, 2012). There has not been enough research on this topic to determine whether the schizotypal symptoms stay persistent or not, however, the findings do show that cannabis can lead to certain schizotypal symptoms.
Diagnosing schizotypal personality disorder can be complex because it is comorbid with other Cluster A personality disorders. Some of the unique factors of schizotypal personality disorder may underlie associations with narcissistic personality disorder and borderline personality disorder (Pulay et al, 2009). When diagnosing someone with a Cluster A personality disorder, accuracy is key because it can be hard to diagnose when you have several disorders that
are comorbid with each other and have similar symptoms.
Schizotypal Personality and Autism
The diagnostic boundaries between autistic and schizophrenia-spectrum disorders have varied and some overlap in criteria (Esterberg, Trotman, Brasfield, Comptom, & Walker, 2008). In the study conducted by Esterberg, Trotman, Brasfield, Comptom, and Walker (2008), the researchers found that adolescents with schizotypal personality disorder showed significantly more severe current and past autistic features in the areas of social impairment and unusual interests and behaviors compared to normal and other personality-disorder controls. To summarize, the main characteristic in the diagnosing process of autism and schizotypal personality disorder are the social impairments that are symptoms of both disorders. Social impairments can include social anxiety and odd or peculiar behavior (Esterberg, Trotman, Brasfield, Comptom, & Walker, 2008).
Treating those with schizotypal personality disorders is difficult due to their paranoia. Research has shown that schizotypal personality disorder is a chronic and often incapacitating disorder and that only 25% of individuals with this disorder has shown good treatment outcome (Ridenour, 2014). The main type of treatment that has been studied is therapy. This personality disorder cannot be cured but therapy can possibly help depending on patient. In order for therapy to be successful, the therapist has to form a healthy working alliance. The paranoia and bizarre thinking that a person with schizotypal personality disorder can hinder the therapist’s ability to form the healthy working alliance with the patient that is needed for it to be successful (Ridenour, 2014). Due to the social impairments that people with this disorder experience, the experience loneliness. “Loneliness might be one factor that motivates individuals with schizotypal tendencies to seek out treatment (Ridenour, 2014).
Schizotypal personality disorder is a Cluster A personality disorder that has not been researched as much as it should. The cause of this personality disorder is unknown but genetics do play a role. A person is more likely to develop this personality disorder if they have a family member with it or schizophrenia. This personality disorder is hard to treat because of the symptoms that people develop, which also makes it a personality disorder that is hard to examine.
ReferencesAnglin, D. M., Corcoran, C., Brown, A., Chen, H., Lighty, Q., Brook, J., et al (2012). Early cannabis use and schizotypal personality disorder symptoms from adolescence to middle adulthood. Schizophrenia Research, 137(1-3), 45-49. 10.1016./j.schres.2012.01.019
Berenbaum, H., Thompson, M. E., Milanak, M., Boden, T., Bredemeier, K. (2008). Psychological trauma and schizotypal personality disorder. Journal of Abnormal Psychology, 117(3), 502-519. 10.1037/0021-843X.117.3.502
Cohen, P., Chen, H., Gordon, K., Johnson, J., Brook, J., Kasen, S. (2008). Socioeconomic background and the developmental course of schizotypal and borderline personality disorder symptoms. Development and Psychopathology, 20, 633-650. 10.1017/S095457940800031X
Esterberg, M. L., Trotman, H, D., Brasfield, J. L., Compton, M. T., Walker, E. F. (2008). Childhood and current autistic features in adolescents with schizotypal personality disorder. Schizophrenia Research, 104, 265-273. 10.1016/j.schres.2008.04.029
Pulay, A. J., Stinson, F. S., Dawson, D. A., Goldstein, R. B., Chou, S. P., Huang, B., et. al (2009). Prevalence, correlates, disability, and comorbidity of DSM-IV schizotypal personality disorder: Results from the wave 2 national epidemiologic survey on alcohol and related conditions. Prim Care Companion J Clin Psychiatry, 11(2), 53-67.
Ridenour, J. M. (2014). Psychodynamic model and treatment of schizotypal personality disorder. Psychoanalytic Psychology, 33(1), 129-146. 10.1037/a0035531