Personality Disorder Support Community

Personality Disorder Support Community

Schizotypal Personality Disorder


Schizotypal Personality Disorder belongs to the eccentric group of personality disorders. People with StPD tend to feel uncomfortable with social interaction, preferring social isolation. They experience anxiety in social situations and find it difficult to maintain close relationships, and may appear odd or peculiar. They also tend to hold odd beliefs and tend to distort reality. This disorder is more predominant in males and occurs in 3% of the general population.

People with this disorder tend to :

  • Come across as aloof and emotionless.

  • Be engrossed in daydreaming and fantasising.

  • Misread or have a distorted sense of reality.

  • Dress and behave in an odd manner.

  • Be suspicious or paranoid.

  • Believe in unconventional beliefs and have magical thinking.

  • Not have any close friends.


In order to be diagnosed with StPD, you will have to meet certain criterion laid out by the DSM IV or the ICD-10.

For the DSM IV, the diagnostic criteria are as follows:

  1. 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 behaviour, 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 behaviour 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, over elaborate, or stereotyped).

    5. Suspiciousness or paranoid ideation.

    6. Inappropriate or constricted affect.

    7. Behaviour or appearance that is odd, eccentric, or peculiar.

    8. Lack of close friends or confidants other than first-degree relatives.

    9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgements about self.


  2. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder. With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.


Note: If criteria are met prior to the onset of Schizophrenia, add "Pre-Morbid," e.g., "Schizotypal Personality Disorder (Pre-morbid)."


The ICD-10 does not have a diagnosis of Schizotypal Personality Disorder; instead it has it listed as Schizotypal Disorder, where it is classified as a schizophrenic based disorder, rather than a personality disorder on its own.

The ICD definition is:

A disorder characterized by eccentric behavior and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies have occurred at any stage. There is no dominant or typical disturbance, but any of the following may be present:

  1. Inappropriate or constricted affect (the individual appears cold and aloof).

  2. Behavior or appearance that is odd, eccentric or peculiar.

  3. Poor rapport with others and a tendency to social withdrawal.

  4. Odd beliefs or magical thinking, influencing behavior and inconsistent with subcultural norms.

  5. Suspiciousness or paranoid ideas.

  6. Obsessive ruminations without inner resistance, often with dysmorphophobia, sexual or aggressive contents.

  7. Unusual perceptual experiences including somatosensory (bodily) or other illusions, depersonalisation or derealisation.

  8. Vague, circumstantial, metaphorical, over-elaborate or stereotyped thinking, manifested by odd speech or in other ways, without gross incoherence.

  9. Occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations and delusion-like ideas, usually occurring without external provocation.


The disorder runs a chronic course with fluctuations of intensity. Occasionally it evolves into overt schizophrenia. There is no definite onset and its evolution and course are usually those of a personality disorder. It is more common in individuals related to people with schizophrenia and is believed to be part of the genetic "spectrum" of schizophrenia.

In order for a diagnosis to be reached, all these other similar disorders or disorders with the same symptoms need to be ruled out.

  • Delusional Disorder.

  • Schizophrenia.

  • Mood Disorder with Psychotic Features.

  • Autistic Disorder.

  • Asperger's Syndrome.

  • Expressive and Mixed Receptive-Expressive Language Disorders.

  • Symptoms that may develop with Chronic Substance Use.

  • Schizoid Personality Disorder.

  • Avoidant Personality Disorder.

  • Narcissistic Personality Disorder.

  • Borderline Personality Disorder.

  • Schizotypal features during adolescence.

  • Communication Disorders.

  • Personality Change due to a General Medical Condition.


Causes

There is a higher occurence of StPD among people who have relatives with Schizophrenia. There is, however, more evidence that childhood neglect and certain parenting styles can lead to it's development.

Diagnosing StPD

If you believe that you may have SPD, you will need to see your gp, who will make a referral to your local mental health unit. Your gp may examine you for any physical symptoms in order to rule out any medical condition.
If you are given an appointment to see a psychologist or a health care professional, you will be need to be assessed in order to be diagnosed with SPD. There will be several sessions at least before a diagnosis is confirmed, if any.

Treatment

People with this disorder tend not to seek medical help for the disorder itself, but might seek help for certain symptoms of depression or anxiety.
Psychotherapy is usually offered, in order to help the sufferer with their distorted perceptions and sense of reality. Certain therapies will also help them overcome social anxieties and provide them with further social skills.
Sometimes medication is offered, usually in times of stress and crisis, and they are usually in the form of anti psychotics, anti depressants or anti anxieties.

Millon's Subtypes

Insipid Schizotypal
This subtype is characterised by schizoid, melancholic and dependent features. People with this subtype are often expressionless and dull. They often feel disconnected, non existent and strange. They can come across as ambivalent and unfeeling to others. Their thoughts tend to be vague and erratic, and they believe that they are able to read thoughts.

Timorous Schizotypal
People who belong to his subtype are usually suspicious, wary and watchful. This subtype has avoidant and negativistic features, so timorous schizotypals are cautios and reserved. They also isolate themselves from others and deliberately obstruct and remove their own thoughts.

©PDChat 2013

References:

Schizotypal Personality Disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)
Schizotypal Personality Disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
Millon, Theodore (2006). "Personality Subtypes Summary”. The Official Website for Theodore Millon, Ph.D., D.Sc.. DICANDRIEN, Inc. http://millon.net/taxonomy/summary.htm.

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