Schizotypal Personality Disorder
Schizotypal Personality Disorder is made up of a pattern of social and interpersonal deficiencies. Individuals with this disorders experience profound discomfort in intimate and close relationships. They also have distortions in their perception and thoughts. They are typically eccentric and odd. These traits are usually recognized by early adulthood and present in a variety of ways, as indicated by five (or more) of the following criteria to meet the diagnosis for Schizotypal Personality Disorder in the DSM IV:
- odd beliefs or magical thinking that influences behavior and is inconsistent with cultural or religious norms, bizarre fantasies or superstitious preoccupations
- unusual perceptual experiences,
- odd thinking and speech (vague, circumstantial, metaphorical, over-elaborate, or stereotyped)
- suspiciousness or paranoid ideation
- inappropriate or constricted affect
- behavior or appearance that is odd, eccentric, or peculiar
- lack of close friends or social support
- excessive social anxiety based in paranoid fears as opposed to negative judgments about self
Individuals with this disorder usually distort reality more so than someone with Schizoid Personality Disorder. They also have trouble relating to others and appear to be emotionally distant. They are aware of their disconnection and typically find their social isolation painful. This tends to lead them to eventually develop distorted perceptions about how relationships are formed and maintained. Their odd behaviors, inappropriate social cues and strange beliefs contribute to their isolation. As a result, individuals with schizotypal personality disorder often are labeled as “drifters,” as they typically move seemingly aimlessly from one job or location to the next, failing to form meaningful connections with others as they drift through life.
Causes
In healthy child development, children move through different stages of social and interpersonal awareness and learn to interpret the relationship cues and intentions of others. For individuals with schizotypal personality disorder this social development is impaired, leading to the development of odd beliefs, magical thinking and paranoid delusions.
The exact reason or cause of any personality disorder is unknown. It is thought that perhaps childhood abuse, neglect and stress result in brain abnormalities that may give rise to schizotypal symptoms. Both genetics and environmental circumstances may contribute to the development of this disorder.
A family history of a parent who has schizophrenia or schizotypal personality increases the changes that an individual may also develop the disorder. Environmental factors that may contribute are growing up in a neglectful or abusive home.
Treatment
Personality disorders are some of the most challenging disorders to treat since they are set in the core of an individual and are intertwined with what defines that individual and their self-perceptions. Long term psychotherapy that has the goals of increasing coping skills and relationship skills is thought to be most helpful.
As with other mental conditions like Delusional Disorder and Paranoid Personality Disorder, it is important in psychotherapy that the therapist not directly challenge any delusional or inappropriate thoughts. Instead a warm supportive approach will establish the necessary therapeutic rapport. As with Avoidant Personality Disorder, the individual lacks an adequate social support system and usually avoids most social interactions because of extreme social anxiety. The patient often reports feelings of being "different" and not "fitting in" with others easily, usually because of their magical or delusional thinking.
There is no simple solution to this personality disorder. Social skills training and other behavioral approaches that emphasize the learning of the basics of social relationships and social interactions are often beneficial.