Schizotypal Personality Disorder is made up of a pattern of social and interpersonal deficiencies. Individuals with this disorder experience profound discomfort in intimate and close relationships. They also have distortions in their perception and thoughts. They are typically eccentric and odd.
Causes of Schizotypal Disorder
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.
Symptoms of Schizotypal Disorder
People who are diagnosed as schizotypal often exhibit a blend of symptoms that are seen in schizophrenia, narcissistic personality disorder, histrionic personality disorder, and social anxiety disorder (Milles).
Traits of Schizotypal Personality Disorder typically appear by early childhood, but are usually recognized by early adulthood and present in a variety of ways, as indicated by five (or more) of the following criteria in the DSM IV:
- Incorrectly interpreting events, facial expressions, or casual conversations
- Magical Thinking
- Distorted perceptions of reality and themselves
- Eccentric thinking and speech, such as rambling, odd vocabulary, and confusing syntax
- Paranoid thoughts
- Not expressing emotions
- Odd behavior and lack of cleanliness and personal hygiene
- An inability to form interpersonal relationships
- Severe social anxiety (MindDisorderStaff)
Diagnosis of Schizotypal Disorder
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.
The issue that professionals face in diagnosing schizotypal disorder is that many of these symptoms are among the criteria for other mental illnesses. For example, people who are schizotypal can experience brief psychotic episodes with delusions and hallucinations, similar to schizophrenia but for the fact that they happen less frequently and are less intense. The idea of having trouble forming interpersonal bonds and misinterpreting facial expressions and events can also lend itself to a diagnosis of borderline personality disorder, but in schizotypal patients it is more severe and inhibiting. Histrionic personality disorder shares the criteria of having magical thoughts (superstitious beliefs in ‘powers’) that are outside of social norms. Severe social anxiety can be interpreted as social anxiety disorder, but for the idea that schizotypal individuals are anxious due to paranoia instead of experiencing anxiety because of their physical appearance (Milles).
Schizotypal personality disorder is believed to affect about 3 percent of the general population (MindDisordersStaff). Usually, symptoms appear in the teen years and can result in the development of other psychiatric problems, such as depression, anxiety disorders, and social problems (Mayo Clinic Staff). It is important for individuals to get help as soon as possible, because treatment for this mental illness becomes more difficult as the affected person ages.
Tools that professionals use to diagnose schizotypal personality disorder include the Minnesota Multiphasic Personality Inventory, the Millon Clinical Multiaxial Inventory, the Rorschach Psychodiagnostic Test, and the Thematic Apperception Test. Even with these, this is a difficult diagnosis for clinicians to make because it is largely based on observations, self-reporting, and symptoms that are shared with numerous other mental illnesses and psychiatric disorders.
Treatment of Schizotypal Disorder
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.