Abnormal Psychology

586 CHAPTER 13

°ideas of reference, in which the individual interprets ordinary events to have

particular meaning for him or her (a milder form of delusions of reference, de-

scribed in Chapter 12)

° suspiciousness or paranoid ideation, which consists of paranoid beliefs that are

less entrenched than paranoid delusions

• Interpersonal
  ° no close friends because of a preference for being alone
  ° constricted affect, showing only a narrow range of emotions
  ° social anxiety that arises because of a general suspiciousness about other people
  ° suspiciousness or paranoid ideation about other people


• Disorganized
  ° odd/eccentric behaviors, such as wearing mismatched or unkempt clothing,
  avoiding eye contact, or being unable to make conversation
  ° odd speech, such as being overly vague or elaborate or using words idiosyncrati-
  cally (as in “My co-worker isn’t talkable”)

IK, in Case 13.4, had symptoms that represent all three groups highlighted in

Table 13.8. Additional facts about schizotypal personality disorder are listed

in Table 13.9.

Table 13.8 • DSM-IV-TR Diagnostic Criteria for

Schizotypal Personality Disorder

A. A pervasive pattern of social and interpersonal defi cits 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 fi ve (or more) of the following:

(1) ideas of reference (excluding delusions of reference)

(2) odd beliefs or magical thinking that infl uences 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)

(3) unusual perceptual experiences, including bodily illusions

(4) odd thinking and speech (e.g., vague, circumstantial, metaphorical, overly elaborate,

or stereotyped)

(5) suspiciousness or paranoid ideation

(6) inappropriate or constricted affect

(7) behavior or appearance that is odd, eccentric, or peculiar

(8) lack of close friends or confi dants other than fi rst-degree relatives

(9) excessive social anxiety that does not diminish with familiarity and tends to be associated

with paranoid fears rather than negative judgments about self.

B. Does not occur exclusively during the course of schizophrenia [Chapter 12], a mood disorder

with psychotic features [Chapter 6], another psychotic disorder [Chapter 12], or a pervasive

developmental disorder [Chapter 14].

Note: Cognitive-perceptual symptoms are in green, interpersonal symptoms are in purple, and disorganized

symptoms are in orange. Note also that Criterion A5 is considered to be both a cognitive-perceptual symptom and an

interpersonal symptom.

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders,

Text Revision, Fourth Edition, (Copyright 2000) American Psychiatric Association.

ideas of reference (excluding delusions of reference)

odd beliefs or magical thinking that infl uences 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, overly elaborate,

or stereotyped)

behavior or appearance that is odd, eccentric, or peculiar

suspiciousness or paranoid ideationsuspiciousness or paranoid ideation

inappropriate or constricted affect

lack of close friends or confi dants other than fi rst-degree relatives

excessive social anxiety that does not diminish with familiarity and tends to be associated

with paranoid fears rather than negative judgments about self.

CASE 13.4 • FROM THE OUTSIDE: Schizotypal Personality Disorder

IK is a 33-year-old man who had both schizotypal personality disorder and obsessive-

compulsive disorder (OCD) for at least 17 years.

His schizotypal symptoms included poor interpersonal relatedness, ideas of reference

(not delusional), social anxiety, unusual perceptual experiences (such as seeing things in