Abnormal Psychology

Personality Disorders 587

Distinguishing Between Schizotypal Personality

Disorder and Other Disorders

Schizotypal personality disorder differs from schizoid personality disorder in that the

former includes cognitive-perceptual symptoms—such as IK’s ideas of reference and

seeing things with peripheral vision that could not be seen with a direct gaze—

and odd behavior. Nevertheless, research suggests that these two disorders may not

be distinct from each other; half of those with schizoid personality disorder are also

diagnosed with schizotypal personality disorder (McGlashan et al., 2000). Some

researchers propose that schizoid personality disorder may simply be a subtype of

schizotypal personality disorder (Raine, 2006).

Schizotypal personality disorder is generally thought of as a milder form of

schizophrenia, and some researchers propose moving this disorder to Axis I, with

schizophrenia (First et al., 2002). Sometimes, it can be diffi cult to determine whether

a person’s symptoms are severe enough to merit a diagnosis of schizophrenia. To

help with diagnosis, clinicians may assess the degree to which patients are convinced

of the reality of their perceptions or beliefs by probing their ability to recognize

other interpretations (Skodol, 2005). When under stress, people with schizotypal

personality disorder may become psychotic for minutes to hours.

Prevalence

• Approximately 2–3% of the general population has schizotypal personality disorder.
  Comorbidity


• Common comorbid Axis I disorders are major depressive disorder, social phobia, and panic
  disorder (American Psychiatric Association, 2000; Raine, 2006).


• Common comorbid Axis II disorders include other Cluster A (odd/eccentric) personality disorders
  (schizoid and paranoid; McGlashan et al., 2000), as well as borderline, avoidant, and obsessive-
  compulsive personality disorders (American Psychiatric Association, 2000; Raine, 2006).
  Onset


• Symptoms arise by early adulthood.


• In childhood and adolescence, symptoms may include social isolation and social anxiety,
  academic underachievement, hypersensitivity, odd fantasies and thoughts, and idiosyncratic
  use of language.
  Course


• Although schizotypal personality disorder most commonly has a stable course, symptoms may
  improve over time for some people (Fossati, Madeddu, & Maffei, 2003). In fact, for almost a
  quarter of patients, symptoms improve to the point where they no longer meet all the diagnos-
  tic criteria (Grilo et al., 2004).


• Among other patients with this disorder the opposite is true: A small percentage go on to
  develop schizophrenia or another psychotic disorder (Grilo et al., 2004).
  Gender Differences


• Schizotypal personality disorder is slightly more common among men than women.
  Source: Unless otherwise noted, the source is American Psychiatric Association, 2000.

Table 13.9 • Schizotypal Personality Disorder Facts at a Glance

the periphery, but not there when viewed directly), constricted affect, and some paranoid

ideation (in particular with regard to police officers, but his father reported that this was

unrealistic).

IK’s social skills deficits were primarily conversation skills, inappropriate affect, poor

assertion skills, and lack of eye contact with the therapist and family members. He was also

prone to aggressive outbursts in the home, often breaking objects due to frustration.

(McKay & Neziroglu, 1996, pp. 190–191)