Understanding Schizotypal Personality Disorder

personality disorder

A personality disorder is a mental condition that is chronic and pervasive throughout one’s life.  It is identified by an unhealthy pattern of thinking, interpreting events, behaving, and reacting.  It causes difficulties for people in relationships, work, and general interactions with others.  There are 10 personality disorders recognized in the DSM-5 (Diagnostic Statistical Manual of Mental Disorders).  Personality disorders can be difficult to treat because individuals who experience them may not recognize the dysfunction in their thinking and behaviors.

Schizotypal Personality Disorder falls in one of the 3 Clusters of these disorders. Cluster A Personality Disorders are defined by odd or eccentric thinking or behavior, and include paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder.

Schizotypal Personality Disorder is an uncommon psychological condition and falls on the Schizophrenia continuum. Key symptoms include distorted thinking and social awkwardness and isolation.  They experience perceptual and cognitive distortions, eccentric behaviors and odd beliefs.  Because individuals with Schizotypal Personality Disorder experience extreme social discomfort, mental health experts hypothesize this is related to deep fears of interacting with people.

In the American Psychiatric Association‘s DSM-5, schizotypal personality disorder is defined as 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 behavior, beginning by early adulthood and present in a variety of contexts.”

According to the DSM-5, at least five of the following symptoms must be present: ideas of reference, strange beliefs or magical thinking, abnormal perceptual experiences, strange thinking and speech, paranoia, inappropriate or constricted affect, strange behavior or appearance, lack of close friends, and excessive social anxiety that does not abate and stems from paranoia rather than negative judgments about self.

It is considered a thought disorder, since key symptoms include paranoid ideation, cognitive distortions, and disconnected insight.  It can often be recognized by others because individuals with the disorder demonstrate odd, eccentric behaviors and a lack of understanding of how their actions impact others. They may dress in unusual ways or demonstrate peculiar behaviors.

It can have similar symptoms to Schizophrenia, yet is considered less severe.  Individuals with Schizotypal Personality Disorder can experience symptoms of psychosis, yet the episodes are often shorter, less extreme and intense, or less frequent.  One distinction between the disorders is that those with Schizotypal symptoms can gain awareness of their psychosis or delusions, where those with Schizophrenia are unable to separate such symptoms from reality.

While it may be easily identified by others, it is a difficult disorder to treat. Individuals with Schizotypal symptoms often underestimate the dysfunction and impact of their social isolation and maladaptiveness perceptual distortions.  They will rarely seek treatment on their own for these symptoms.  Individuals tend to be diagnosed through the treatment of co-morbid mental health disorders or other presenting health issues.  Individuals who are treated for Schizotypal Personality Disorder can be prescribed antipsychotic medications used to treat Schizophrenia.  Symptoms can be reduced through medication and therapeutic treatments. However, due to the nature of the thought disorder symptoms, compliance with medication can also be a challenge unless individuals are in a controlled treatment setting.

If you believe a family member or friend is suffering from Schizotypal Personality Disorder, reach out and find help. Mental health professionals can guide friends and families through the process of diagnostic and treatment options.

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Karen Doll, Psy.D., L.P

Karen Doll, Psy.D., L.P

Karen Doll has been a Licensed Psychologist in the Twin Cities for 20 years, working in organizational consulting. She leverages her education in Clinical Psychology with her leadership assessment expertise in her practice. She is an executive coach focusing on helping people maximize their potential.
Karen Doll, Psy.D., L.P

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