There are many similarities between the Schizotypal and
Schizoid personalities. Most notable of the similarities is the
inability to initiate or maintain relationships (both friendly and
romantic). The difference between the two seems to be that those labeled
as Schizotypal avoid social interaction because of a deep-seated fear of
people. The Schizoid individual simply feels no desire to form
relationships, because they quite literally see no point in sharing
their time with others.
An important distinction is that people with Schizoid
Personality don't typically experience the perceptual distortions,
paranoia or illusions typical of Schizotypal Personality or the
psychotic episodes of Schizophrenia.
Based on family inheritance and genetic studies,
Schizophrenia, Schizotypal Personality Disorder and Schizoid PD are
considered to be part of a "schizophrenic spectrum" of mental illness.
Although Schizophrenia is categorized as a Psychotic Disorder and both
Schizoid and Schizotypal are Personality Disorders, all three share
several symptoms, including avoidance of social relations and flat
emotional affect. An important distinction is that people with Schizoid
Personality don't typically experience the perceptual distortions,
paranoia or illusions typical of Schizotypal Personality or the
psychotic episodes of Schizophrenia.
Although listed in the
DSM-IV-TR on Axis II, schizotypal personality disorder is widely
understood to be a "schizophrenia spectrum" disorder. If you
look at the relatives of individuals who have been diagnosed
with schizophrenia, rates of schizotypal PD will be much higher
in those individuals than in the relatives of people with other
mental illnesses or in the relatives of community controls with
no mental illness. Technically speaking, schizotypal PD is an
"extended phenotype" that helps geneticists track the familial
or genetic transmission of the genes that are implicated in
schizophrenia[2]
There are dozens of studies showing that individuals with
schizotypal PD look similar to individuals with schizophrenia on
a very wide range of neuropsychological tests. Cognitive
deficits in patients with schizotypal PD are very similar to,
but somewhat milder than, those for patients with schizophrenia.
Social / Environmental
People with schizotypal PD,
like patients with schizophrenia, may be quite sensitive to
interpersonal criticism and hostility, and there is now evidence
to suggest that parenting styles, early separation and early
childhood neglect can lead to the development of schizotypal
traits.
It has been speculated that
the schizotypal individual develops a fear of, strong objection
to, or incapacity for social interaction, due to the sum of
their past social experiences being negative in nature. That as
infants they do not learn how to interact with others, and as
children and adults this inability quickly makes them a target
for other people. Eventually, the individual learns (most often
unconsciously) to see people as harmful and a source of
negativity, suffering and ostracization. This leads to the
development of "ideas of reference," in which the schizotypal
individual believes that events are of special relevance to them
or that benign events are somehow related to them (e.g., sees
two people laughing and believes that the people are laughing at
them). The individual may realize that their ideas of reference
are irrational, but maintains them nonetheless. This exacerbates
the individual's social anxiety, causing them to skew away from
society and withdraw into their own world.
Schizotypal personality
disorder is a mental disorder related to schizophrenia. Symptoms
of schizotypal personality disorder are actually so similar to
schizophrenia that some researchers speculate the personality
disorder is actually a mild variety of schizophrenia.
Like most types of personality
disorders, the cause of schizotypal personality disorder is
unknown. Researchers have suggested that the personality
disorder is closely related to schizophrenia, and schizotypal
personality disorder is more common in families with a history
of schizophrenia. This connection has suggested a genetic basis
for schizotypal personality disorder, but definitive proof of a
genetic cause has yet to be found.
Abnormal behavior patterns and
beliefs vary in severity among people with schizotypal
personality disorder. Severe cases may closely resemble
schizophrenic delusions, including bizarre claims and paranoia
(believing that dogs are government agents, for instance, or
that news reporters are capable of mind control).
The prevalence of schizotypal personality
disorder is estimated to range from 0.6% to 5.1%, with a median
rate of about 3% of the nonclinical population. In a clinical
sample of psychiatric patients, the prevalence ranged from 2.0%
to 64%, with a median prevalence of 17.5%. This wide variation
in prevalence rates may reflect the controversy surrounding the
classification of schizotypal disorder as a separate personality
disorder, instead of a component of schizophrenia.
Treatment for schizotypal
personality disorder may be with a combination of medication and
one or more of several types of therapy:
Medications:
There's no specific drug treatment for the disorder;
however, doctors may prescribe antidepressant or
antipsychotic medications to help alleviate associative
conditions such as anxiety, depression or other mood
disorders. For example, treatment for distorted thinking may
be with the prescription medications risperidone (Risperdal)
and olanzapine (Zyprexa).
Psychotherapy:
Building a trusting rapport in therapy may help people with
schizotypal personality disorder contradict the mistrust or
discomfort they have with developing interpersonal
relationships.
Behavior therapy:
People with schizotypal personalities often need to learn
specific interpersonal skills and new behaviors, as they
often have difficulty responding appropriately to social
cues. For example, they might learn to express appropriate
feelings or adjust facial expressions and voices in reaction
to certain stimuli.
Cognitive therapy:
People with schizotypal personality disorder may respond to
exercises that focus on interrupting distortions in thought.
For example, this type of therapy may use reasoning
exercises to clarify social confusion and overcome
self-defeating thoughts, especially in interpersonal
situations.
Family therapy:
Treatment can be more effective when family members are
involved. Seeking professional counseling as a group may
help diminish angry confrontations or emotional distancing
in the home. Family therapy may also offer the affected
person reassurances of a support structure and a boost in
morale.
Until recently, doctors have
generally believed that once a personality disorder has
developed it will last throughout life. However, new research
has suggested that the symptoms of conditions such as
schizotypal personality disorder may improve significantly over
time. Factors that appear most likely to reduce the symptoms of
this disorder include positive relationships with friends and
family as well as a sense of achievement at school, work and in
extracurricular activities.
Researchers believe that these experiences may create a
protective effect by fostering — among other positive traits —
self-confidence, a belief in one's ability to overcome
difficulty and a sense of social support. These findings also
indicate that early interventions such as youth programs that
foster personal achievement and strong community relationships
may help prevent personality disorders in at-risk children. The
earlier these kinds of interventions reach a child in any
challenging situation, the better his or her chances of doing
well.
