T3 - Schizotypal Personality Disorder

For our second to last installment in the Personality Disorder Parade, we're going to look at Schizotypal Personality Disorder. (It's pronounced skitso-TYPE-al for those who were wondering.)

Obviously, it shares a similar base word with the word schizophrenia. The Greek origin of "schizo" is "to split," and a person with Schizotypal PD experiences some of the same altered perceptions as someone with schizophrenia, just not usually for as long a duration.

The dominant feature of Schizotypal is a pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships. They also have cognitive or perceptual disturbances and eccentricities of behavior. There are nine symptoms associated with this personality disorder, and a person has to have five or more of them to be diagnosed with it. So let's get started!

1) They often have ideas of reference, meaning that they'll interpret some casual event of happening as having particular meaning for specifically for them. (This is different from delusions of reference in which they hold the belief with delusional conviction.)

2) They may be superstitious of overly preoccupied with paranormal phenomena (and no cracks about me liking vampires, folks). Usually these preoccupations are outside the norms of their culture, like thinking they have special powers to read thoughts or some sort of sixth sense to see events before they happen. More commonly, the might believe in witches and aliens, focused on magic control and ritual. (They might think that because their spouse cooked spaghetti that night it was adirect result of them having thought only an hour or so ago that they would like spaghetti.)

3) They may have perceptual alterations, like hearing their name being murmured or sensing another person's presence. This can be a transient psychotic episode, but usually it only lasts a few minutes to a few hours, insufficient in duration to have full-blown Brief Psychotic Disorder or something else.

4) Their speech patterns might be unusual with how they phrase words or construct their sentences. It might be "loose"speech, where the thoughts just don't seem to go together, and it can be vague or chasing rabbits, but they don't actually come across as incoherent (where they string words together in no sense whatsoever--called word salad). These are the people that you sorta look at your friend after you hear them say something and go, "Huh?"

5) They are often suspicious and may have paranoid ideation, which means that think people are out to get them, or get the best of them, or undermining them. These are very cautious, distrustful people.

6) They often appear inappropriate and stiff because they usually can't use the full range of emotional interpersonal cues that are required for successful relationships.

7) They are often considered to be odd or eccentric because of unusual mannerisms and weird, unkempt manner of dressing. They don't follow the mold, and definitely march to their own drummer. They may pay very little attention to the usual social conventions of chatting over the water cooler at work, or happy hour banter. They usually don't look put together quite right.

8) They experience interpersonal relatedness as problematic and are uncomfortable relating to other people. They usually have no friends or confidants other than first-degree relatives.

9) They are often anxious in social situations, in particular those involving unfamiliar people. They honestly prefer to keep to themselves, because they don't have to worry about fitting in. this anxiety never really goes away, even after spending several hours in a situation, because their anxiety revolves around a suspiciousness of other peoples' motives.

You've got to consider a person's cultural background, in particular about religious beliefs and rituals. For example, a person into voodoo or speaking in tongues or the "evil eye" phenomenon, or sixth sense, shamanism, mind reading and magical beliefs...all to the uninformed outsider might look "crazy" or "odd," but for the person practicing them, not be eccentric at all.

People who develop this PD, commonly thought to be about 3% of the population, are usually solitary in childhood, with poor peer relationships, social anxiety and underachievement in school. They usually have bizarre fantasies and peculiar thoughts, which often serve to isolate them. They usually attract teasing.

People with this PD can go on to develop other disorders, namely schizophrenia or Delusional Disorder or some other similar type problems, but only a small percentage have this happen. Usually, the course of the disorder is pretty stable. Antipsychotics can help, as can talk therapy, but this is a long-term, chronic illness.

Q4U: Not to end on a bummer note, so let's have a discussion about how this type of person could really liven up a novel or movie. Do you have any examples from movies or books of someone who might fit this description? Think side-kicks and the like. I'll go first. In Failure to Launch, Zooey Deschanel played Kit, Sarah Jessica Parker's eccentric roommate. She dressed funny, usually brought the comic relief in any scene she was in, was obsessed with the bird outside the window, thinking it was there only to annoy just her. She might not have Schizotypal full-blown, but you get the idea. Who else?