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Thursday, December 10, 2009

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?

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Maureen said...

This is such a great site! Thank you, Jeannie.

With the schizotypal person, I wonder how long you could go on after meeting someone like this and not notice the disorder. Would it be immediately obvious or might it take you a while? And when you say not quite "put together" do you mean sloppy or just not a snappy dresser? What would be the reason for their inability to present themselves well - lack of motivation or resources?

Would it be unusual to find someone with this disorder in a professional occupation? Does underperformance in school generally lead them to stay in the lower employment strata - thus adding to their odd appearance?

(I can't wait to hear some of the character examples from my fellow posters, since I can't think of any myself at the moment.)

Diane said...

Whew! Sounds tiring.... :O)

Jeannie Campbell, LMFT said...

maureen - those are some great questios. you wouldn't be around this person five minutes and not think something was wrong. it's noticeable immediately. they don't look put together according to normal social standards. so their dress could be ragged, torn, stained, etc., and they just don't the lack of motivation reason comes closer to the truth. what you said about underachievement in school leading to staying a lower employment strata just might be dead on. something researchers have to really be careful with is causation v. causality, meaning they have to determine if two things exist because one prompted the other or if they arrived separately. what you mentioned could be either, and i'm just not sure....but it makes sense to think of it that way.

thanks so much for stopping by. glad you like the site...and hope to see you more often. i like questions thta make me think. :)

diane - i imagine it does. :)

Jm Diaz said...

holly Moses, I'm a Schizotypaler-er-r.
however, I excelled in school, which makes me disagree with this point: "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."

Along those same lines, this is where I draw most of my inspiration for writing. I LOT of voices up there, just begging to be heard. :)

And I still LOVE you site!

Sherrinda Ketchersid said...

Hhhhmmmm, how about Bill Murray in What About Bob? He had major issues (but maybe more OCD). Oooo, and that guy in A Beautiful Mind. Oh, and Nicolas Cage in Matchstick Men...that may be more OCD too. Hhmmm, I can't think beyond that! lol

Jeannie Campbell, LMFT said...

Jm...there are exceptions to every rule. that's why you only have to have a certain number of criteria to be diagnosed...not all nine. :)

sherrinda - i applaud your efforts! seems you have focused on OCD a bit more....but keep that in mind. next week's last personality disorder is OCPD. check it out.

SLeever said...

Just stumbled upon this blog while doing a bit of research for my self-portrait photograph set depicting each personality disorder (just for fun; personality disorders have always fascinated me). Regarding movie characters and such, I've always thought Amelie Poulain in the French film 'Amelie' depicted some of the behavioral characteristics of a Schizotypal personality. She's shy and awkward, she lives most of her life through fantasies (the magical thinking), she has odd/interesting hobbies, interests, and thoughts and does some odd things, her clothing is a bit eccentric/shabby, and she's very uncomfortable in social interactions. Maybe not full-blown schizotypal, but could have definitely been inspired by it.

Jeannie Campbell, LMFT said...

I haven't seen Amelie, SLeever, so I'm not sure. Sounds like she's definitely got the traits, though.

Anonymous said...

The 40 year old virgin was schizotypal

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.