Table of Contents:

  1. Introduction
  2. Features of StPD
  3. Schizotypal personality style vs disorder
  4. StPD vs Schizotypal Disorder
  5. Resources & FAQs

Schizotypal Personality Disorder

Schizotypal personality disorder (StPD) prototypic description:

Schizotypals are eccentric, disorganised people whose emotions and speech are strange and blunted. Their strange beliefs are associated with ideas of reference and magical thinking, but don't extend to full-blown psychosis. It's not uncommon for schizotypals to be misdiagnosed as being autistic.

StPD is part of the schizophrenic spectrum, and is a schizotaxic PD. It may develop into schizophrenia or delusional disorder (premorbid).

Features of StPD

  • Triggering Event(s): Close relationships
  • Behavioral Style: Eccentric, bizarre; strange speech; struggles with work and school and often become drifters and wanderers; avoids long-term commitment and looses touch with society’s expectations; dissociative
  • Interpersonal Style: Loners; socially anxious, apprehensive, suspicious and paranoid, which doesn’t fade as they get to know people; tends to live on the margins of society and relationships; often choose jobs with minimal social interaction that are usually below their skill level; indifferent to social norms
  • Cognitive Style: Scattered; obsessive and tends to ruminate; superstitious, bizarre fantasies; vague ideas of reference (thinking things are about them when they’re not, e.g. someone laughing is directed at them) and magical thinking (thinking they caused something to happen by thinking about it); dissociative
  • Affective Style: Cold, humourless, aloof; difficult to engage with; suspicious and mistrustful; hypersensitive; may react inappropriately for the situation
  • Temperament: Passive (schizoid subtype); fearful (avoidant subtype)
  • Attachment Style: Fearful-dismissing
  • Parental Injunction: “You’re a strange bird.”
  • Self-View: Different than other people
  • World-View: Life is strange and unusual; others have special magic intentions, so they are curious but also cautious when interacting with the world
  • Maladaptive Schemas: Alienation; abandonment; dependence; vulnerability to harm
  • Optimal Diagnostic Criterion: Thinking, speech, behaviour, or appearance that is odd, eccentric, or peculiar

Subtypes: Insipid; Timorous (Millon)

Often comorbid with: anxiety disorders, dissociative disorders, somatic disorders, brief psychotic disorder, schizophreniform disorder, delusional disorder, schizophrenia, AvPD, SzPD, PPD, BPD

Often confused with: other psychotic disorders, autism & other neurodevelopmental disorders, substance abuse, SzPD, AvPD, PPD, BPD (Millon), NPD

Schizotypal Personality Style vs Disorder
Style Disorder
Tend to be tuned into and sustained by their own feelings and beliefs. Ideas of reference; suspicious or paranoid ideation; inappropriate or constricted affect.
Keen observation of others, and are particularly sensitive to how others react to them. Excessive society anxiety, e.g., extreme discomfort in social situations involving unfamiliar people.
Tend to be drawn to abstract and speculative thinking. Odd beliefs or magical thinking, influencing behavior and inconsistent with subculture with norms, e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense.”
Receptive and interested in the occult, extrasensory, and the supernatural. Unusual perceptual experiences, e.g., illusions, sensing the presence of a force or person not actually there (e.g., “I felt as if my dead mother were in the room with me”).
Tend to be indifferent to social convention, and lead interesting and odd unusual lifestyle. Odd or eccentric behavior or appearance, e.g., unkempt, unusual mannerisms, talks to self, speech.
Usually are self-directed and independent, requiring few close relationships. No close friends or confidants (or only one) other than first-degree relatives.

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Differences between Schizotypal Personality Disorder and Schizotypal Disorder

In the DSM, Schizotypal Personality Disorder is classed as a personality disorder first and a schizophrenic spectrum disorder second.

In the ICD-11, Schizotypal Disorder (SD) is classed as a schizophrenic spectrum disorder.

Both diagnoses include:

  • Ideas of reference
  • Odd beliefs
  • Magical thinking
  • Unusual perceptual experiences
  • Odd thinking & speech
  • Suspiciousness & paranoia
  • Restricted or inappropriate affect (emotional expressiveness)
  • Eccentric appearance & behaviour
  • Poor social skills
  • Social withdrawal, lack of close friends

Schizotypal Personality Disorder explicitly includes social anxiety, which isn’t part of the SD criteria.

Schizotypal Disorder explicitly includes obsessive rumination (thinking about the same topic over and over), which isn’t part of the StPD criteria.

In the ICD-11, as a psychotic disorder, clinicians can add symptoms to a Schizotypal Disorder diagnosis:

  • positive psychotic symptoms,
  • negative psychotic symptoms,
  • depression,
  • mania,
  • psychomotor symptoms,
  • and cognitive symptoms.

The DSM acknowledges the presence of depression and anxiety in StPD, but doesn’t include any other symptom manifestations other than the criteria.