Simone Hoermann, Ph.D., is a Psychologist in private practice in New York City. She specializes in providing psychotherapy for Personality Disorders, Anxiety, and Depression
People with Schizotypal Personality Disorder (SPD) tend to be very uncomfortable with other people and therefore often only have a few close relationships. Based on the definition in DSM IV-TR, they can come across as reserved and distant, as well as odd and eccentric. People with SPD frequently experience unusual perceptions, for instance, noticing flashes of light or seeing objects or shadows in the corner of their eyes and then realizing that nothing is there. They often have a hard time trusting other people, even when they get to know them or are close to them. People with Schizotypal Personality Disorder often dress, talk, or behave in ways that are unusual- for instance, talking in metaphors, or wearing a winter coat in the middle of the summer. They may have spiritual or religious beliefs that do not fit into their culture and that would be considered extreme by people in their environment, for instance, about telepathy, superstitions, or a sixth sense.
Schizotypal Personality Disorder can look somewhat similar to Schizophrenia, a severe mental illness that has to do with perceiving reality in a way that is extremely different from other people. Symptoms of schizophrenia include hallucinations, for instance, seeing or hearing things that are not actually there, as well as delusions, which means having beliefs that are irrational or not true. Examples of delusions would be the belief that the television is sending special messages, or that someone is controlling one’s thoughts. The expression of emotions can be impacted, too, in that often people with schizophrenia can appear like they are withdrawn and emotionally expressionless. Moreover, the way someone who has schizophrenia thinks and speaks can be affected. Thoughts can come and go rapidly, attention and concentration can be affected, and the thoughts can come out on a way of speaking that can be disorganized and jumbled. Depending upon the specific combination of these symptoms, someone with schizophrenia can present as withdrawn, lacking in motivation, and disengaged, or, alternatively, as agitated and preoccupied.
Emil Cocarro and Larry Siever, who have done a lot of research on schizotypal personality disorder and its genetic and biological underpinnings, quote studies on families with schizophrenia showing that relatives of people with schizophrenia are at increased risk of having Schizotypal Personality Disorder. There is some indication that there is a strong genetic relation between the two disorders, since some of the symptoms and abnormal patterns in brain chemistry, brain structure, and brain functioning found in people with schizophrenia can also be found in people with Schizotypal Personality Disorder. Some experts argue that schizotypal personality disorder might be a mild form of schizophrenia, whereas other researchers suggest that there is evidence that schizotypal personality disorder shares some characteristics with schizophrenia and that there are similar deficits in certain areas, but that there are also important differences in other brain functions that prevent people with schizotypal personality disorders from developing schizophrenia.
It is difficult to estimate how common Schizotypal Personality Disorder is, because people with SPD tend to be socially withdrawn, which is why they may not seek help as frequently as other people, so we may not see people with SPD in our practices and clinics, and they may be less likely to participate in research studies than other people. Estimates of how prevalent SPD is in the community range from 1% to 3% of the population.
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