Personality is understood as a pattern of behaviour and thinking that is relatively stable throughout the life cycle and across time and situations that provides us with behavioural preference patterns and that influences the way we understand and act in the world and ourselves.

However, on some occasions the personality that is forged throughout the development is not structured in an adaptive and functional way with respect to the environment in which it is lived, which is a difficulty in limiting one’s own performance and reducing the possibilities of the subject in addition to producing frustration and suffering.

For example, it may make it difficult to establish intimate relationships, to adapt behaviour to the context or to present ways of thinking and acting that are imaginative and removed from reality. This is what happens in schizotypal personality disorder .

Schizotypal personality disorder

Schizotypal personality disorder is understood as the set of relatively consistent patterns of behaviour and thought throughout the subject’s life and through the situations in which the individual suffering from it manifests a pattern of interpersonal deficiencies that make it difficult for him/her to have close personal relationships while maintaining a considerable amount of eccentric behaviour and in which various cognitive alterations occur.

Schizotypal personality disorder is classified as a severe personality disorder , which would fall under cluster A. It is a severe difficulty for the sufferer, as it makes it difficult to maintain social relationships and can cause feelings of helplessness and emptiness. It can also make it difficult for them to focus on specific objectives and present episodes of de-realisation and depersonalisation. There is a limited and decontextualized affectivity, and sometimes anhedonia.

People with schizotypal personality often hold beliefs and ideas that are considered to be fantasy or strange. Paranoid and self-referential beliefs stand out, although they do not usually reach the level of delirium. It is also common to have magical and superstitious beliefs and thinking. It is not uncommon for them to experience perceptual alterations, such as illusions and images. Their behavior may not be appropriate to the social context or situations they are experiencing.

Your social skills

The social abilities of people with schizotypal personality disorder are limited, manifesting extravagant behaviour and a high level of social anxiety that remains despite frequent and familiar contact. This is largely produced by paranoid ideas that make them very suspicious of the behaviour of others.

In addition, these people are cold and distant and tend to isolate themselves . However, although not in all cases their isolation is due more to anxiety and distrust than to a lack of social interest.

Their language also presents particularities , since in spite of maintaining logic and coherence they tend to use striking terms and to have a tangential discourse that does not go directly to the question they want to raise. The use of metaphors and circumlocutions is frequent.

Causes of the disorder

As a personality disorder, schizotypal personality disorder is a pattern of thinking and behavior that is largely learned and acquired throughout life, despite the fact that there is a genetic predisposition to manifest certain characteristics . However, it must be taken into account that depending on the context this predisposition may not be expressed, so that the environment has a great importance in its appearance.

Studies of biological elements that may explain this disorder seem to indicate that schizotypal personality disorder is more common in relatives of schizophrenic patients , suggesting that it is possible that genetic and/or educational aspects may cause this type of personality. The presence of elements similar to schizophrenia has also been reported, such as the presence of difficulties in the ocular follow up of movement or the presence of low concentrations of platelet monoamine oxidase.

The ascending reticular system and the limbic system are parts of the brain that have been attempted to link to the etiology of this disorder. The presence of hypersensitivity to humiliation or disapproval by peers and/or reference figures during development are also mentioned as elements that may trigger this disorder along with poor stimulation.

Treatment

The treatment of a personality disorder is particularly complex, since involves altering the way a person sees the world, thinks and acts . Personality is a set of traits that tend to remain more or less stable throughout life, making it difficult to change.

However, there are methods that can serve this purpose. For schizotypal personality disorder the type of treatment usually applied is cognitive-behavioral , although psychodynamic therapy has also been successfully employed.

First of all, it must be taken into account that individuals with this type of characteristics tend to be very suspicious and prone to paranoid thinking , so it is essential to establish a very good therapeutic relationship based on trust and respect in order to reduce suspicions and possible conflicts in order to work efficiently with the situation.

As far as the presence of cognitive distortions is concerned, the treatment in question involves proposing to the patient the performance of behavioural experiments that prove or distort his beliefs, so that he can evaluate his thoughts.

Aspects such as the aforementioned suspicion or magical thinking can be greatly reduced, with direct confrontation of beliefs not being effective. It is also necessary to make them reflect on their way of thinking and acting and the damage they cause. Thus, it is common to employ techniques such as cognitive restructuring .

Intervention on personal relationships

Another crucial aspect is social skills training to alleviate their interpersonal difficulties. The use of group therapy is recommended and techniques such as psychodrama and social behaviour modelling can be very useful to improve aspects such as the adaptation of behaviour to the context and the development of communication.

In addition, this allows the existence of a feedback of the behavior of each subject from the rest of the participants. It is also useful to contribute to the improvement of their language and expressiveness, proposing the use of summaries in case of circumstance.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Millon, T. (1999). Personality disorders: beyond DSM IV. Masson: Barcelona.
  • Olivencia, J.J. and Cangas, A.J. (2005). Psychological treatment of schizotypal personality disorder. A case study. Psicothema, 17 (3). 412-417.
  • Quiroga, E. & Errasti, J. (2001). Effective psychological treatments for personality disorders. Psicothema, Vol. 13, no. 3, pp. 393-406. University of Almería and University of Oviedo.
  • Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Román, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.