Schizophrenia, schothymia, schizoid, schizotypal, schizoaffective, schizophreniform… I’m sure the vast majority of psychologists and psychology students are familiar with these terms. But… what is schizotypy? Is it a new disorder? Is it a personality disorder? What’s different about it?

In this article we will go into the interesting concept of schizotypy through a brief historical analysis of the term, and we will see how it is more a personality trait than a mental disorder of the psychotic sphere.

What is schizotypy?

Leaving aside the categorical view of psychosis (whether one has psychosis or not), schizotypy is a psychological construct that aims to describe a continuum of trait s and personality characteristics, along with experiences close to psychosis (specifically schizophrenia).

It should be clarified that this term is not currently used and is not included in either the DSM-5 or the ICD-10 , as these manuals already contain personality disorders related to it, such as Schizotypal Personality Disorder. Schizotypy is not a personality disorder, nor has it ever been, but a set of personality traits that form a continuum of degree.

Brief historical review of schizotypy

The categorical conception of psychosis is traditionally related to Emil Kraepelin (1921), who classified the different mental disorders from the medical model . This world-renowned German psychiatrist developed the first nosological classification of mental disorders, adding new categories such as manic-depressive psychosis and early dementia (today known as schizophrenia thanks to Educen Bleuler, 1924).

Until recently, the diagnostic systems that psychologists have used over the years maintained Kraepelin’s categorical vision, until the arrival of the DSM-5 , which, despite the criticism it has received, provides a rather dimensional point of view.

Meehl (1962) distinguished in his studies between schizotypy (personality organization that had the potential to decompensate) and schizophrenia (the full-blown psychotic syndrome). Rado’s (1956) and Meehl’s approach to schizotypal personality has been described as the clinical antecedent of the schizotypal personality disorder we know today in the DSM-5, far from the nomenclature of schizotypy.

However, we owe the term schizotypy in its entirety to Gordon Claridge, who, together with Eysenck, advocated the belief that there was no clear dividing line between madness and “sanity”, that is, they advocated a conception closer to the dimensional than to the categorical. They believed that psychosis was not an extreme reflection of symptoms, but that many characteristics of psychosis could be identified to varying degrees within the general population.

Claridge called this idea schizotypal , and suggested that it could be broken down into several factors, which we will address below.

Factors of Schizotypy

Gordon Claridge was devoted to studying the concept of schizotypy through the analysis of strange or unusual experiences in the general population (without diagnosed psychotic disorders) and the symptoms grouped in people with diagnosed schizophrenia (clinical population). Assessing the information carefully, Claridge suggested that the personality trait of schizophrenia was much more complex than it initially appeared, and devised the breakdown into four factors that we will now look at:

  • Unusual experiences: it is what we know today as delusions and hallucinations . It is the disposition to live unusual and strange cognitive and perceptive experiences, such as magical beliefs, superstitions, etc.
  • Cognitive disorganization : the way of thinking and thoughts become totally disorganized, with tangential ideas, incoherence in discourse, etc.
  • Anhedonia introvert : Claridge defined it as introverted behavior, emotionally flat expressions, social isolation, decrease in the ability to feel pleasure, either in general or on a social and physical level. It is what corresponds today to the criterion of negative symptoms of schizophrenia.
  • Impulsive non-conformity: this is the presence of unstable and unpredictable behaviour with respect to socially established rules and norms. Non-adaptation of behaviour to imposed social norms .

What does it have to do with psychosis and mental illness?

Jackson (1997) proposed the concept of “benign schizotypy”, when studying that certain experiences related to schizotypy, such as unusual experiences or cognitive disorganization, were related to having greater creativity and capacity to solve problems , which could have an adaptive value.

There are basically three approaches to understanding the relationship between schizophrenia as a trait and the diagnosed psychotic illness (the quasi-dimensional, the dimensional and the fully dimensional), although they are not without controversy, since in studying the characteristic features of schizotypy it has been observed that it does not constitute a homogeneous and unified concept, and therefore the conclusions that can be drawn are subject to many possible explanations.

All three approaches are used, in one way or another, to reflect that schizophrenia constitutes a cognitive and even biological vulnerability for the development of psychosis in the subject. In this way, the psychosis remains latent and would not be expressed unless triggering events (stressors or substance use) occurred. We are going to focus mainly on the totally dimensional and dimensional approach, since they make up the latest version of Claridge’s model.

Dimensional approach

It is heavily influenced by Hans Eysenck’s theory of personality. It is considered that diagnosable psychosis lies at the extreme limit of the gradual spectrum of schizotypy , and that there is a continuum between people with low and normal levels of schizotypy and those with high levels.

There has been much support for this approach because high scores in schizotypy can fit within the diagnostic criteria of schizophrenia, schizoid personality disorder, and schizotypal personality disorder.

Fully dimensional approach

From this approach schizotypy is considered a dimension of personality, similar to Eysenck’s PEN model (Neuroticism, Extraversion and Psychoticism). The “schizotypal” dimension is normally distributed throughout the population, that is, each and every one of us could score and have some degree of schizotypalism, and that would not mean that it would be pathological.

In addition, there are two graded continuums, one dealing with schizotypal personality disorder and the other with schizophrenic psychosis (in this case, schizophrenia is considered to be a process of the individual’s collapse). Both are independent and gradual. Finally, it is stated that schizophrenic psychosis does not consist of a high or extreme schizotypy, but that other factors must converge to make it pathologically and qualitatively different .