Mark Dombeck, Ph.D. Updated: Oct 25th 2005
A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
* ideas of reference (excluding delusions of reference)
* odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or "sixth sense"; in children and adolescents, bizarre fantasies or preoccupations)
* unusual perceptual experiences, including bodily illusions
* odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
* suspiciousness or paranoid ideation
* inappropriate or constricted affect
* behavior or appearance that is odd, eccentric, or peculiar
* lack of close friends or confidants other than first-degree relatives
* excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self
Cynthia Levin, Psy.D. Updated: Oct 25th 2005
Personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions. Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.
As with most personality disorders, schizotypal personality disorder is best treated with some form of psychotherapy. Individuals with this disorder usually distort reality more so than someone with Schizoid Personality Disorder.
As with Delusional Disorder and Paranoid Personality Disorder, the clinician must exercise care in therapy to not directly challenge delusional or inappropriate thoughts. A warm, supportive, and client-centered environment should be established with initial rapport. As with Avoidant Personality Disorder, the individual lacks an adequate social support system and usually avoids most social interactions because of extreme social anxiety. The patient often reports feelings of being "different" and not "fitting in" with others easily, usually because of their magical or delusional thinking. There is no simple solution to this problem. Social skills training and other behavioral approaches that emphasize the learning of the basics of social relationships and social interactions may be beneficial.
While individual therapy is the preferred modality at the onset of therapy, it may be appropriate to consider group therapy as the client progresses. Such a group should be for this specific disorder, though, which may be difficult to form or find in smaller communities.
Medication can be used for treatment of this disorder's more acute phases of psychosis. These phases are likely to manifest themselves during times of extreme stress or life events with which they cannot adequately cope. Psychosis is usually transitory, though, and should effectively resolve with the prescription of an appropriate anti-psychotic.
There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder. Such approaches would likely not be very effective because a person with this disorder is likely to be mistrustful and suspicious of others and their motivations, making group help and dynamics unlikely and possibly harmful.
Portions are from Internet Mental Health, by Phillip W. Long, M.D.