Much gratitude to Bismarkable for sharing the following insights and reflexions. For a student, such as myself, subjective accounts of felt ipseity disturbances assists greatly in both humanizing and contextualizing clinical vocabulary and psychiatric theory.
“Based on family inheritance and genetic studies, schizophrenia, schizotypal personality disorder and schizoid personality disorder are considered to be part of a “schizophrenic spectrum” of mental illness. Although schizophrenia is categorized as a psychotic disorder and both schizoid and schizotypal are personality disorders , all three share several symptoms, including avoidance of social relations and flat emotional affect. An important distinction is that people with schizoid personality don’t typically experience the perceptual distortions, paranoia or illusions typical of schizotypal personality or the psychotic episodes of schizophrenia (Nakamura 2005, Questa 2001, Widiger 2007).
Schizotypal personality disorder can easily be confused with schizophrenia, which is characterized by intense psychosis, a severe mental state characterized by a loss of contact with reality. While people with schizotypal personalities may experience brief psychotic episodes with delusions or hallucinations, they are not as pronounced, frequent or intense as in schizophrenia.
Another key distinction between schizotypal personality disorder and schizophrenia is that people with the personality disorder usually can distinguish between their distorted ideas and reality. Those with schizophrenia generally can’t be swayed from their delusions.
Both disorders, along with schizoid personality disorder, belong to what’s generally referred to as the schizophrenic spectrum. Schizotypal personality falls in the middle of the spectrum, with schizoid personality disorder on the milder end and schizophrenia on the more severe end.”
“Social impairment and isolation are common signs of schizotypal personality disorder. Individuals with the personality disorder do not desire social isolation; isolation results from continuously experiencing intense discomfort in social situations, and enduring the negative reactions to the unusual beliefs and behavior exhibited by so many schizotypal personality disorder sufferers.”
“The schizotypal personality disorder was introduced in the DSM-III in 1980. The term schizotype was first used by Sandor Rado in 1953 as a combination of schizophrenic and genotype. The concept came from the awareness that there were nonpsychotic but eccentric and dysfunctional personalities who were considered to have attenuated expressions of the constitutional defect that underlay schizophrenia (Akhtar, 1992, pp. 260-261). Rado hypothesized that these schizotypal individuals had the same two constitutional defects that were found in schizophrenia, i.e., deficiency in integrating pleasurable experiences and a distorted awareness of the bodily self. The symptoms of StPD came from these two defects and included: chronic anhedonia and poor development of the pleasurable emotions; continual engulfment in emergency emotions, e.g. fear and rage; extreme sensitivity to rejection and loss of affection; feelings of alienation; a rudimentary sexual life; and, a propensity for cognitive disorganization under stress (Akhtar, 1992, p. 263).”
“Schizotypal personality disorder has many similarities to schizoid personality disorder, but individuals with this disorder are more odd and eccentric. They have many difficulties in social situations. They are often very suspicious of the motives of others and tend to be somewhat paranoid.” “Fairbairn described three prominent characteristics of schizoid personalities: These include: 1. an attitude of omnipotence, 2. an attitude of detachment and, 3. preoccupation with fantasy and inner reality. Guntrip (1969) cited in Akhtar (1987) outlined nine characteristics of the schizoid personality disorder. These include: introversion, withdrawal, narcissism, self-sufficiency, a sense of superiority, loss of affect, loneliness, depersonalization and tendency towards regression.”
List of scholarly works for further reading:
Guntrip, H. Schizoid phenomena, object-relations and the self. New York: International Universities Press (1969).
Klein, Ralph. Disorders of the Self: New Therapeutic Horizons, Brunner/Mazel (1995).
Lentz, Vanessa (MD, MSc) and Jennifer Robinson (MA) and James M. Bolton (MD, FRCPC). Childhood Adversity, Mental Disorder Comorbidity, and Suicidal Behavior in Schizotypal Personality Disorder. The Journal of Nervous and Mental Disease Vol.198(11), November 2010 .
Meehl, P.E. Schizotaxia, schizotypy, schizophrenia. American Psychologist, 17, (1962): 827-838.
Oldham JM, Skodol AE, Kellman HD, Hyler SE, Doidge N, Rosnick L, Gallaher PE. Comorbidity of axis I and axis II disorders. Am J Psychiatry, 152(4), April 1995: 571-8.
Suhr, J.A. (M.B.). Factor versus cluster models of schizotypal traits. I: A comparison of unselected and highly schizotypal samples. Spitznagel Schizophrenia Research. Volume 52(3), 1 December 2001: 231-239.
Voliena, Meinte G and van den Bosch, Robert J. The Multidimensionality of Schizotypy. Schizophrenia Bulletin Vol 21(1), (1995): 19-31.
Yoon, Seon-Ah (PhD) and Do-Hyung Kang (MD) and Jun Soo Kwon (MD, PhD). The Emotional Characteristics of Schizotypy. Psychiatry Investigative, 5(3), September 2008:148–154.
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