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According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), schizotypal personality disorder is primarily characterized by an individual’s persistent social deficits marked by serious discomfort with close relationships and by cognitive distortions of behavior. The pattern of social deficits begins by early adulthood and presents itself in a multitude of contexts.

Individuals with schizotypal personality disorder are typically uncomfortable relating to other individuals. They may claim to be unhappy about their lack of relationships, but their behavior shows a low desire for intimacy.

Diagnostic Criteria for Schizotypal Personality Disorder DSM-5 301.22 (F21)

This pattern of social deficits due to mental distortions and discomfort with close relationships is indicated by at least five of the following:

  • The individual’s ideas of reference (not including delusions of reference)
  • He or she has strange beliefs or magical thinking that influences behavior and that is quite different from subcultural norms (e.g., feelings about superstition, telepathy, “sixth sense”, and generally bizarre fantasies).
  • The individual has odd perceptual experiences, such as bodily illusions.
  • He or she has strange thinking and speech habits; for example, the individual is excessively vague or metaphorical.
  • He or she is excessively suspicious or paranoid.
  • The individual has inappropriate or restricted feelings.
  • The individual behaves peculiarly or eccentrically, or has an odd appearance.
  • He or she lacks a closeness with others except with first-degree relatives.
  • He or she experiences excessive social anxiety even with the comfort of familiar people or places; this anxiety tends to relate to paranoid fears rather than self-consciousness.

The disturbance does not occur exclusively during the course and development of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder.

In response to the stress that comes with this disorder, individuals may have psychotic episodes, which can last a single minute or many hours. The duration is typically not sufficient enough to merit an additional diagnosis of another disorder like brief psychotic disorder; however, 30% to 50% of individuals with schizoid personality disorder do have a coexisting diagnosis of major depressive disorder. It’s also possible for schizoid, paranoid, avoidant, and borderline personality disorders to co-occur.

Who Is at Risk of Developing Schizotypal Personality Disorder DSM-5 301.22 (F21)?

Community studies of schizotypal personality disorder show a 4.6% prevalence rate in a U.S. community sample. Meanwhile, the prevalence rate of the disorder in clinical populations seems intermittent (0%-1.9%), and the one found in the general population by the National Epidemiologic Survey on Alcohol and Related Conditions comes in at 3.9%.

The only individuals that appear to be at a higher risk of developing schizoid personality disorder are those with first-degree relatives diagnosed with schizophrenia. However, cultures and religions come into play when diagnoses are being made, as some religious rituals or beliefs can come off as schizotypal to another person who is unfamiliar with the practice or view.

Treatment for Schizotypal Personality Disorder

Individuals who suffer from this disorder don’t typically seek treatment for the personality disorder features but rather the associated symptoms of anxiety or depression. Nonetheless, they do have a few treatment options:

1. Psychotherapy: This form of therapy, otherwise know as talk therapy, may help individuals with schizotypal personality disorder trust others more easily and readily. It may involve:

  • Cognitive-behavioral therapy, which works to identify and fix distorted thought patterns.
  • Supportive therapy, which focuses on encouraging the individual and promoting adaptive techniques.
  • Family therapy, which involves family members to help reduce emotional distance between them and the individual and also works to improve trust at home.

2. Medications: While there aren’t any medications approved to directly treat schizotypal personality disorder, an individual with the disorder may be prescribed an antipsychotic, antidepressant, or an anti-anxiety drug to help him or her deal with the symptoms.

Schizotypal Personality in Mythical Characters

There are many popular series and movies these days that place different universes and mythical creatures within our present day and world in which we live. The story-book characters—like the vampires, the witches, the werewolves—are easy to tell apart from the average humans, as they talk differently, dress differently, and are characterized by their magical powers. However, in many of these shows and movies, the mythical creatures do their best to hide these magical secrets and typically succeed. But, not without coming across as a little or a lot strange. They may even come off as or be explained as schizotypal.

Example
Vampire Diaries: In this series, vampires live among normal people and attempt to hide their magical differences. These differences include superhuman strength and speed and a diet that consists primarily of blood, just to name a few. But they’re also marked by other differences: old English vocabulary, talk of olden times and myths, and strange belongings they tote around like swords and ancient stones—casual. Onlookers as well as those they attempt to confide in may chalk up their odd behavior to schizotypal personality disorder; the odd perceptual experiences are there, as are the strange speech habits, the paranoia, and magical beliefs.

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