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  3. Schizotypal Personality
  • Cited by 33
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    • Publisher:
      Cambridge University Press
      Publication date:
      August 2010
      September 1995
      ISBN:
      9780511759031
      9780521454223
      9780521033251
      DOI:
      https://doi.org/10.1017/CBO9780511759031
      Dimensions:
      (228 x 152 mm)
      Weight & Pages:
      0.877kg, 532 Pages
      Dimensions:
      (228 x 152 mm)
      Weight & Pages:
      0.785kg, 532 Pages
      • Subjects:
      Psychiatry and Clinical Psychology, Medicine, Psychiatry
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    • Selected: Digital
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    Subjects:
    Psychiatry and Clinical Psychology, Medicine, Psychiatry
    Information

    Book description

    This book is devoted to schizotypal personality. It provides a comprehensive overview of our knowledge from some of the world's leading researchers in the field, and includes reviews of genetics, neurodevelopment, assessment, psychophysiology, neuropsychology and brain imaging. Central themes are the exploration of categorical and dimensional approaches to the understanding of schizotypal disorder and its relationship to schizophrenia. Valuable introductory and concluding chapters set in context the sometimes divergent opinions and findings presented by the book's contributors and there are reviews of methodological issues and assessment schedules for the benefit of researchers in the field. In setting out to answer, from phenomenological, psychological and neurobiological perspectives, the fundamental question 'What is schizotypal disorder?' and to develop coherent etiological models, this book will serve as an authoritative resource for clinicians and researchers interested in this major personality disorder.

    Reviews

    ‘… it is a valuable resource not only for researchers new to the area but also for those who want a sophisticated overview of both classic findings and the latest biological and methodological efforts … An encyclopedic subject index and the inclusion of a name index also make this an extremely useful reference work … an excellent book … The editors express hope that this book will stimulate researchers to devote ‘even more time and resources to pursuing the causes and prevention of this enigmatic disorder’. It is hard to imagine a stimulus more likely to do so.’

    David A. Smith Source: Clinical Psychology Review

    ‘… a comprehensive introduction to the field of schizotypal personality … it encompasses what is known about SPD from a biological/medical perspective … it also covers some interesting psychological phenomena … I strongly recommend the book.’

    Gerhard Andersson Source: Scandinavian Journal of Behaviour Therapy

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    Contents

    Page 1 of 2

    Contents
    • 1 - Conceptual and theoretical issues in schizotypal personality research
      pp 3-16
    • View abstract

      Summary

      This chapter indicates that schizotypal personality disorder (SPD) is a disturbance that may be genetically related to schizophrenia. It argues that SPD research is of key importance in overcoming methodological weaknesses of schizophrenia research. The chapter outlines some of conceptual and theoretical issues in directing research along productive lines. These issues are grouped under the following headings: diagnostic issues, phenomenological and assessment issues, methodological issues, mechanisms and etiology, and clinical issues. SPD is viewed as an Axis II disorder alongside other personality disorders. Clinical studies of SPD recruit subjects from a hospital sample; or alternatively, they are recruited from the community and have not previously been hospitalized. The control groups in clinical research may include borderline personality disorder, which has been closely associated with SPD; or an Axis II disorder that is unrelated to schizophrenia spectrum disorders, such as self-defeating personality disorder.
    • 2 - Family–genetic research and schizotypal personality
      pp 19-42
    • View abstract

      Summary

      The history of schizotypal personality disorder (SPD) begins with the history of schizophrenia. Eugen Bleuler, in his initial description of schizophrenic illness, broadened Kraepelin's construct of dementia praecox to include what Bleuler termed latent schizophrenia, a less severe, non-psychotic presentation of schizophrenia. Empirical evidence that latent schizophrenia might share a common etiology with more severe schizophrenia was Bleuler's observation of a familial link between latent and chronic schizophrenia. Kretschmer published illustrative pedigrees demonstrating the occurrence of schizophrenia-like symptoms among the family members of schizophrenic individuals, and described in some detail the characteristics of what he called a schizoid temperament observed among some of the relatives of these patients. The body of family-genetic research in schizophrenia provides empirical evidence for the presence of a non-psychotic syndrome characterized by milder forms of the symptoms of chronic schizophrenia in some of the biological relatives of schizophrenic individuals.
    • 3 - Schizotypal personality disorder characteristics associated with second-trimester disturbance of neural development
      pp 43-55
    • View abstract

      Summary

      This chapter examines the hypothesis that second-trimester neural developmental disturbance is associated with increased presence of schizotypal personality disorder (SPD) characteristics, which in turn increases the risk for adult schizophrenia. First, it reviews the literature on schizophrenia and neurodevelopment and the literature on SPD and neurodevelopment. Second, the chapter reports on findings relevant to the hypothesis emanating from the Helsinki Influenza Project, which has studied a cohort of individuals exposed in utero to the 1957 type A2/Singapore influenza epidemic. The type A2 influenza epidemic lasted from October 8 to November 14, 1957. The index year cohort consisted of all children born in Uusimaa County, which encompasses Greater Helsinki, Finland, from November 15, 1957, to August 14, 1958, and diagnosed schizophrenic and admitted before the age of 29 years and 10 months as an inpatient to one or more of the eight psychiatric hospitals serving the county of Uusimaa.
    • 4 - Neurodevelopmental processes in schizophrenia and schizotypal personality disorder
      pp 56-76
    • View abstract

      Summary

      This chapter offers some speculations on the neuropathological substrate that gives rise to both schizotypal personality disorder (SPD) and schizophrenia. It examines the developmental phenomenology of schizophrenia and SPD. Research on the biological offspring of schizophrenic patients indicates that those who are diagnosed with SPD in adulthood showed neuromotor abnormalities in infancy. A comprehensive neurodevelopmental model of any disorder must account for its changing manifestations of dysfunction across the life course. In case of schizophrenia, the evidence of neuromotor dysfunction in particular, dyskinesia is most pronounced early and late in the life course, and florid psychotic symptoms that are most pronounced in early adulthood. Differences between SPD and schizophrenia may be revealed by positron emission tomography (PET) in studies of receptor activity in the limbic striatum. Postmortem investigations are performed to identify differences between SPD and schizophrenia in myelination and cytoarchitectonics of the limbic circuitry.
    • 5 - Scales for the measurement of schizotypy
      pp 79-106
    • View abstract

      Summary

      The Eysencks suggested that sociopaths and criminals are high on psychoticism and schizophrenics are the highest of all. Accordingly, the Eysencks built their Psychoticism Scale primarily around aspects of personality often found in sociopaths and criminals. Nielsen and Petersen developed a scale of schizophrenism, which they defined as a subschizophrenic trait indexed by withdrawal and cognitive peculiarities. Venables et al. needed a schizotypy scale for a research project in Mauritius and found that none of the previously published scales quite met their needs. They wanted a scale to measure positive and negative symptoms of schizotypy, types of symptoms that they believed might correspond to positive and negative schizophrenia. A number of researchers have investigated the usefulness of various Minnesota Multiphasic Personality Inventory (MMPI) scales and indicators for the detection of schizotypy. Schizoidia is the underlying syndrome that gives rise to schizotypal symptoms.
    • 6 - Schizotypal status as a developmental stage in studies of risk for schizophrenia
      pp 107-132
    • View abstract

      Summary

      This chapter examines how plausible it is to extend the multidimensional view of schizophrenia, which is gaining credence, into the concept of schizotypy. Strauss, Carpenter, and Bartko, in a theoretical review, proposed a three-dimensional view of schizophrenia and stated that the symptoms of schizophrenia are not specific only to schizophrenia but are related to other human behaviors through continua. They suggested that symptoms could be grouped into three categories: positive symptoms, negative symptoms, and disorders of relating. The chapter measures schizotypy by means of a scale that is short, and that has items not immediately identifiable as tapping abnormality. The Mauritius High-Risk study was the major initial user of this scale, although the original development was made on a less exotic population. Another way of probing the parallelism of dimensions of schizophrenia and of schizotypy is to examine how far sex differences in aspects of schizophrenia are repeated in schizotypy.
    • 7 - Tracking the taxon: on the latent structure and base rate of schizotypy
      pp 135-167
    • View abstract

      Summary

      Descriptions of schizotypic psychopathology have a long history in the clinical psychopathology literature. Kraepelin and Eugen Bleuler made note of what they termed latent schizophrenia, a form of personality aberration thought to be, in essence, a quantitatively less severe expression of schizophrenia. P. E. Meehl described what he believed to be the four fundamental signs and symptoms of schizotypy: cognitive slippage, interpersonal aversiveness, anhedonia, and ambivalence. According to Meehl's model, schizotypy, as a personality organization reflective of a latent liability for schizophrenia, can manifest itself behaviorally and psychologically in various degrees of clinical compensation. Finally, Meehl conjectures that the base rate of schizotaxia in the general population is approximately 10%. Meehl's base rate estimate is found on a dominant-gene formulation, which posits that every schizophrenic person must have a parent of schizotype namely, a parent carrying the schizophrenia producing genotype.
    • 8 - Detection of a latent taxon of individuals at risk for schizophrenia-spectrum disorders
      pp 168-191
    • View abstract

      Summary

      This chapter reviews empirical findings from a prospective, longitudinal study of offspring of schizophrenic parents. Specifically, it focuses on a series of taxometric analyses that attempt to discern whether schizotypal symptoms and signs assessed during childhood, young adulthood, and middle age define a latent class of individuals with high risk for developing schizophrenia-spectrum disorders, and examines the stability of schizotypal class membership across the life-span. The chapter reviews the genetic relationship between schizophrenia and schizotypal personality disorder (SPD) and the contributions of environmental factors to the development of schizophrenia in genetically at-risk individuals. It also explains premorbid behavioral antecedents of the schizophrenia spectrum and stability of schizotypal symptoms and signs over time. The chapter explains taxometric analyses of putative schizotypy indicators from the Copenhagen schizophrenia high-risk project. It concludes with evidence that the signs and symptoms of SPD define a class of individuals with high risk for schizophrenia-spectrum disorders.
    • 9 - Fully and quasi-dimensional constructions of schizotypy
      pp 192-216
    • View abstract

      Summary

      This chapter concerns the dimensionality inherent to describe and understand schizotypy and schizotypal personality disorder (SPD). It concerns attempts that are being made to discover experimental paradigms to characterize the cognitive functioning of schizotypal and schizotypally disordered individuals; or, develop markers of cognitive nature that might be helpful in high-risk and genetics research. Two traditional views of dimensionality can be discerned, and roughly align to the psychiatric and psychological models. The psychiatric view of continuity is characteristically quasi-dimensional. Focusing on variations within the illness domain, and taking the abnormal state as its reference point, it construes dimensionality as degrees of expression of a disease process. Typical questions include diagnostic and nosological issues such as the relationship between full-blown psychosis and forms of personality disorder as possible formes frustes of disease: SPD in the case of schizophrenia. The fully dimensional takes normality or health as the starting point.
    • 10 - Schizotypal personality and skin conductance orienting
      pp 219-249
    • View abstract

      Summary

      This chapter focuses on the growing literature on the application of skin conductance orienting response (SCOR) to schizotypal personality, and attempts to place the findings of this field into a wider neuroscience context. The nature of SC orienting as a sensitive measure of information processing is outlined together with a very brief summary of key findings on SC orienting in schizophrenic patients and subjects at risk for schizophrenia. The SCOR has been viewed by many as a sensitive measure of information processing, reflecting the extent to which the subject pays attention to and cognitively processes the orienting stimulus. It is hypothesized that positive symptom schizotypals may be characterized by SC orienting deficits that reflect a lack of inhibition and working memory deficits underpinned by prefrontal dysfunction; and hyporesponsivity may be specific to schizotypals who are also antisocial.
    • 11 - Attention, startle eye-blink modification, and psychosis proneness
      pp 250-271
    • View abstract

      Summary

      This chapter discusses a review of startle eye-blink reflex in normal subjects, schizophrenic patients, and schizotypal patients and putatively psychosis-prone subjects. The startle reflex is elicited in a variety of species by any abrupt or unexpected stimulus change of sufficient intensity. The degree of inhibition of startle in a short lead-interval startle eye-blink modification (SEM) paradigm may be a useful index of the protective aspects of the automatic processing of the prestimulus. The degree and direction of modification of the startle response in a long lead-interval SEM paradigm may be a useful index of the degree and direction of allocation of controlled attentional resources. The chapter determines whether the relatively remitted patients and putatively at-risk students exhibit similar SEM deficits and determines whether these deficits qualify as impairments in automatic or controlled cognitive processes, or both.
    • 12 - Brain structure/function and the dopamine system in schizotypal personality disorder
      pp 272-286
    • View abstract

      Summary

      This chapter presents the biology of schizotypal personality disorder (SPD) as model of the interaction of altered brain structure/function and the dopamine system in SPD and schizophrenia. Both schizophrenic and schizotypal patients evince symptoms that are related to psychosis as well as to social deficits. The psychotic symptoms of schizophrenia include hallucinations, delusions, and evidence of gross thought disorder. The psychotic-like or "positive" symptoms of SPD include ideas of reference, magical thinking, perceptual distortions, and possibly suspiciousness. The study of schizophrenia-spectrum personality disorders, particularly SPD, offers a relatively unique opportunity to disentangle and clarify pathophysiological processes that may interact in chronic schizophrenia. Neuropsychological and psychophysiological correlates like poor smooth-pursuit eye movements and poor attentional performance on the Continuous Performance Task (CPT) were particularly associated with "negative" schizotypy. Deficient information processing appears to contribute to the deficit-like symptoms of SPD.
    • 13 - Neuropsychological abnormalities associated with schizotypal personality
      pp 289-328
    • View abstract

      Summary

      The study of cognitive and neuropsychological deficits constitutes an area in which research on schizotypals can be particularly useful. On the basis of the extensive neuroimaging and neuropsychological literature in schizophrenia, Bilder and Degreef proposed that the three affected systems include the periventricular region, the frontolimbic system, and the development of cerebral specialization, particularly the normal differentiation of the right and left hemispheres. Neuropsychological performance on tests measuring frontolimbic deficits and abnormalities of cerebral asymmetry has been studied extensively in schizotypy. Four types of neuropsychological tests examining different facets of cognitive inhibition have been utilized in studies of schizotypy. In order of increasing processing demands, these four include perceptual/sustained attention tasks, priming tasks, learning tasks, and conceptual inhibition tasks measuring perseveration. The evidence of hemispheric abnormalities in schizotypals has been presented in the context of three potential explanatory theories: left hemisphere deficit, left hemisphere overactivation, and interhemispheric transfer (IHT) abnormality.
    • 14 - Syndromes of schizotypy: patterns of cognitive asymmetry, arousal, and gender
      pp 329-352
    • View abstract

      Summary

      In acute schizophrenia, three syndromes: the active syndrome, the withdrawn syndrome, and the unreality syndrome, have been derived from a comprehensive clinical evaluation with the Present State Evaluation and the Brief Psychiatric Rating Scale (BPRS). Two of the syndromes were related to a behavioral and physiological activation dimension and associated with opposite patterns of hemispheric activation. The two factors having affinities with the active and withdrawn syndromes in schizophrenia would have identical patterns of cognitive asymmetry on the Warrington Recognition Memory Test (WRMT), and would be differentiated by arousal levels as measured with the Thayer Activation-Deactivation scales: Tension, Energy, Calmness, Tiredness. This chapter explains the etiological importance of hemispheric asymmetry in both schizotypy and schizophrenia through the relation disclosed between syndromes or personality factors and patterns of cognitive asymmetry, handedness, and gender.
    • 16 - Brain morphology in schizotypal personality as assessed by magnetic resonance imaging
      pp 385-405
    • View abstract

      Summary

      This chapter briefly reviews relevant findings in the schizophrenia-neuroimaging literature and describes those studies that have been done on brain morphology in schizotypy. It discusses how studies of brain morphology may be used to explore alternative models of the relationship between schizotypy and schizophrenia. Examples are provided through preliminary analyses of magnetic resonance imaging (MRI) data that have been collected in laboratory over the last several years. Alternative strategies, including the study of schizotypal-proneness among normal controls, and its relationship to brain morphology, are also presented. Finally, the limitations of the approach and implications for research are discussed. Phrenology, the study of the contours of the skull, was pioneered by Francis Gall in the 1800s based on his theory that the skull's conformation would mirror the underlying brain surface, and prove to be related to specific mental abilities and personality characteristics.
    • 17 - The potential of physiological neuroimaging for the study of schizotypy: experiences from applications to schizophrenia
      pp 406-426
    • View abstract

      Summary

      This chapter is intended for investigators of schizotypy who contemplate incorporation of physiological neuroimaging methods, or who wish to have a better appreciation of the potential and limitations of such methods. Isotopic techniques for imaging neurophysiology make use of the fact that active neurons have metabolic needs for oxygen and glucose, and that cerebral blood flow rates change in response to these needs. Such measures can help identify regions of abnormal physiological activity associated with behavioral deficits. These isotopic techniques for measuring cerebral metabolism and blood flow can be traced to the pioneering method of Kety and Schmidt for measuring whole-brain metabolism and blood flow. Positron emission tomography (PET) has made it possible to measure in vivo biochemical and physiological processes in the human brain. Neuropsychological batteries can be distinguished from standard psychological tests in that they can provide links between a profile of behavioral measures and brain topography.

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