Diagnostic Criteria, Schizotypal Disorder

Diagnostic Criteria

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

Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.

Note: If criteria are met prior to the onset of Schizophrenia, add "Premorbid," e.g., "Schizotypal Personality Disorder (Premorbid)."


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Differential Diagnosis*
Delusional Disorder; Schizophrenia; Mood Disorder With Psychotic Features; Autistic Disorder; Asperger's Disorder; Expressive and Mixed Receptive-Expressive Language Disorders; Communication Disorders; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use; Paranoid Personality Disorder; Schizoid Personality Disorder; Avoidant Personality Disorder; Narcissistic Personality Disorder; Borderline Personality Disorder; Schizotypal features during adolescence. (Mentalhealth.com)

**Differential Diagnosis means all the other illnesses that must be ruled out before a Dx of an illness may be made. It is just as much of the diagnosis as meeting the criteria is and cannot be ignored.

Ideas of reference: Interpreting unrelated events as having direct reference to the patient such as the television is talking directly to them.

hi im not sure if this is what i have or not. some of the symptoms sound like me.

ideas of reference (excluding delusions of reference) - i dont understand what this is.

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) - i believe in ghosts & am very paranoid about them being everywhere i am. & my mum said to me yesterday, 'your 17 today {it was my birthday!} but you still act like a 5 year old' i asked how & she said ' you live in a dream world. you get fantasies that can't possibly come true, but you wont accept that.'

unusual perceptual experiences, including bodily illusions
odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped) sometimes i feel like my body isn't part of me. or, like my spirit isn't part of my body, like itz coming out of my body. is this what you mean? n i do think odd thoughts all the time!! and i talk strangely, others notice it & so do i & i find it embarassin. i talk in quite a posh accent sometimes, which isn't me, and i talk about wierd stuff that doesn't make sense at all. when trying to explain something, i really go into detail to try to make it clear, but the other person has no idea what im going on about.

suspiciousness or paranoid ideation im paranoid as f**k, have been for a long time.

inappropriate or constricted affect i dont understand this

behavior or appearance that is odd, eccentric, or peculiar i act wierd sometimes, but i wouldn't say eccentric. i dont think i look wierd either (atleast i hope i dont!)

lack of close friends or confidants other than first-degree relatives true

excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self completely 100% true


judging by my answers, what can you tell me? thanks x|X|x

Ideas of reference: Interpreting unrelated events as having direct reference to the patient such as the television is talking directly to them.

ok i think i get it now. well, here's an example:
say i'm worrying i may be pregnant, but i dont know for sure. everytime an advert comes on T.V for a pregnancy test, i think '$#%^, its a sign. i must b pregnant' etc...

i take everything as a sign these days. it only started happening recently and i dont know why because i never thought like that before. eg i have a poster on my wall, yesterday i was thinkin about moving it but decided not to. today one corner of the poster was hanging down, i took this as a sign that i was supposed to take it down, so i did.

i also talk to my posters and believe they're real. sometimes i think that they're smiling at me. i get embarassed sometimes when im getting dressed in my room because i think eminem and 50 cent are watching me. ow crazy iz dat lol

i dont know if this is exactly what you mean, or if it means anything!, but this is the closest i feel to how you described the 'ideas of reference'.

Wow, my email has been screwed up since the first of this year and I just discovered it. I'm really sorry for all the unanswered messages and questions that I didn't respond to.

If you're still around, I don't know if at your age, I take it your in your teens, did you say 17? You're not that grown up okay? and there's no a DAMN thing wrong with that.

You probably need therapy. For a non professional to try to diagnose you would be insane and a dis-service to you. You do need to see a professional no doubt about that.

Magical thinking is not a good sign if you have it going on. But I'm religious person and I have no doubt God gives me signs. He knows I think so poorly of myself that I don't see how even God could love me. He has His way of letting me know.

I can remember a time I might have thought the posters could see me and then I'd laugh at myself a bit. I also remember a time I had the crap scared out of me. I was about 15. Shrinks would say I was crazy perhaps. I wasn't crazy, if I was I was TOTALLY gone. No, supernatural things did happen that night.

Religion and the mind. It's a dangerous place to tread. Faith, it can't be proven. Just as love, it can't be proven. When it comes to that you're going to need a really good professional. I doubt that much about God is taught in medical school. That's where the professional has to draw on his on life. Maybe you should find out what they believe before you decide if what they say is true or not true.

You can't really evaluate your own magical thinking. If you believe it then that's when it's a problem. People say they forget stuff and wonder if it is a problem. It's a problem when you don't know you have forgotten.

Just my layman's opinion.

Seeing how I am a Christian person with StPD I have found a lot of comfort in my faith. Faith is proven by every breath we breathe. We belives that we will be able to take another breath or blink another eye that's faith and we do it so unconsciously that we tend to think nothing of it. But since this Pandora's box is open, let's take a look at how one having a faith in God can help a person with StPD. I'm a Pentecostal, often called a "Holy Roller" we pray in tongues. Some people of other denominations might not do this or like that but as someone with StPD, I find it to be soothing and I connect. Being involved being there. Social situations, I can go there and not feel aggravated or annoyed. As far as seeing how God could love you or me because our lives are so screwed up, God already knew you before you were born, He knew what struggles you will face and and how you would deal with them before they ever happened. God would not have let you be if he didn't have a plan for you. I was 17 when I was diagnosed with StPD. I am 40 now and have had to deal with this a lot. At 17, I was afraid of this condition, ashamed and didn't understand it. "Why am I a lab rat" all the time have to see the shrink?
One thing I learned early on is that a lot of those over-inflated words are accusing us of things it's taking the time to do to it's very self. Those words are fluff to fill up empty space on paper. Pull out the dictionary and look those words up. It's true in my opinion I think the DSM book is my worst enemy right now.
Do you have a 6th sense? yes, Even as a Christian person, of whom is not supposed to believe in that I do feel that I do have a 6th sense of which in recent studies have been shown that it's a genetic disposition that we are lacking certain genes. So I'm not a mutant X-Man and the closest thing to magic I can do is walk through the doors at Walmart. Doesn't mean I'm a heretic to the faith. I'm 40 years old, I have been through all of this and I know what to expect. At the age of 17 the DSM book is a very intimidating and daunting book filled with exotic words that even the norms don't use in everyday speech. Do I still want to do something larger than life? You bet! Do I want to be bigger than I am? Certainly! As i get older, I have not quite reached that point. I still find I want to. I'm 40 and i want to talk more and more about this disorder as I find others who have or may have it.

Hmm, I seem to half fit this... I seem much less paranoid than the textbook StPD:

ideas of reference (excluding delusions of reference): used to up to 12-13. I had this imaginary fantasy land that I thought was sending me signs.

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): used to up to th age of 12-13. I thought there was an "alternate dimension/world" which in my imagination was perfect (fictional girlfreind, ruled everything, killed viciously any 'rebels'). I would always re-shape this world every time I read a book and wanted to incorporate its fantasy.

unusual perceptual experiences, including bodily illusions
odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped) : hmm nothing here, i speak perfect English, and am a bit of a grammar nazi! I will however sometimes get stuck on a phrase and I take me a good five times to say it properly.

suspiciousness or paranoid ideation: none. I am a man of science, an have great fascination with it.

inappropriate or constricted affect: meaning how I act? Yeah I will often do things that everyone thinks is horribly out of context, over the top etc. I will often have to remind myself to act like I care about something that I absolutely don't when I'm with my family/"freinds"

behavior or appearance that is odd, eccentric, or peculiar: I can't afford to wear my own choice of clothes, but when I can, I dress to look intimidating and slightly formal. Long overcoat nearly always . I also prefer to not let any emotion show on my face unless I'm pretending some other emotion.

lack of close friends or confidants other than first-degree relatives: I pretended to be freinds with the people I have close contact with in school, but I don't like being around them. My family is split, and I don't really like any of them.

excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self : hmm I think So, every relationship I have tried to make (attractive girls, yeah yeah) has only lasted 24 hours before the other party backs away/refuses to talk to me, but I always had to do these over the Internet, I could never speak face to face, even after a conversation over the Internet the previous night.

A couple of things about this diagnostic criteria:

1. Ideas of reference - so, this might manifest in incidents where one believes that every group of people standing together as you walk through the supermarket is either a) glancing at you, even when you aren't looking at them or 2) murmuring or commenting about you in some way when you DO see them glance at you. Also, if one sees two people talking to each other at a great distance away, and one of them glances at you, you immediately assume that they are telling the other person something about you. The example of the TV talking directly to you is more schizo-phrenic (because more severe) than -typal.

2. Bizarre preoccupations or beliefs - so, this might manifest in a belief (that has turned into an obsession) that sexual activity in general is something to be feared because there is something seriously WRONG with the opposite sex's genitalia, and an unusual exagerrated fear of bodily fluids. Or, a perpetual fear of gas stations because of an underlying fear of hazardous fuel vapours on the health of the brain. Something like those.

3. Magical thinking - ANY connection to witchcraft, or related spiritual ephemeral esoteric groups or movements generally speaking.

4. Body/somatic dysmorphisms - If I gather correctly, this would be moments where you hear voices around you, which ARE REAL and BELONG to REAL PPL, BUT you hear your name being called by one of them. Also, when the wind blows, and electrical transformers on telephone poles start to spark, you think that bombs are being dropped out of airplanes, this also from a great distance. Of course, actually that might be more like psychotic delusions.

If you haven't guessed already, I suffer from all of the above, and the evidence suggests that CBT will alleviate some of these sorts of symptoms. I have yet to use Cognitive-Behavioural-Therapy, but plan on it.