Schizotypy: what it is and how it relates to psychosis

Schizophrenia, schizothymia, schizoid, schizotypal, schizoaffective, schizophreniform… for sure that the vast majority of psychologists and psychology students are familiar with these terms. But… what is schizotypy? Is it a new disorder? Is it a personality disorder? What is different from the rest?

In this article we are going to delve into the interesting concept of schizotypy through a brief historical analysis of the term, and we will see how It's more of a personality trait. that of a mental disorder of the psychotic sphere.

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What is schizotypy?

Leaving aside the categorical vision of the psychosis (you have psychosis, or you don't), schizotypy is a psychological construct that purports to describe a continuum of traitss and personality characteristics, along with experiences close to psychosis (specifically schizophrenia).

We must clarify that this term is not currently used and It is not included in either the DSM-5 or the ICD-10

, since these manuals already include personality disorders related to it, such as Schizotypal Personality Disorder. Schizotypy is not a personality disorder nor has it ever been, but rather a set of personality traits that form a continuum of degree.

Brief historical review of schizotypy

The categorical conception of psychosis is traditionally related to emil kraepelin (1921), who classified the different mental disorders from the medical model. This world-renowned German psychiatrist developed the first nosological classification of mental disorders, adding new categories such as manic-depressive psychosis and dementia praecox (today known as schizophrenia thanks to Educen Bleuler, 1924).

Until recently, the diagnostic systems that psychologists have been using over the years they maintained the categorical vision of Kraepelin, until the arrival of the DSM-5, which, despite the criticism it has received, provides a rather dimensional point of view.

Meehl (1962) distinguished in his studies schizotypy (personality organization that had the potential to decompensate) and schizophrenia (the complete psychotic syndrome). Rado (1956) and Meehl's approach to schizotypal personality has been described as the clinical history of schizotypal personality disorder that we know today in the DSM-5, far from the nomenclature of schizotypy.

However, we owe the term schizotypy entirely to Gordon Claridge, who along with Eysenck, advocated the belief that there was a clear dividing line between madness and "sanity", that is, they opted for a conception closer to the dimensional than to the categorical. They believed that psychosis was not an extreme reflection of symptoms, but rather that many features of psychosis could be identified to varying degrees within the general population.

Claridge called this idea schizotypal, and he suggested that this could be broken down into various factors, which we will address below.

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Factors of schizotypy

Gordon Claridge dedicated himself to studying the concept of schizotypy through the analysis of strange or unusual experiences in the general population (without diagnosed psychotic disorders) and clustered symptoms in people with diagnosed schizophrenia (clinical population). By weighing the information carefully, Claridge suggested that the personality trait of schizotypy was much more complex than it seemed at first, and devised the decomposition into four factors that we are going to see below. continuation:

• Unusual experiences: it is what we know today as delusions and hallucinations. It is about the disposition to live unusual and strange cognitive and perceptual experiences, such as magical beliefs, superstitions, etc.
• cognitive disorganization: the way of thinking and thoughts become totally disorganized, with tangential ideas, incoherence in speech, etc.
• introverted anhedonia: Claridge defined it as introverted behavior, emotionally flat expressions, social isolation, decreased ability to feel pleasure, either in general or on the social and physical level. It is what today corresponds to the criterion of Negative symptoms of schizophrenia.
• Impulsive disagreement: it is the presence of unstable and unpredictable behavior with respect to socially established rules and norms. Non-adaptation of behavior to imposed social norms.

What relationship does it have with psychosis and mental illness?

Jackson (1997) proposed the concept of "benign schizotypy" when studying that certain experiences related to schizotypy, such as unusual experiences or cognitive disorganization, related to having increased creativity and problem-solving ability, which could have an adaptive value.

There are basically three approaches to understanding the relationship between schizotypy as a trait and the diagnosed psychotic illness (the almost-dimensional, dimensional and totally dimensional), although they are not without controversy, since when studying the characteristic features of the It has been observed that schizotypy does not constitute a homogeneous and unified concept, so the conclusions that can be drawn are subject to many possible explanations.

The three approaches are used, in one way or another, to reflect that schizotypy constitutes a cognitive and even biological vulnerability to the development of psychosis on the subject. In this way, the psychosis remains latent and would not express itself unless triggering events (stressful or substance use) occurred. We are going to focus mainly on the fully dimensional and dimensional approximation, since they make up the latest version of Claridge's model.

Dimensional approximation

She is heavily influenced by Hans Eysenck's theory of personality. Diagnosable psychosis is considered lies at the extreme limit of the graded spectrum of schizotypy, and that there is a continuum between people with low and normal levels of schizotypy and high.

There has been much support for this approach because high scores on schizotypy may fit within the diagnostic criteria for schizophrenia, schizoid personality disorder, and schizotypal personality disorder personality.

Full Dimensional Approximation

From this approach, schizotypy is considered a dimension of personality, similar to the PEN model (Neuroticism, Extraversion and Psychoticism) by Eysenck. The "schizotypy" dimension is normally distributed throughout the population, that is, each and every of us could punctuate and have some degree of schizotypy, and that would not mean that it would be pathological.

In addition, there are two graduated continuums, one that addresses schizotypal personality disorder and the other relative to schizophrenic psychosis (in this case, schizophrenia is considered as a process of collapse of the individual). Both are independent and gradual. Finally, it is stated that schizophrenic psychosis does not consist of a high or extreme schizotypy, but rather other factors must come together that make it pathologically and qualitatively different.