Schizotypal Personality: Neurodevelopmental and Psychosocial Trajectories

Department of Psychology and Neuroscience Program, University of Southern California, Los Angeles, California 90089-1061, USA.
Annual Review of Clinical Psychology (Impact Factor: 12.92). 02/2006; 2(1):291-326. DOI: 10.1146/annurev.clinpsy.2.022305.095318
Source: PubMed

ABSTRACT Schizotypal personality research holds the promise of critically important insights into the etiology and ultimate prevention of schizophrenia. This article provides a critical overview of diagnostic, developmental, demographic, psychosocial, genetic, neurodevelopmental, psychophysiological, neurochemical, neurocognitive, brain imaging, and prevention-treatment issues pertaining to this personality disorder. It is argued that genetic and early environmental influences act in concert to alter brain structure/function throughout development, resulting in disturbances to basic cognitive and affective processes that give rise to three building blocks of schizotypy-cognitive-perceptual, interpersonal, and disorganized features. Two clinical subtypes are hypothesized: (a) neurodevelopmental schizotypy, which has its roots in genetic, prenatal, and early postnatal factors, is relatively stable, has genetic affinity to schizophrenia, and may benefit preferentially from pharmacological intervention, and (b) pseudoschizotypy, which is unrelated to schizophrenia, has its roots in psychosocial adversity, shows greater symptom fluctuations, and may be more responsive to psychosocial intervention.

    • "Early intervention and detection of people at risk of developing psychosis have become a major focus of clinical research on schizophrenia. Schizotypal traits are a putative phenotypic marker of elevated risk for schizophrenia, and evidence has accumulated that there might be a schizotypy–schizophrenia spectrum not only with regards to symptoms and clinical signs, but also common underlying biological factors (Raine, 2006; Hazlett et al., 2012; Nelson et al., 2013; Ettinger et al., 2014). "
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    ABSTRACT: Schizotypal traits are phenotypic risk factors for schizophrenia, associated with biological changes across a putative schizophrenia spectrum. In this study, we tested the hypothesis that brain structural changes in key brain areas relevant to this spectrum (esp. medial and lateral prefrontal cortex) would vary across different degrees of schizotypal trait expression and/or phenotypic markers of psychosis proneness in healthy non-clinical volunteers. We analysed high-resolution 3Tesla magnetic resonance images (MRI) of 59 healthy volunteers using voxel-based morphometry (VBM), correlating grey matter values to the positive and negative symptom factors of the schizotypal personality questionnaire (SPQ, German version) and a measure of psychosis proneness (community assessment of psychic experiences, CAPE). We found positive correlations between positive SPQ dimension and bilateral inferior and right superior frontal cortices, and positive CAPE dimension and left inferior frontal cortex, as well as CAPE negative dimension and right supplementary motor area (SMA) and left inferior parietal cortex. However, only the positive correlation of the right precuneus with negative schizotypy scores was significant after FWE correction for multiple comparisons. Our findings confirm an effect of schizotypal traits and psychosis proneness on brain structure in healthy subjects, providing further support to a biological continuum model. Copyright © 2015 Elsevier B.V. All rights reserved.
    Schizophrenia Research 07/2015; DOI:10.1016/j.schres.2015.06.017 · 4.43 Impact Factor
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    • "Indeed schizotypal features include sub-clinical psychotic symptoms like bizarre behavior, magical ideation, social withdrawal/anxiety , lack of feelings, and perceptual abnormalities (Raine, 2006). These sub-threshold psychotic experiences are common in general population (Van Os et al., 2009; Fagnani et al., 2011; Brambilla et al., 2014) and they are associated to an increased risk of developing a psychotic disorder both temporally and for experiential continuity (Linscott and Van Os, 2013). "
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    ABSTRACT: Psychometric tools, such as the Perceptual Aberration Scale (PAS), have been developed to identify people at risk to develop psychosis. This paper aims at providing an Italian version of the Perceptual Aberration Scale and its normative data for the general juvenile Italian population. The Italian version of the PAS was produced using three independent translators. It was administered to 1089 non-clinical participants, stratified into three age-groups, i.e., 8-13, 14-17 and 18-24. The Italian version of the PAS displayed good internal consistency in each age-group evaluated (i.e. Alpha Coefficients: 0.90 for the 8-13 age-group, 0.84 for the 14-17 age-group, and 0.87 for the 18-24 age-group) and the assumption of unidimensionality was corraborate. Furthermore, normative data for the three groups were collected (i.e. cut-offs: 25 for the 8-13 age-group, 21 for the 14-17 age-group and 20 for the 18-24 age-group) and an age-related difference, as the 18-24 group scored lower than the younger groups, was found. The Italian version of the PAS proved to be a reliable psychometric tool to investigate perceptual aberration during childhood, adolescence and young adulthood. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    06/2015; DOI:10.1016/j.psychres.2015.05.058
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    • "As such, impairments in working memory, attention, processing speed, and verbal learning have been found in subjects with schizotypal personality disorder (see review by Siever et al., 2002). Along with the increasing body of evidence for a continuum that encompasses schizotypal personality disorder (Raine, 2006), subclinical psychosis (Rössler et al., 2007; Rössler et al., 2013a) or psychotic experiences (Linscott and van Os, 2013) in the general population , research is needed concerning cognitive capacities at the low "
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    ABSTRACT: Evidence is growing that persons along the schizophrenia spectrum, i.e., those who also display subclinical psychotic symptoms, exhibit deficits across a broad range of neuropsychological domains. Because sex differences in the association between cognitive deficits and psychosis have thus far been mostly neglected, we believe that ours is the first study specifically focused upon those differences when examining the relationship between subclinical psychosis and processing speed. Using a sample of 213 persons from the general population from Zurich, Switzerland, psychotic symptoms were assessed with three different questionnaires including the Schizotypal Personality Questionnaire, an adaptation of the Structured Interview for Assessing Perceptual Anomalies, and the Paranoia Checklist. Processing speed was assessed with the WAIS digit-symbol coding test. Two higher-order psychosis domains were factor-analytically derived from the various psychosis subscales and then subjected to a series of linear regression analyses. The results demonstrate that in both men and women associations between subclinical psychosis domains and processing speed were weak to moderate (β ranging from -0.18 to -0.27; all p<0.05). However, we found no sex-differences in the interrelation of subclinical psychosis and processing speed (ΔR(2)<0.005; p>0.30). In conclusion, it appears that sex differences in psychosis manifest themselves only at the high end of the continuum (full-blown schizophrenia) and not across the sub-threshold range. The small magnitude of the effects reported herein conforms to the etiopathology of the disorder. Since schizophrenia and related disorders from the spectrum are assumed to be multifactorial diseases, it follows that many etiological components of small effect are involved. Copyright © 2015 Elsevier B.V. All rights reserved.
    Schizophrenia Research 06/2015; 166(1-3). DOI:10.1016/j.schres.2015.05.026 · 4.43 Impact Factor
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