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: 12.67). 02/2006; 2(1):291-326. DOI: 10.1146/annurev.clinpsy.2.022305.095318
Source: PubMed


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.

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    • "In a longitudinal study, Barbato et al. (2014) found that those who later convert to psychosis had stronger beliefs that worrying is positive and helpful, and negative beliefs about thoughts and their controllability. Integrated models of psychosis incorporate both bottom-up and top-down mechanisms (Morrison, 2001; Waters et al., 2012); however, less is known about the contribution of metacognitive processes to schizotypal symptoms, which are commonly regarded as existing on the schizophrenia spectrum and representing a vulnerability to psychosis (see Raine, 2006). Factor analyses have found that the three-factor model of schizotypy (cognitive-perceptual abnormalities, interpersonal deficits, and disorganization) as proposed by Raine et al. (1994) is shared by patients with schizophrenia , their non-psychotic first-degree relatives, and healthy undergraduate students (Bergman et al., 2000; Rossi and Daneluzzo , 2002). "
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    ABSTRACT: Metacognitive abnormalities have been implicated in the experience of psychotic symptoms; however, the process through which this occurs remains unclear. The aim of this study was to clarify the association of self-reported schizotypy with metacognitive beliefs and neural activity related to higher-order cognition. Event-related potentials (ERPs) including the error-related negativity (ERN) and error positivity (Pe) were recorded during a Flanker task in 20 controls and 22 individuals with high self-reported schizotypy on the Schizotypal Personality Questionnaire-Brief Revised (SPQ-BR). Participants continuously evaluated their task performance and completed the Metacognitions Questionnaire-30 (MCQ-30). The high schizotypy group demonstrated higher scores on all subscales of the MCQ-30. In contrast, task performance, accuracy of self-performance evaluation, and amplitudes of the ERN and Pe did not differ between groups. The MCQ-30 factors that measure cognitive confidence and positive beliefs about worry significantly predicted SPQ-BR total score, whereas ERPs did not. High self-reported schizotypy appears to be more associated with dysfunctional metacognitive beliefs than physiological abnormalities in brain areas related to metacognition.
    09/2015; DOI:10.1016/j.psychres.2015.09.006
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    • "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; 168(1). DOI:10.1016/j.schres.2015.06.017 · 3.92 Impact Factor
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    • "Several scales have been proposed in the form of clinical interview or self-report questionnaires such as the Chapman scales assessing psychotic traits and the Schizotypy Personality Scale (STA) (Lenzenweger, 2006; Mason and Claridge, 2006). Nevertheless, all different types of assessment converge on the schizotypy characterisation by the three factor model (Raine, 2006). Adjustments were made to include the impulsive nonconformity factor (Fonseca-Pedrero et al., 2011). "
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    ABSTRACT: Despite major progress in diagnostic accuracy and symptomatic treatment of mental disorders, there is an ongoing debate about their classification aiming to follow current advances in neurobiology. The main goal of this review is to provide a comprehensive summary of the put forward schizotypy concept that follows the needs for objective assessment of schizophrenia-like personality traits in the general population. We focus on major achievements in the field from the perspective of magnetic resonance imaging-based computational anatomy of the brain. Particular interest is devoted to overlapping brain structure findings in schizotypy and schizophrenia to promote a dimensional view on schizophrenia as extension of phenotype traits in the non-clinical general population.
    Schizophrenia Research: Cognition 06/2015; 128(2). DOI:10.1016/j.scog.2015.05.001
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