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.
"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). "
[Show abstract][Hide abstract] 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.
"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). "
"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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