Ep 42: The Almost Psychotic Personality | Schizotypal in the DSM

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) dive into the origins, diagnostic criteria, and oddities associated with schizotypal personality disorder and what it means to be almost psychotic, but not quite. We unpack idiosyncrasies and “cognitive slippage” of schizotypals that include odd speech patterns, suspiciousness, emotional expression, and social anxiety. This episode also highlights the importance of cultural context in diagnosis and not overpathologizing trends or religious norms. We also explore the overlap with and risk of schizophrenia in schizotypals, along with long-term implications of living in a quasi-psychotic cognitive space.

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Chapters

• 00:00 Intro & History of Schizotypal Personality
• 01:15 DSM Criteria Schizotypal Personality
  • 02:59 Ideas of Reference
  • 05:35 Odd Beliefs and Magical Thinking
    • 08:18 Exploring Cultural Oddities vs Psychosis
  • 11:05 Unusual Perceptual Experiences
  • 12:44 Odd Thinking & Speech
  • 17:45 Suspiciousness and Paranoia
  • 18:34 Emotional Expression, Behavior, and Appearance
  • 20:13 Lack of Close Relationships and Anxiety
• 23:42 Schizotypal Differential Diagnosis
• 24:46 Schizotypals’ Relationship to Schizophrenia
• 29:33 Summary and Conclusion

Additional Podcast References

• Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc.