CMN 552
Module 4
Primary Study Guide
University of South Alabama
, CMN 552
Module 4 Primary Study Guide
DSM5 Section II: Schizophrenia Spectrum
Delusions
Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Their
content may include a variety of themes (e.g., persecutory, referential, somatic, religious, grandiose).
● Persecutory delusions (i.e., belief that one is going to be harmed, harassed, and so forth by an
individual, organization, or other group) are most common.
● Referential delusions (i.e., belief that certain gestures, comments, environmental cues, and so forth
are directed at oneself) are also common.
● Grandiose delusions (i.e., when an individual believes that he or she has exceptional abilities,
wealth, or fame)
● Erotomanic delusions (i.e., when an individual believes falsely that another person is in love with
him or her)
● Nihilistic delusions involve the conviction that a major catastrophe will occur
● Somatic delusions focus on preoccupations regarding health and organ function.
Delusions are deemed bizarre if they are clearly implausible and not understandable to same culture
peers and do not derive from ordinary life experiences. An example of a bizarre delusion is the belief that
an outside force has removed his or her internal organs and replaced them with someone else’s organs without
leaving any wounds or scars. Delusions that express a loss of control over mind or body are generally
considered to be bizarre; these include the belief that one‘s thoughts have been ―removed‖ by some outside
force (thought withdrawal), that alien thoughts have been put into one‘s mind (thought insertion), or that
one‘s body or actions are being acted on or manipulated by some outside force (delusions of control).
An example of a nonbizarre delusion is the belief that one is under surveillance by the police, despite a lack
of convincing evidence.
The distinction between a delusion and a strongly held idea is sometimes difficult to determine and depends in
part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence
regarding its veracity. Assessing delusions in individuals from a variety of cultural backgrounds can be
difficult. Some religious and supernatural beliefs (e.g., evil eye, causing illness through curses, influence of
spirits) may be viewed as bizarre and possibly delusional in some cultural contexts but be generally accepted
in others. However, elevated religiosity can be a feature of many presentations of psychosis. Individuals who
have experienced torture, political violence, or discrimination can report fears that may be misjudged as
persecutory delusions; these may represent instead intense fears of recurrence or posttraumatic symptoms. A
careful evaluation of whether the person‘s fears are justified given the nature of the trauma can help to
differentiate appropriate fears from persecutory delusions.
Hallucinations
Hallucinations are perception-like experiences that occur without an external stimulus. They are vivid
and clear, with the full force and impact of normal perceptions, and not under voluntary control. They may
occur in any sensory modality, but auditory hallucinations are the most common in schizophrenia and
related disorders. Auditory hallucinations are usually experienced as voices, whether familiar or unfamiliar, that
are perceived as distinct from the individual’s own thoughts. The hallucinations must occur in the
context of a clear sensorium; those that occur while falling asleep (hypnagogic) or waking up
(hypnopompic) are considered to be within the range of normal experience. Hallucinations may be a normal
part of religious experience in certain cultural contexts.
,Disorganized Thinking (Speech) hb hb
Disorganized thinking (formal thought disorder) is typically inferred from the individual’s speech. The in
hb hb hb hb hb hb hb hb hb hb hb hb h b
dividual may switch from one topic to another (derailment or loose associations). Answers to questions ma
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
y be obliquely related or completely unrelated (tangentiality). Rarely, speech may be so severely disorganiz
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ed that it is nearly incomprehensible and resembles receptive aphasia in its linguistic disorganization (incohere
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
nce or ―word salad‖). Because mildly disorganized speech is common and nonspecific, the symptom must be
hb hb hb hb hb hb hb hb hb hb hb hb hbhb hb hb h
severe enough to substantially impair effective communication. The severity of the impairment may be diffi
b hb hb hb hb hb hb hb hb hb hb h b hb hb hb
cult to evaluate if the person making the diagnosis comes from a different linguistic background than that of the p
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb hb hb hb
erson being examined. For example, some religious groups engage in glossolalia (―speaking in tongues‖); other
hb hb hb hb hb hb hb hb hb h b hb hb hb hb
s describe experiences of possession trance (trance states in
hb hb hb hb hb hb hb hb
which personal identity is replaced by an external possessing identity). These phenomena are characterized b
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
y disorganized speech. These instances do not represent signs of psychosis unless they are accompanied by
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
other clearly psychotic symptoms. Less severe disorganized thinking or speech may occur during the prod
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
romal and residual periods of schizophrenia.
hb hb hb hb hb
Grossly Disorganized or Abnormal Motor Behavior (Including Catatonia)
hb hb hb hb hb hb hb
Grossly disorganized or abnormal motor behavior may manifest itself in a variety of ways, ranging from childlike
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
―silliness‖ to unpredictable agitation. Problems may be noted in any form of goal-
hb hb hb hb hb hb hb hb hb hb hb hb
directed behavior, leading to difficulties in performing activities of daily living.
h b hb hb hb hb hb hb hb hb hb
Catatonic behavior is a marked decrease in reactivity to the environment. This ranges from resistance to in
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
structions (negativism); to maintaining a rigid, inappropriate or bizarre posture; to a complete lack of verbal and
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
motor responses (mutism and stupor). It can also include purposeless and excessive motor activity without ob
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
vious cause (catatonic excitement). Other features are repeated stereotyped movements, staring, grimaci
hb hb hb hb hb hb hb hb hb h b hb
ng, and the echoing of speech. Although catatonia has historically been associated with schizophrenia, catat
hb hb hb hb hb hb hb hb hb hb hb hb h b hb
onic symptoms are nonspecific and may occur in other mental disorders (e.g., bipolar or depressive disorders
hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb
with catatonia) and in medical conditions (catatonic disorder due to another medical condition).
hb hb hb hb hb hb hb hb hb hb hb hb h b
Negative Symptoms hb
Negative symptoms account for a substantial portion of the morbidity associated with schizophrenia but are less
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b h
prominent in other psychotic disorders. Two negative symptoms are particularly prominent in schizophren
b hb hb hb hb hb hb hb hb hb hb hb h b
ia: diminished emotional expression and avolition.
hb hb hb hb hb
● Diminished emotional expression includes reductions in the expression of emotions in the face, e hb hb hb hb hb hb hb hb hb hb hb hb h b
ye contact, intonation of speech (prosody), and movements of the hand, head, and face that normally giv
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
e an emotional emphasis to speech. hb hb hb hb hb
● Avolition is a decrease in motivated self initiated purposeful activities. The individual may sit for lo hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ng periods of time and show little interest in participating in work or social activities.
hb hb hb hb hb hb hb hb hb hb hb hb hb hb
Other negative symptoms include alogia, anhedonia, and asociality.
hb hb hb hb hb hb hb
● Alogia is manifested by diminished speech output hb hb hb hb hb hb
● Anhedonia is the decreased ability to experience pleasure. Individuals with schizophrenia can still hb hb hb hb hb hb hb hb hb hb hb hb h b
enjoy a pleasurable activity in the moment and can recall it, but show a reduction in the frequency of en
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
gaging in pleasurable activity hb hb hb
● Asociality refers to the apparent lack of interest in social interactions and may be associated with a hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
volition, but it can also be a manifestation of limited opportunities for social interactions. hb hb hb hb hb hb hb hb hb hb hb hb hb
Schizotypal (Personality) Disorder: Diagnostic Criteria hb hb hb hb
, A. A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced c
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
apacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior,
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
1. Ideas of reference (excluding delusions of reference). hb hb hb hb hb hb
2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
g., superstitiousness, belief in clairvoyance, telepathy, or ―sixth sense‖; in children and adolescents, biz
hb hb hb hb hb hb hb hb hb hb hb hb h b
arre fantasies or preoccupations). hb hb hb
3. Unusual perceptual experiences, including bodily illusions. hb hb hb hb hb
4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).
hb hb hb hb hb hb hb hb hb hb
5. Suspiciousness or paranoid ideation. hb hb hb
6. Inappropriate or constricted affect. hb hb hb
7. Behavior or appearance that is odd, eccentric, or peculiar. hb hb hb hb hb hb hb hb
8. Lack of close friends or confidants other than first-degree relatives. hb hb hb hb hb hb hb hb hb
9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with p hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
aranoid fears rather than negative judgments about self. hb hb hb hb hb hb hb
B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder w
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ith psychotic features, another psychotic disorder, or autism spectrum disorder.
hb hb hb hb hb hb hb hb hb
Note: If criteria are met prior to the onset of schizophrenia, add ―premorbid‖
hb hb hb hb hb hb hb hb hb hb hb hb
Schizotypal (Personality) Disorder: Differential Diagnosis hb hb hb hb
Other mental disorders with psychotic symptoms
hb hb hb hb hb
Schizotypal personality disorder can be distinguished from delusional disorder, schizophrenia, and a bipolar or d
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
epressive disorder with psychotic features because these disorders are all characterized by a period of persisten
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
t psychotic symptoms (e.g., delusions and hallucinations). To give an additional diagnosis of schizotypal per
hb hb hb hb hb hb hb hb hb hb hb hb h b hb
sonality disorder, the personality disorder must have been present before the onset of psychotic sympt
hb hb hb hb hb hb hb hb hb hb hb hb h b hb
oms and persist when the psychotic symptoms are in remission. When an individual
hb hb hb hb hb hb hb hb hb hb hb hb
has a persistent psychotic disorder (e.g., schizophrenia) that was preceded by schizotypal personality disorder, s
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
chizotypal personality disorder should also be recorded, followed by ―premorbid‖
hb hb hb hb hb hb hb hb hb
Neurodevelopmental disorders. hb
There may be great difficulty differentiating children with schizotypal personality disorder from the heterogeneous
hb hb hb hb hb hb hb hb hb hb hb hb h b
group of solitary, odd children whose behavior is characterized by marked social isolation, eccentricity, or peculia
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb
rities of language and whose diagnoses would probably include milder forms of autism spectrum disorder or lang
hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb hb
uage communication disorders. Communication disorders may be differentiated by the primacy and severity o
hb hb hb hb hb hb hb hb h b hb hb hb hb
f the disorder in language and by the characteristic features of impaired
hb hb hb hb hb hb hb hb hb hb hb
language found in a specialized language assessment. Milder forms of autism spectrum disorder are differe
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ntiated by the even greater lack of social awareness and emotional reciprocity and stereotyped behaviors and i
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb
nterests.
Personality change due to another medical condition hb hb hb hb hb hb
Schizotypal personality disorder must be distinguished from personality change due to another medical condition
hb hb hb hb hb hb hb hb hb hb hb hb h b
, in which the traits that emerge are a direct physiological consequence of another medical condition.
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb
Substance use disorders hb hb
Schizotypal personality disorder must also be distinguished from symptoms that may develop in association with
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
persistent substance use. hb hb
Other personality disorders and traits hb hb hb hb
Module 4
Primary Study Guide
University of South Alabama
, CMN 552
Module 4 Primary Study Guide
DSM5 Section II: Schizophrenia Spectrum
Delusions
Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Their
content may include a variety of themes (e.g., persecutory, referential, somatic, religious, grandiose).
● Persecutory delusions (i.e., belief that one is going to be harmed, harassed, and so forth by an
individual, organization, or other group) are most common.
● Referential delusions (i.e., belief that certain gestures, comments, environmental cues, and so forth
are directed at oneself) are also common.
● Grandiose delusions (i.e., when an individual believes that he or she has exceptional abilities,
wealth, or fame)
● Erotomanic delusions (i.e., when an individual believes falsely that another person is in love with
him or her)
● Nihilistic delusions involve the conviction that a major catastrophe will occur
● Somatic delusions focus on preoccupations regarding health and organ function.
Delusions are deemed bizarre if they are clearly implausible and not understandable to same culture
peers and do not derive from ordinary life experiences. An example of a bizarre delusion is the belief that
an outside force has removed his or her internal organs and replaced them with someone else’s organs without
leaving any wounds or scars. Delusions that express a loss of control over mind or body are generally
considered to be bizarre; these include the belief that one‘s thoughts have been ―removed‖ by some outside
force (thought withdrawal), that alien thoughts have been put into one‘s mind (thought insertion), or that
one‘s body or actions are being acted on or manipulated by some outside force (delusions of control).
An example of a nonbizarre delusion is the belief that one is under surveillance by the police, despite a lack
of convincing evidence.
The distinction between a delusion and a strongly held idea is sometimes difficult to determine and depends in
part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence
regarding its veracity. Assessing delusions in individuals from a variety of cultural backgrounds can be
difficult. Some religious and supernatural beliefs (e.g., evil eye, causing illness through curses, influence of
spirits) may be viewed as bizarre and possibly delusional in some cultural contexts but be generally accepted
in others. However, elevated religiosity can be a feature of many presentations of psychosis. Individuals who
have experienced torture, political violence, or discrimination can report fears that may be misjudged as
persecutory delusions; these may represent instead intense fears of recurrence or posttraumatic symptoms. A
careful evaluation of whether the person‘s fears are justified given the nature of the trauma can help to
differentiate appropriate fears from persecutory delusions.
Hallucinations
Hallucinations are perception-like experiences that occur without an external stimulus. They are vivid
and clear, with the full force and impact of normal perceptions, and not under voluntary control. They may
occur in any sensory modality, but auditory hallucinations are the most common in schizophrenia and
related disorders. Auditory hallucinations are usually experienced as voices, whether familiar or unfamiliar, that
are perceived as distinct from the individual’s own thoughts. The hallucinations must occur in the
context of a clear sensorium; those that occur while falling asleep (hypnagogic) or waking up
(hypnopompic) are considered to be within the range of normal experience. Hallucinations may be a normal
part of religious experience in certain cultural contexts.
,Disorganized Thinking (Speech) hb hb
Disorganized thinking (formal thought disorder) is typically inferred from the individual’s speech. The in
hb hb hb hb hb hb hb hb hb hb hb hb h b
dividual may switch from one topic to another (derailment or loose associations). Answers to questions ma
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
y be obliquely related or completely unrelated (tangentiality). Rarely, speech may be so severely disorganiz
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ed that it is nearly incomprehensible and resembles receptive aphasia in its linguistic disorganization (incohere
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
nce or ―word salad‖). Because mildly disorganized speech is common and nonspecific, the symptom must be
hb hb hb hb hb hb hb hb hb hb hb hb hbhb hb hb h
severe enough to substantially impair effective communication. The severity of the impairment may be diffi
b hb hb hb hb hb hb hb hb hb hb h b hb hb hb
cult to evaluate if the person making the diagnosis comes from a different linguistic background than that of the p
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb hb hb hb
erson being examined. For example, some religious groups engage in glossolalia (―speaking in tongues‖); other
hb hb hb hb hb hb hb hb hb h b hb hb hb hb
s describe experiences of possession trance (trance states in
hb hb hb hb hb hb hb hb
which personal identity is replaced by an external possessing identity). These phenomena are characterized b
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
y disorganized speech. These instances do not represent signs of psychosis unless they are accompanied by
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
other clearly psychotic symptoms. Less severe disorganized thinking or speech may occur during the prod
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
romal and residual periods of schizophrenia.
hb hb hb hb hb
Grossly Disorganized or Abnormal Motor Behavior (Including Catatonia)
hb hb hb hb hb hb hb
Grossly disorganized or abnormal motor behavior may manifest itself in a variety of ways, ranging from childlike
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
―silliness‖ to unpredictable agitation. Problems may be noted in any form of goal-
hb hb hb hb hb hb hb hb hb hb hb hb
directed behavior, leading to difficulties in performing activities of daily living.
h b hb hb hb hb hb hb hb hb hb
Catatonic behavior is a marked decrease in reactivity to the environment. This ranges from resistance to in
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
structions (negativism); to maintaining a rigid, inappropriate or bizarre posture; to a complete lack of verbal and
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
motor responses (mutism and stupor). It can also include purposeless and excessive motor activity without ob
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
vious cause (catatonic excitement). Other features are repeated stereotyped movements, staring, grimaci
hb hb hb hb hb hb hb hb hb h b hb
ng, and the echoing of speech. Although catatonia has historically been associated with schizophrenia, catat
hb hb hb hb hb hb hb hb hb hb hb hb h b hb
onic symptoms are nonspecific and may occur in other mental disorders (e.g., bipolar or depressive disorders
hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb
with catatonia) and in medical conditions (catatonic disorder due to another medical condition).
hb hb hb hb hb hb hb hb hb hb hb hb h b
Negative Symptoms hb
Negative symptoms account for a substantial portion of the morbidity associated with schizophrenia but are less
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b h
prominent in other psychotic disorders. Two negative symptoms are particularly prominent in schizophren
b hb hb hb hb hb hb hb hb hb hb hb h b
ia: diminished emotional expression and avolition.
hb hb hb hb hb
● Diminished emotional expression includes reductions in the expression of emotions in the face, e hb hb hb hb hb hb hb hb hb hb hb hb h b
ye contact, intonation of speech (prosody), and movements of the hand, head, and face that normally giv
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
e an emotional emphasis to speech. hb hb hb hb hb
● Avolition is a decrease in motivated self initiated purposeful activities. The individual may sit for lo hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ng periods of time and show little interest in participating in work or social activities.
hb hb hb hb hb hb hb hb hb hb hb hb hb hb
Other negative symptoms include alogia, anhedonia, and asociality.
hb hb hb hb hb hb hb
● Alogia is manifested by diminished speech output hb hb hb hb hb hb
● Anhedonia is the decreased ability to experience pleasure. Individuals with schizophrenia can still hb hb hb hb hb hb hb hb hb hb hb hb h b
enjoy a pleasurable activity in the moment and can recall it, but show a reduction in the frequency of en
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
gaging in pleasurable activity hb hb hb
● Asociality refers to the apparent lack of interest in social interactions and may be associated with a hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
volition, but it can also be a manifestation of limited opportunities for social interactions. hb hb hb hb hb hb hb hb hb hb hb hb hb
Schizotypal (Personality) Disorder: Diagnostic Criteria hb hb hb hb
, A. A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced c
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
apacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior,
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
1. Ideas of reference (excluding delusions of reference). hb hb hb hb hb hb
2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
g., superstitiousness, belief in clairvoyance, telepathy, or ―sixth sense‖; in children and adolescents, biz
hb hb hb hb hb hb hb hb hb hb hb hb h b
arre fantasies or preoccupations). hb hb hb
3. Unusual perceptual experiences, including bodily illusions. hb hb hb hb hb
4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).
hb hb hb hb hb hb hb hb hb hb
5. Suspiciousness or paranoid ideation. hb hb hb
6. Inappropriate or constricted affect. hb hb hb
7. Behavior or appearance that is odd, eccentric, or peculiar. hb hb hb hb hb hb hb hb
8. Lack of close friends or confidants other than first-degree relatives. hb hb hb hb hb hb hb hb hb
9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with p hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
aranoid fears rather than negative judgments about self. hb hb hb hb hb hb hb
B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder w
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ith psychotic features, another psychotic disorder, or autism spectrum disorder.
hb hb hb hb hb hb hb hb hb
Note: If criteria are met prior to the onset of schizophrenia, add ―premorbid‖
hb hb hb hb hb hb hb hb hb hb hb hb
Schizotypal (Personality) Disorder: Differential Diagnosis hb hb hb hb
Other mental disorders with psychotic symptoms
hb hb hb hb hb
Schizotypal personality disorder can be distinguished from delusional disorder, schizophrenia, and a bipolar or d
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
epressive disorder with psychotic features because these disorders are all characterized by a period of persisten
hb hb hb hb hb hb hb hb hb hb hb hb hb hb h b
t psychotic symptoms (e.g., delusions and hallucinations). To give an additional diagnosis of schizotypal per
hb hb hb hb hb hb hb hb hb hb hb hb h b hb
sonality disorder, the personality disorder must have been present before the onset of psychotic sympt
hb hb hb hb hb hb hb hb hb hb hb hb h b hb
oms and persist when the psychotic symptoms are in remission. When an individual
hb hb hb hb hb hb hb hb hb hb hb hb
has a persistent psychotic disorder (e.g., schizophrenia) that was preceded by schizotypal personality disorder, s
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
chizotypal personality disorder should also be recorded, followed by ―premorbid‖
hb hb hb hb hb hb hb hb hb
Neurodevelopmental disorders. hb
There may be great difficulty differentiating children with schizotypal personality disorder from the heterogeneous
hb hb hb hb hb hb hb hb hb hb hb hb h b
group of solitary, odd children whose behavior is characterized by marked social isolation, eccentricity, or peculia
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb
rities of language and whose diagnoses would probably include milder forms of autism spectrum disorder or lang
hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb hb
uage communication disorders. Communication disorders may be differentiated by the primacy and severity o
hb hb hb hb hb hb hb hb h b hb hb hb hb
f the disorder in language and by the characteristic features of impaired
hb hb hb hb hb hb hb hb hb hb hb
language found in a specialized language assessment. Milder forms of autism spectrum disorder are differe
hb hb hb hb hb hb hb hb hb hb hb hb hb h b
ntiated by the even greater lack of social awareness and emotional reciprocity and stereotyped behaviors and i
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb hb
nterests.
Personality change due to another medical condition hb hb hb hb hb hb
Schizotypal personality disorder must be distinguished from personality change due to another medical condition
hb hb hb hb hb hb hb hb hb hb hb hb h b
, in which the traits that emerge are a direct physiological consequence of another medical condition.
hb hb hb hb hb hb hb hb hb hb hb hb hb hb hb
Substance use disorders hb hb
Schizotypal personality disorder must also be distinguished from symptoms that may develop in association with
hb hb hb hb hb hb hb hb hb hb hb hb hb h b hb
persistent substance use. hb hb
Other personality disorders and traits hb hb hb hb
