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Monday, March 11, 2019

Childhood Precursors of Schizotypal Personality Disorder


When Do Positive and Negative Symptoms Begin to Emerge?



By: THEODORE MILLON and
      Seth Grossman
      Carrie Millon
      Sarah Meagher
      Rowena Ramnath

Researchers have traditionally divided the symptoms of the schizophrenic syndromes into two types.

First are the positive symptoms, mainly perceptual-cognitive in nature, which represent a surplus or exaggeration of normal functioning. These include suspiciousness, ideas of reference, odd beliefs, magical thinking, unusual perceptual experiences, and circumstantial and tangential speech.

Second are the negative symptoms, mainly social-interpersonal in nature, which represent deficits in normal functioning. These include constricted or inappropriate affect, speech problems (i.e., poverty of speech, stilted speech), social indifference, social isolation, flatness of emotion, and odd behavior or appearance.

Because some children show schizoid-like behavior from early childhood, there has been some interest in determining if early behavioral manifestations of either the positive or negative symptoms might develop into full-fledged disorders later in life.

S. Olin et al. (1997) studied teachers’ ratings of adolescents who were subsequently diagnosed as schizotypal personalities and compared them with several groups, including a group of normal adolescents whose parents were both normal. They found that childhood analogs of adult schizotypal symptoms were evident as early as late childhood and early adolescence.

When compared with children who later became healthy adults, children who later were diagnosed as schizotypal were more passive, more socially unengaged, more sensitive to criticism, and reacted more nervously. However, they were not rated as more anxious by their teachers.

The preschizotypal children differed from children who later became schizophrenic, who were more disruptive and hyper-excitable.

The results support a continuity of the negative symptoms from late childhood on into adulthood.
Unfortunately, no studies have yet addressed the positive symptoms of the schizotypal personality. Because it is developmentally normal for young children to believe in magic and to make attributions accordingly (Rosengren, Kalish, Hickling, & Gelman, 1994; Vikan & Clausen, 1993), it would be instructive to look at the development of these symptoms in schizotypal children.

Perhaps a reluctance or inability to relinquish early magical thinking, which is developmentally normal and generally manifested by all children, may doom a child to some serious psychopathology later in life.

References

Personality Disorders in Modern Life, second edition, 2000, 2004 by John Wiley & Sons, Inc.

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