Schizotypal personality disorder involves an acute discomfort with, and reduced capacity for, close relationships, as well as eccentric behavior and distorted cognition or perception, indicated by at least five of the following:
- “Ideas of reference,” i.e., feeling that events or circumstances apply to them personally. Examples include feeling that strangers are talking about them, believing that events have been deliberately contrived for them, or thinking that posts on social network websites have hidden meanings pertaining to them.
- Odd beliefs or magical thinking that influences behavior and is inconsistent with cultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations).
- Unusual perceptual experiences, including bodily illusions.
- Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).
- Suspicious or paranoid thinking.
- Inappropriate or constricted affect.
- Behavior or appearance that is odd, eccentric, or peculiar.
- Lack of close friends or confidants other than first-degree relatives.
Excessive social anxiety does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.