Schizotypy, schizotypal personality, and psychosis risk

Current models of schizophrenia suggest that it is the most severe expression of a broad range of clinical and subclinical symptoms and impairment referred to as schizotypy. This chapter reviews the predictive validity of schizotypy for schizophrenia-spectrum psychopathology in nonclinical and genetic and clinical high-risk participants, as well as the developmental course of schizotypal personality disorder. High schizotypy is consistently associated with elevated rates of symptoms. Furthermore, longitudinal studies indicate that positive schizotypy is associated with risk for developing psychotic disorders, and both positive and negative schizotypy are associated with risk for schizophrenia-spectrum disorders. Findings indicate the relevance of assessing premorbid schizotypy traits in clinical high-risk individuals, as obtaining a comprehensive profile may help to tailor psychological and pharmacological interventions and address features that may be obscured by prominent attenuated psychotic symptoms. Also, continuous models of schizotypy fit well with dimensional approaches to psychopathology like the Research Domain Criteria.