Questions About Schizoid, Schizotypal, Intrusive Thoughts and More

Reader’s Question

I have a few unanswered questions, hope you can help clarify them for me. What are the main differences between Schizotypal and Schizoid Personality Disorder? And what are the main differences between high functioning Autism and Asperger’s?

How do you decipher if the person is encountering strong intrusive thoughts that they have succumbed to believing are true (OCD type) and psychosis, when they have poor articulation? Also they don’t seem to hear voices, but see what is described as a controlling image that can command?

Our Consulting Clinical Psychologist’s Reply

Here we go: Schizoid Personality Disorder suggests a life-long pattern of social detachment and isolation as well as a restricted range of emotions, interests, and social activities. Schizoid individuals are often more than loners and often don’t even enjoy the company of their family. Schizotypal Personality Disorder also has social detachment but thinking, perceptual, and behavioral distortions as well. Schizotypal individuals have a level of paranoia as well as odd beliefs and magical thinking, often including belief in supernatural, spiritual, and perceptual experiences that are unique to the individual and not part of a normal religious belief in their culture. Schizotypal also includes some unusual illusions, body perceptions/sensations, and oddities of language.

Asperger’s Disorder is considered to be a type of high-functioning Autism and is part of the Autistic Spectrum. Individuals with Asperger’s Disorder can typically participate in education, employment, and social relationships at some level while Autistic individuals typically are profoundly impaired.

Intrusive thoughts are common in OCD as you mention. You begin to move in the direction of a psychosis when you start believing these thoughts are not yours, that they have been inserted into your brain, that you are being given commands for some significant purpose (save the world, from the government, etc.), and that the voices/thoughts are part of a plan to control or manipulate you. Most people can’t articulate these mental health sympmtoms very well. When seen in treatment, people often report “voices” or “sensations”. It’s then up to the professional to ask questions that separate OCD from psychosis for example.