A Dimensional Approach to Schizotypy

lt;p>Simone Cheli, PhD is an adjunct professor at the St. John's University in Rome and founding director of Tages Onlus, a mental health charity located in Florence. A chartered psychologist, he is currently involved in testing a new integrative treatment for those struggling with schizotypal personality disorder, namely Evolutionary Systems Therapy for Schizotypy. His daily work is as therapist with persons diagnosed with personality disorders and psychosis.

Paul H. Lysaker, PhD is a Clinical Psychologist at the Richard L Roudebush VA Medical Center, Indianapolis, IN and a Professor of Clinical Psychology in the Department of Psychiatry at the Indiana University School of Medicine. He has over 35 years of experience providing recovery oriented psychotherapy to adults diagnosed with a serious mental illness and is an author of over 500 peer reviewed articles.

Introduction - Schizotypy as a treatable dimension (Simone Cheli & Paul H. Lysaker) - (10 pp): We present the aim and the scope of the book and its structure.

Part 1 -Schizotypy as a feature of personality and psychopathology (70-80 pp)

The first section presents multiple perspectives from which schizotypy can be conceptualized as a transdiagnostic dimension.

1.1 The neurodevelopmental perspective (Anna Docherty): A summary is offered of the neuroscience foundation of schizotypy as a continuum between normality and pathology and along ontogenetic development.

1.2 The evolutionary perspective (Martin Brune): Schizotypy is discussed from an evolutionary point of view, highlighting the phylogenetic relationship between social cognition and severe mental disorders.

1.3 The psychopathological perspective (Roman Kotov): Dimensional (e.g. AMPD) and hierarchical (e.g. HiTOP) models of psychopathology support a view of schizotypy as a continuum are discribed.

1.4 The phenomenological perspective (Lisa Bortolotti): The psychopathological manifestations of schizotypy are presented in terms of personal significance, the understanding of which supports clinical work.

1.5 The psychometric perspective (Neus Barrantes-Vidal): The measures used to formulate an assessment are discussed and briefly described through a dimensional and transdiagnostic perspective.

1.6 The transcultural perspective (Tanya Luhrmann): The different forms of psychopathology are discussed through an anthropological perspective, with particular attention to how societies define schizotypy.

Part 2 - Transdiagnostic mechanisms (60-70 pp)

The second section explores the psychological processes or mechanisms that may cause and sustain deficits in psychosocial functioning.

2.1 Metacognition (Paul Lysaker): Metacognition, as the capacity to understand and integrate one's own and other's mental state, is discussed as a central psychopathological factor in defining the level of impairment and appropriate treatment.

2.2 Mentalizing (Martin Debannè): Mentalizing, as the process by which we make sense of each other and ourselves, is presented as protective factor in facing adverse events in those at risk for psychosis.

2.3 Attachment (Katherine Barry): The role of attachment in the course of the different forms of psychopathology and in affecting therapeutic relationship is discussed.

2.4 Self-criticism (Paul Gilbert): Self-criticism as the inability to sooth one's own suffering is presented as a trigger of psychopathology, generally speaking, and specifically in those at risk for psychosis.

2.5 Interpersonal threat (Christopher Hopwood): The perception of relational situations as threatening represents both a trigger of psychopathology and a target of the intervention. Its role is discussed.

Part 3 - Integrated interventions (120-140 pp)

The third section presents a review of interventions targeting the mechanisms described in the second section that can be easily applied to different symptoms from a transdiagnostic point of view.

3.1 Attachment-based interventions (Andrew Gumley): A summary is offered of the interventions focused or based on the role of attachment, and their integration with CBT and psychodynamic approaches.

3.2 Compassion-focused Therapy (Charles Hariot-Maitland): A summary of how Compassion-focused Therapy works with schizotypy manifestations such as hearing voices.

3.3 Metacognitive, Reflection and Insight Therapy (Ilanit Hasson-Ohayon): A summary is offered regarding  how Metacognitive, Reflection and Insight Therapy works can be offered in the treatment of psychopathological manifestations of with schizotypy such as psychosis.

3.4 Metacognitive Interpersonal Therapy (Giancarlo Dimaggio): A summary is offered of how Metacognitive Interpersonal Therapy can be applied in the the treatment of manifestation of schizotypy manifestations such as Cluster A Personality Disorders.

3.5 Compassion and Metacognition based Interventions (Simone Cheli): A summary is offered concerning Compassion Focused Therapy can be integrated along with Metacognitively Oriented Psychotherapy to targeting schizotypy.

3.6 Mentalization Based Treatment (Jeremy Rideneour): A summary is offered of how Mentalization Based Treatment can be offered to treat manifestation of schizotypy such as psychosis.

3.7 Integration of CBT and psychodynamics (Michael Garrett): A summary of how to integrate CBT and psychodynamics in treatment targeting schizotypy.

3.8 Psychoanalytic treatments (Ondrej Pec): A summary of how psychoanalytic treatment can be applied to treatment psychopathological manifestations of schizotypy including psychosis.

3.9 Relation-informed online interventions (Sandra Bucci): A summary is offered outlining the state of the art of online interventions for psychosis that are rooted in the relational dimension of schizotypy.

3.10 Clinical staging and psychopharmacological treatments (Jessica Hartmann): A summary is offered of the state of the art of pharmacological treatments for schizotypy through the clinical staging perspective.

Conclusion - Future directions (Simone Cheli & Paul H. Lysaker) - (10 pp): We summarize how the issues discussed may support the clinical work and future research.