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This makes sense given that schizophrenia shares some symptoms with each of the odd/eccentric personality disorders. Additional evidence that genes play a role is the fact that the rates of schizotypal personality disorder are higher among family members of people with schizophrenia than among the general population (Siever & Davis, 2004; Tienari et al. Psychological Factors in Odd/Eccentric Personality Disorders Like people with schizophrenia, those with schizotypal personality disorder tend to have specific cognitive deficits. These include problems with attention (distinguishing relevant from irrelevant stimuli), memory, and executive function (used in problem solving, planning, and judgment) (Voglmaier et al. According to Beck and colleagues (2004), schizotypal personality disorder is unusual among the personality disorders in that the primary distortions are in mental processes. Although people with schizotypal personality disorder have cognitive deficits, they generally have better cognitive skills than do people with schizophrenia (Trestman et al. In addition, core maladaptive beliefs and strategies of people with each of the odd/eccentric personality disorders may differ (see Table 13. Schizotypal Unreal, detached, loner; vulnerable, socially conspicuous; supernaturally sensitive and gifted Untrustworthy, malevolent Watch for and neutralize malevolent attention from others. People with any of these three disorders also often behave in unusual ways (hence the label "odd/eccentric"), and these behaviors then make them noticeable to others. And their obvious unusual behavior can make other people more likely to mistreat them (intentionally or not), confirming their beliefs about themselves and other people. People with these disorders also pay attention to , remember, and interpret stimuli in ways that are consistent with their beliefs and that thus reinforce their isolation and avoidance of other people. N P S Social Factors in Odd/Eccentric Personality Disorders In contrast to their lesser role in schizophrenia, certain social factors appear to play a relatively large role in the onset of schizotypal personality disorder. These social factors include physical abuse or neglect, insecure attachment to parents, and discrimination (Berenbaum et al. In fact, some of these social factors may be related to each other: Insecure attachment may, at least in part, arise from abuse or neglect. Children who develop schizotypal personality disorder are more likely to have experienced trauma, abuse, and neglect than are those who went on to develop most other personality disorders (Yen et al. For instance, early social stressors such as neglect and trauma can contribute to brain abnormalities, particularly if a genetic or other neurological vulnerability exists before birth. The neurological changes, in turn, contribute to disturbances in cognitive and emotional functioning (Raine, 2006). These cognitive and emotional disturbances then can lead to problems in social interactions and increased stress (Skodol, Gunderson et al. Moreover, trauma, neglect, and insecure attachment may give rise to a paranoid attributional style and a discomfort with others (Raine, 2006). People with an odd/eccentric personality disorder tend not to be interested in treatment and, if urged or coerced into it, are often reluctant participants at best. Thus, the particular challenge of treating people with odd/eccentric personality disorders Personality Disorders 5 9 1 is their tendency not to collaborate with the therapist to develop goals for treatment (Beck, Freeman, & Davis, 2004; Farmer & Nelson-Gray, 2005). Most of the medications that effectively treat symptoms of schizophrenia can also treat symptoms of schizotypal personality disorder, although the medications are often taken at a lower doses (Koenigsberg et al. One preliminary study investigated such treatments for people who had some symptoms of schizotypal personality-but not enough symptoms to receive the diagnosis of the personality disorder; the results suggest that social skills training can be effective (Liberman & Robertson, 2005). Schizoid personality disorder is characterized by a restricted range of emotions in social interactions and few-if any-close relationships; people with this disorder have poor social skills. Many of the factors that give rise to schizophrenia also appear to give rise to schizotypal personality disorder: genes and the prenatal environment; problems with attention, memory, and executive function as well as an impaired theory of mind; and physical abuse or neglect in childhood, insecure attachment, and discrimination. Paranoid, schizoid, and schizotypal personality disorders are on the spectrum of schizophrenia-related disorders, and close relatives of people with any of these odd/eccentric personality disorders are more likely to have schizophrenia. Schizotypal personality disorder involves neurological abnormalities that are less severe than those associated with schizophrenia. She ran out of the house barefoot, then ran for miles through the city on glass-strewn sidewalks.

Unfortunately, learning disorders may cast a long shadow over many areas of life for many years. People with learning disorders are 50% more likely to drop out of school than are other people in the general population, and work and social relationships are also more likely to suffer (American Psychiatric Association, 2000). Social factors can lead a child to be incorrectly diagnosed with a learning disorder. For example, immigrant children may not have English language skills advanced enough to allow their reading, writing, or math skills to approach the expected level of performance. These next steps may include observing the child in the classroom, recommending a formal evaluation, and/or talking with the parents. Understanding Learning Disorders Like mental retardation and pervasive developmental disorders, learning disorders arise in large part because of neurological factors. Neurological Factors Among the three types of learning disorders, dyslexia has been studied the most extensively. Evidence is growing that impaired brain systems underlie this disorder and that genes contribute to these impaired systems. Childhood Disorders 6 4 5 Brain Systems In most forms of dyslexia, the brain systems involved in auditory processing do not function as they should (Marshall et al. For example, one study used electrodes placed on the scalp to examine the brain waves of infants while they listened to syllables coming out of a speaker. The children who were classified as dyslexic at 8 years old had brain-wave patterns in infancy (while they listened to spoken syllables) that were different from those of the children whose reading ability was classified as normal, which suggests that the children with dyslexia were born with processing problems in the auditory system (Molfese, 2000). Further research has suggested that these brain-wave differences continue at least through the first 4 years of life (Espy et al. The results of many neuroimaging studies have converged to identify a set of brain areas that is disrupted in people who have dyslexia (Shaywitz, Lyon, & Shaywitz, 2006). First, two rear areas in the left hemisphere are not as strongly activated during reading tasks in people with dyslexia as they are in people who read normally. One of these areas, at the junction of the parietal and temporal lobes, appears to be involved in converting visual input to sounds (Friedman, Ween, & Albert, 1993). The other area, at the junction of the parietal and occipital lobes, appears to be used to recognize whole words, based on their visual forms (Cao et al. Moreover, these areas are not activated normally even in young children with dyslexia, and thus the malfunction observed in adults cannot be a result of not reading properly over the course of many years but probably contributes to reading disorder (Shaywitz et al. Second, two other brain areas (the bottom part of the frontal lobe and the right occipital-temporal region) are more activated in people with a reading disorder than in people who read normally. These areas appear to be used in carrying out compensatory strategies, which rely on stored information instead of the usual vision-sound conversion process. Consistent with the neuroimaging results, researchers have also reported structural differences between the brains of people with dyslexia and normal readers. Compared to people who read normally, people with dyslexia have reduced gray matter (which includes the cell bodies of neurons) in the temporal lobes, particularly the left temporal lobe (Vinckenbosch, Robichon, & Eliez, 2005), and portions of their frontal lobes are relatively large (Vinckenbosch, Robichon, & Eliez, 2005; Zadina et al. Moreover, people who have relatively large occipital lobes (which are specialized for vision) tend to read better than those with smaller occipital lobes (Zadina et al. However, the precise brain areas involved in dyslexia are influenced by culture, as manifested by the language spoken in a society. Specifically, part of the left frontal lobe is impaired in dyslexic children who speak Chinese, instead of the areas just discussed (which were assessed in English-speaking children). Chinese writing does not depend on an alphabet, but instead requires memorizing specific characters that correspond to words (Siok et al. The frontal lobes are involved in using stored information to help register current stimuli, and such processing may play a large role in reading Chinese characters. At least some forms of dyslexia also appear to reflect a specific problem in processing visual stimuli-independent of problems in connecting those stimuli to sounds-which may be why some people with dyslexia reverse letters when they write (Vidyasagar, 2005). Thus, findings regarding brain systems suggest that there are probably different forms of dyslexia, with different underlying causes.

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