NAME of Client: Travis DATE: ____________

Schizotypal Personality Disorder STPD

(Diagnostic Criteria for Schizotypal Personality Disorder DSM-5 301.22 (F21)

Checklist
Instruction: Below is a list of statements/criterion that are essential features common among
people with Schizotypal Personality Disorder (STPD). Please read each statement carefully, and
put a check mark on the column that best applies to the case presented. (5 or more of the following
symptoms is an indicator of having STPD).

SYMPTOMS Highly Not Observable STPD Traits/symptoms

indicative
1 The individual’s ideas of
reference (not including
delusions of reference)
2 He or she has strange beliefs
or magical thinking that
influences behavior and that
is quite different from
subcultural norms (e.g.,
feelings about superstition,
telepathy, “sixth sense”, and
generally bizarre fantasies).
3 The individual has odd
perceptual experiences, such
as bodily illusions.
4 He or she has strange
thinking and speech habits;
for example, the individual
is excessively vague or
metaphorical.
5 He or she is excessively
suspicious or paranoid.
Indicative
/ The client’s belief that watching a
porn show for a first date is normal
because that’s the kind of movies he
always watch and he doesn’t know
about the interests of a girl.
/ The client has strange depiction of
the people in the city, and he has
bizarre fantasizes. He claims that all
the animals come out at night,
whores, skunk pussies, buggers,
queens, fairies, dopers, junkies, sick
and venal. He even fantasizes that
someday a real rain will come and
wash all those he considered as
“scum” off the streets. He also
depicts Betsy as an angel among the
filthy people in the city.
/ The client was talking to himself in
the mirror as if it is separate from him
as said the infamous line “Are you
talking to me?” which manifested a
total disintegration of self.
/ The client has a lot of interesting
thoughts that he records in his diary
like, “You are only as healthy as you
feel”.; “Women are like a union, they
are cold and distant”; “Its real clean,
like my conscience.” He is
excessively using vague or
metaphorical statements.
/ He has paranoid thoughts and
fantasies and displays inappropriate
expressions of emotions towards a
girl.
6 The individual has
inappropriate or restricted
feelings.
7 The individual behaves
peculiarly or eccentrically,
or has an odd appearance.
8 He or she lacks a closeness
with others except with first-
degree relatives.
9 He or she experiences
excessive social anxiety even
with the comfort of familiar
people or places; this
anxiety tends to relate to
paranoid fears rather than
self-consciousness.
TOTAL
/ The client has an obsession with a
girl who does not like him but he is
compelled to protect her. When he
was rejected, he felt extreme rage but
cannot express it to the girl and yet
he has positive feelings for her and
not to be construed as love.
/ The client with his rage and
frustration, he shaved his head in a
Mohawk style and gone amok to the
place of work of the girl.
/ The client has no close relationships
with other people, even with his
parents he do not want to let them
know where he is staying.
/ The client has excessive disgust with
people around him in contradictory
with his line of work being a taxi
driver.
9/9

FINDINGS:

The client has satisfied the minimum symptoms requirement of the DSM5
Diagnostic Criteria of Schizotypal Personality Disorder. The client has met the maximum
9 out of 9 criteria to consider him with SPD. However, PTSD must also be considered
as premorbidity of SPD.

A. A pervasive pattern of social and interpersonal deficits marked by acute discomfort

with, and reduced capacity for, close relationships as well as by cognitive or
perceptual distortions and eccentricities of behavior, beginning by early adulthood
and present in a variety of contexts as indicated by the following:

A. 1 The client’s belief that watching a porn show for a first date is normal because
that’s the kind of movies he always watch and he doesn’t know about the interests
of a girl.

A.2 The client has strange depiction of the people in the city, and he has bizarre
fantasizes. He claims that all the animals come out at night, whores, skunk pussies,
buggers, queens, fairies, dopers, junkies, sick and venal. He even fantasizes that
someday a real rain will come and wash all those he considered as “scum” off the
streets. He also depicts Betsy as an angel among the filthy people in the city.
 A.3 The client was talking to himself in the mirror as if it is separate from him as said
the infamous line “Are you talking to me?” which manifested a total disintegration of
self.

A.4 The client has a lot of interesting thoughts that he records in his diary like, “You
are only as healthy as you feel”.; “Women are like a union, they are cold and
distant”; “Its real clean, like my conscience.” He is excessively using vague or
metaphorical statements.

A.5. He has paranoid thoughts and fantasies and displays inappropriate

expressions of emotions towards a girl.

A.6. The client has an obsession with a girl who does not like him but he is
compelled to protect her. When he was rejected, he felt extreme rage but cannot
express it to the girl and yet he has positive feelings for her and not to be construed
as love.

A.7. The client with his rage and frustration, he shaved his head in a Mohawk style
and gone amok to the place of work of the girl.

A.8. The client has no close relationships with other people, even with his parents
he do not want to let them know where he is staying.

A.9. The client has excessive disgust with people around him in contradictory with
his line of work being a taxi driver.

It is further noted that the client was a Vietnam war veteran and may have been
suffering from Post-Traumatic Stress Disorder (PSTD). Comorbidity with the symptoms
of depression and Insomnia is also considered. His insomnia can be a symptom of
depression. The memories of war did not allow him to sleep or socialize with people.
This made him reclusive and opted to work at night and sleep during day. He also
shows unpacking of monologues with self. PSTD will be considered as premorbid to
Schizotypal Personality Disorder.

RECOMMENDATION

Based on the information presented on the case data and the findings, it is
recommended that the client will be assessed for a possibility of a Post-Traumatic
Stress Disorder. However, it is best to give the client primary treatment for the PTSD as
Schizotypal Personality Disorder was a subsequent disorder to the PTSD. The
treatment will be specifically designed for PTSD for war veterans.

1. COGNITIVE BEHAVIORAL therapy (CBT) is considered to have the strongest

evidence for reducing the symptoms of PTSD in veterans and has been shown to
be more effective. It focuses on the relationship among thoughts, feelings, and
 behaviors; targets current problems and symptoms; and focuses on changing
patterns of behaviors, thoughts and feelings that lead to difficulties in functioning
(www.apa.org). Two techniques of CBT will be employed Cognitive Processing
Therapy (CPT) and Prolonged Exposure (PE) therapy.

2. COGNITIVE PROCESSING THERAPY focuses on the impact of the trauma. In

CPT, the therapist helps the client identify negative thoughts related to the event,
understand how they can cause stress, replace those thoughts, and cope with
the upsetting feelings (Management of Post-Traumatic Stress Working Group,
2010). The treatment will help the client into adapting from a war zone living
condition to a normal living condition. The client has difficulty living his life after
war as he was used to be trained to kill legally as bounded by his duty as a
military. He cannot reconcile the justice not being served to the injustices of the
world (e.g. child sex slavery, chaotic city life) he sees in the real setting.

3. PROLONGED EXPOSURE THERAPY has been shown to be effective in 60% of

veterans with PTSD. The client will be subjected to the repeated revisiting of the
trauma in a safe, clinical setting and it will help the client change how he reacts to
memories of traumatic experiences, as well as learn how to master fear- and
stress-inducing situations moving forward (www.ptsd.va.gov).

PE and CPT treatments each take approximately 12 weekly sessions to

complete (www.ptsd.va.gov).

Evaluated by:

DESIREE O. LABIO JULY 31, 2021

Signature over printed name Date of evaluation

Prepared by:

Evangeline C. Digamon
PH GC 606