A network model of the aetiology of schizotypal personality: evidence for the central role of mentalization, disorganization, and PTSD-symptoms

Abstract

Schizotypal personality traits are related to exposure to childhood trauma and to neurodevelopmental anomalies. Mentalization, attachment, openness, intellect, and social support are factors that may mediate or buffer the effect of such risk factors. However, to date, no study has investigated the associations between these constructs and schizotypy in a single model. We collected data in a large and demographically heterogeneous general population sample (N = 3441, 68% female, mean age = 39 years). We assessed schizotypal traits, environmental factors such as early traumas and perceived social support during adolescence, and putative mediators and protective factors such as openness/intellect, mentalization, and attachment. We estimated a Gaussian Graphical Model to examine the complex multivariate associations between the above constructs. Bootstrapping showed that the model was reliable. The importance of nodes was inferred using node centralities. Mentalization, disorganized schizotypy, and PTSD-like symptoms were the most central nodes in terms of strength and closeness. Disorganized schizotypy was related to early developmental anomalies, positive and negative schizotypy, and reduced intellect, mentalization was primarily related to reduced attachment avoidance and anxiety, while PTSD-like symptoms were linked to traumas and attachment anxiety. The results are in line with theories that emphasize the importance of mentalization and disorganized schizotypy in outcomes related to the extended psychosis-spectrum phenotypes. The findings may facilitate the generation of hypotheses for prospective and intervention studies.

Autistic and schizotypal traits exhibit similarities in their impact on mentalization and adult attachment impairments

“…Positive schizotypy is also directly linked to adult attachment anxiety and avoidance, aligning with previous literature (Carr et al, 2018). However, a large-scale network analysis (Polner et al, 2021b) failed to identify positive traits as a central component in the relationship between schizotypy, mentalizing, and attachment. These results are unexpected, given that in cases of clinical SCH, paranoid delusions and hallucinations have been linked to deficits in mentalizing (Finn et al, 2018;Frith, 2004;Montag et al, 2011).…”

“…The total score of the questionnaire cannot be reliably applied, thus the use of separate scores for each of the three subscales is warranted (Cronbach's α = 0.8-0.9). During the Hungarian adaptation, satisfactory reliability indices were found in a sample of healthy adults (Cronbach's α = 0.76-0.87) (Polner et al, 2021b). In the present study, we obtained comparable reliability for the positive…”

“…Disorganized schizotypy was associated with both adult attachment anxiety and avoidance, mediated by difficulties in mentalizing. Previous research suggested that disorganized traits are a central component of schizotypy (Polner et al, 2021a), are associated with poorer cognitive and emotional control functions (Kerns, 2006), and inversely relate to mentalizing (Polner et al, 2021b). Consequently, individuals with higher levels of disorganized schizotypy may experience difficulties in maintaining and tracking conversations with others, as well as integrating social cues from various sources (e.g., gestures, facial expressions, tone of voice, and verbal content).…”