Schizotypal Personality Disorder (STPD) is characterized by 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 (American Psychiatric Association, 2022). A core challenge for individuals with STPD is impaired social functioning, often stemming from pervasive social anxiety, paranoid ideation, odd beliefs, and difficulties with social cues and emotional expression. Understanding how different treatments impact this crucial area is vital.

Comparing Cognitive Behavioral Therapy (CBT) to pharmacological treatment with Risperidone for their effect on overall social functioning in adults with STPD reveals distinct mechanisms and variable outcomes.

Cognitive Behavioral Therapy (CBT) and Social Functioning in STPD

CBT for STPD aims to identify and restructure unhelpful thought patterns, beliefs, and behaviors that contribute to social isolation and dysfunction. The primary mechanisms through which CBT seeks to improve social functioning include:

• Challenging Distorted Cognitions: Individuals with STPD often harbor paranoid thoughts (e.g., suspiciousness of others’ intentions) or ideas of reference (e.g., believing ordinary events have special meaning for them). CBT helps patients identify these distorted thoughts and collaboratively test their validity. By reducing the intensity of these beliefs, social anxiety and withdrawal can decrease, making social interactions less threatening.