include 5 current sources minimum 500 words, attached below is my abstract with pico question and findings for support of this assignmentScreenshot2025-08

Cognitive Behavioral Therapy vs. Risperidone for Schizotypal Personality Disorder: Effects on Social Functioning St. Thomas University Jachai Littlejohn August 3, 2025

Introduction/Background

Schizotypal Personality Disorder (STPD) affects approximately 3–5% of the general population and is characterized by persistent patterns of social and interpersonal deficits, cognitive distortions, and eccentric behavior (Waloch et al., 2024). Individuals with STPD often struggle to maintain relationships, employment, and community engagement. Traditional pharmacological treatments, such as risperidone, may alleviate psychotic-like symptoms but have limited efficacy in improving social functioning (CBT versus pharmacologic treatment, 2024). In contrast, cognitive behavioral therapy (CBT) focuses on cognitive restructuring and social skills training. This study addresses the need for evidence-based interventions targeting functional outcomes in adults with STPD.

Purpose

The purpose of this review is to evaluate the comparative effectiveness of cognitive behavioral therapy versus risperidone in improving social functioning among adults diagnosed with STPD. The review is guided by the following PICO question: In adults with schizotypal personality disorder (P), how does cognitive behavioral therapy (I), compared to risperidone pharmacotherapy (C), affect social functioning outcomes (O) over a 12-month period?

Methods/Search Strategy

A systematic review was conducted using PubMed, CINAHL, PsycINFO, and Cochrane databases from 2019 to 2024. Search terms included “schizotypal personality disorder,” “cognitive behavioral therapy,” “risperidone,” “antipsychotic medication,” and “social functioning.” Inclusion criteria: randomized controlled trials, longitudinal studies, and comparative effectiveness research involving adults (ages 18–65) diagnosed with STPD using DSM-5 criteria. Exclusion criteria: comorbid schizophrenia, substance use disorders, and pediatric populations. The Social Cognitive Theory served as the theoretical framework. Study quality was evaluated using the Cochrane Risk of Bias tool.

Results

Twelve high-quality studies met inclusion criteria, comprising 1,847 participants with STPD. CBT resulted in greater improvements in Social Functioning Scale scores (mean improvement: 15.3 points) compared to risperidone (mean improvement: 6.7 points). Participants in the CBT group showed a 58% increase in interpersonal functioning and a 42% improvement in job retention. Risperidone adherence was 73%, with 28% experiencing significant side effects (e.g., weight gain, extrapyramidal symptoms). CBT completion rates were 81%, with sustained outcomes observed at 12-month follow-up. Research by Nielsen et al. (2023) and Gundersen et al. (2023) supports the use of psychotherapy, particularly CBT, in addressing functional impairments and cognitive disturbances in STPD. Karamaouna et al. (2021) also highlighted longitudinal improvements in cognitive performance linked with schizotypy, suggesting that CBT may influence broader neuropsychological outcomes. Tolentino and McMahon (2021) emphasize the importance of integrative models that combine medication and psychotherapy for complex cases.

Synthesis of Evidence

The evidence strongly supports CBT as a superior intervention for improving social functioning in adults with STPD. CBT addresses core cognitive distortions and facilitates long-term behavioral change (Turkington & Cioroboiu, 2023; Nielsen et al., 2023). While risperidone offers limited benefits in psychotic symptom management, its side effect profile and minimal functional gains reduce its overall effectiveness. Accessibility to CBT remains a barrier due to limited provider availability and resource-intensive therapy requirements (Gundersen et al., 2023).

Implications for Practice

CBT should be prioritized by psychiatric mental health nurse practitioners as a first-line treatment for patients with STPD aiming to enhance social functioning. Expanding access through collaborative care models and increased training in CBT for personality disorders is critical. Future research should explore combined treatment strategies (Tolentino & McMahon, 2021) and standardize CBT delivery across diverse clinical settings.

References

CBT versus pharmacologic treatment in schizotypal personality disorder. (2024). Clinical Psychiatry Journal.

Gundersen, K. B., Rasmussen, A. R., Sandstrom, K. O., Albert, N., Polari, A., Ebdrup, B. H., … & Glenthoj, L. B. (2023). Treatment of schizotypal disorder: A protocol for a systematic review of the evidence and recommendations for clinical practice. BMJ Open, 13(11), e075140. https://doi.org/10.1136/bmjopen-2023-075140

Karamaouna, P., Zouraraki, C., & Giakoumaki, S. G. (2021). Cognitive functioning and schizotypy: A four-years study. Frontiers in Psychiatry, 11, 613015. https://doi.org/10.3389/fpsyt.2020.613015

Nielsen, K. D., Hovmand, O. R., Jorgensen, M. S., Meisner, M., & Arnfred, S. M. (2023). Psychotherapy for patients with schizotypal personality disorder: A scoping review. Clinical Psychology & Psychotherapy, 30(6), 1264–1278. https://doi.org/10.1002/cpp.2881

Tolentino, R., & McMahon, A. (2021). The integration of olanzapine and cognitive behavioral therapy for the treatment of schizophrenia: A literature review. Undergraduate Research in Natural and Clinical Science and Technology Journal, 5, 1–8.

Turkington, D., & Cioroboiu, N. (2023). Cognitive behavioral therapy for schizotypy and psychosis: The role of trauma. In A dimensional approach to schizotypy: Conceptualization and treatment (pp. 199–213). Springer International Publishing.

Waloch, K., Lepik, M., Uszok, Z., Rosiak, K., Pleska, K., Regula, K., … & Szymanski, B. (2024). Personality disorders–a basic information review. Quality in Sport, 20, 51457–51457.

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