Ketogenic diet has a positive association with mental and emotional well-being in the general population

OBJECTIVES

A ketogenic diet reduces pathologic stress and improves mood in neurodegenerative and neurodevelopmental disorders. However, the effects of a ketogenic diet for people from the general population have largely been unexplored. A ketogenic diet is increasingly used for weight loss. Research in healthy individuals primarily focuses on the physical implications of a ketogenic diet. It is important to understand the holistic effects of a ketogenic diet, not only the physiological but also the psychological effects, in non-clinical samples. The aim of this cross-sectional study with multiple cohorts was to investigate the association of a ketogenic diet with different aspects of mental health, including calmness, contentedness, alertness, cognitive and emotional stress, depression, anxiety, and loneliness, in a general healthy population.

METHODS

Two online surveys were distributed: cohort 1 used Bond-Lader visual analog scales and Perceived Stress Scale (n = 147) and cohort 2 the Depression Anxiety Stress Scale and revised UCLA Loneliness Scale (n = 276).

RESULTS

A ketogenic diet was associated with higher self-reported mental and emotional well-being behaviors, including calmness, contentedness, alertness, cognitive and emotional stress, depression, anxiety, and loneliness, compared with individuals on a non-specific diet in a general population.

CONCLUSION

This research found that a ketogenic diet has potential psychological benefits in the general population.

The role of loneliness and negative schemas in the moment-to-moment dynamics between social anxiety and paranoia

Social anxiety and paranoia often co-occur and exacerbate each other. While loneliness and negative schemas contribute to the development of social anxiety and paranoia separately, their role in the development of the two symptoms co-occurring is rarely considered longitudinally. This study examined the moment-to-moment relationship between social anxiety and paranoia, as well as the effects of loneliness and negative schemas on both experiences individually and coincidingly. A total of 134 non-clinical young adults completed experience sampling assessments of momentary social anxiety, paranoia, and loneliness ten times per day for six consecutive days. Participants' negative-self and -other schemas were assessed with the Brief Core Schema Scale. Dynamic structural equation modelling revealed a bidirectional relationship between social anxiety and paranoia across moments. Loneliness preceded increases in both symptoms in the next moment. Higher negative-self schema was associated with a stronger link from paranoia to social anxiety; whereas higher negative-other schema was associated with a stronger link from social anxiety to paranoia. Our findings support the reciprocal relationship between social anxiety and paranoia. While loneliness contributes to the development of social anxiety and paranoia, negative self and other schemas appear to modify the relationships between the two symptoms.

Salivary testosterone and cortisol levels in borderline personality disorder before and after a 12-week group dialectical behavior therapy intervention

Background

Borderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following psychological treatment.

Methods

Participants with BPD (n = 33) completed a 12-week Dialectical Behavior Therapy group program. Pre and post salivary testosterone and cortisol were analyzed. Baseline hormones in the BPD group were compared to age-and-sex matched controls (n = 33). Non-parametric tests were utilized to investigate group differences, pre-post treatment hormone and symptom changes, and associations between symptoms and hormone levels.

Results

Participants with BPD had significantly higher testosterone levels than controls. Mean testosterone levels in females with BPD were double that of female controls. Testosterone and cortisol levels were related, and some BPD symptoms were associated with with hormone levels. BPD symptoms reduced significantly with treatment, however pre to post hormone levels did not change.

Conclusions

This study supports an association between BPD symptoms and neuroendocrine dysfunction at baseline, however we found no reduction in hormone dysfunction post treatment. Further research into relationships between stress signaling and neuroendocrine disturbances in BPD may inform aetiological and treatment models.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018.

Dark Triad Personality Traits, Second-to-Forth Digit Ratio (2D:4D) and Circulating Testosterone and Cortisol Levels

INTRODUCTION

Dark Triad (DT) personality traits (psychopathy, Machiavellianism, and narcissism) show sex differences and associations with hormones. Understanding aetiology may assist in mitigating the harm of these potentially adverse characteristics. Low second-to-fourth digit ratio (2D:4D) is hypothesised to be a marker of high prenatal testosterone exposure and may provide important information about organisational hormones. The aim of the present study was to measure Dark Triad and Big 5 personality traits in relation to digit ratio, salivary testosterone, and cortisol.

METHODS

A non-clinical sample (N=268; 49.25% Female, age M25.20 ± 8.77yrs) completed the Short Dark Triad and International Personality Inventory Pool - Mini. Afternoon saliva was analysed for testosterone and cortisol, and 2D:4D finger ratios were measured.

RESULTS

Males scored higher on DT traits than females. Females scored higher on Big 5 agreeableness and neuroticism. Males had higher testosterone and cortisol levels and lower 2D:4D than females. Digit ratio correlated inversely with salivary testosterone, Machiavellianism, and psychopathy. Testosterone levels correlated positively with cortisol levels and psychopathy and negatively with agreeableness, neuroticism, and Machiavellianism.

CONCLUSIONS

These results provide indications that Machiavellianism and psychopathy (Dark Triad) traits, but not narcissism or Big 5 traits, are linked to markers of prenatal testosterone exposure. Results also replicate sex differences seen in 2D:4D digit ratios, with males having a shorter second-relative-to-forth finger. Links between circulating testosterone, digit ratios, cortisol and personality traits provide further information about potential biological bases of personality.

Mindfulness and Imagery Enhanced Behavioral Parenting: Effectiveness Pilot of the Confident Carers Cooperative Kids Program

Mindfulness is increasingly offered to parents of children presenting with behavioral problems, either as a stand-alone intervention, or integrated within existing behavioral parenting interventions. There is relatively modest support for mindful parenting, with small to medium effect size improvements demonstrated across child and parent outcome measures. Here we introduce a mindfulness and imagery enhanced behavioral parenting program. We argue blending mindfulness, imagery and behavioral skills could produce improved parenting engagement and perseverance, leading to stronger outcomes. Pilot data is presented from two contrasting real world clinical settings. Parents attending the 8-week Confident Carers Cooperative Kids (CCCK) group program in a university clinic setting were invited to be included in the study (n = 20). Permission was also gained to use archival data from a community organisation offering CCCK groups to parents who were at risk of child welfare involvement (n = 14). Pre- and post-intervention measures were completed across both groups on parent-reported child behavior, parent wellbeing, adaptive parenting, and mindful parenting. Parents from both groups achieved significant pre- to post-intervention improvements in child behavior problems, parent wellbeing, adaptive parenting, and mindful parenting, with large effect sizes. Larger improvements in child behavior problems were reported by parents from the community group compared with the university group. The CCCK intervention appears beneficial across child and parent outcomes, including for families most in need. A larger sample is required to replicate and extend these promising findings.

Invited discussant comments during the UCL-Penn Global COVID Study webinar 'How Do We Trust (Again): Paranoia and Mental Health': part 1 of 2

The article provides commentary on Wong et al.'s investigation of the relationship between schizotypal traits, social mistrust and aggression, mental and physical health outcomes across three waves of data collection commencing in April 2020. The researchers aimed to consider the nature of the relationship between these variables and the stability of these relationships as coronavirus (Covid-19) restrictions fluctuated over time. Their results suggested that loneliness reflects a hub which links the trait variables of schizotypal and social mistrust to aggression and mental and physical health symptoms. Their network did not vary by demographic factors nor wave of data collection, suggesting that stable individual differences were driving results. Their results propose that interventions which increase social connection could provide positive health benefits as well as decreasing aggression (via reductions in social mistrust). Their data contributes to understanding about how schizotypal traits link to outcomes under conditions of social stress.

The profile of unusual beliefs associated with metacognitive thinking and attributional styles

Cognitive interpretations of daily events may differ in people from the general population who hold unusual beliefs. It is also important to understand whether different belief profiles exist to appreciate which patterns of beliefs are less psychologically healthy. Cluster analysis was used to form unusual belief profiles in a general population sample (n = 578; M_age = 22 years, SD = 6.98; 80% female) across paranoid, paranormal, and magical ideation beliefs, and we assessed whether they differed in attribution style and metacognitive beliefs about worry. Four clusters were formed: low on all measures (low all); high on all measures (high all); comparably higher on paranormal beliefs (paranormal group); and comparably higher on paranoid beliefs (paranoid group). For total Metacognitions Questionnaire‐30, the high all and high paranoid clusters did not differ, and both clusters scored higher than the high paranormal group, who all scored higher than the low all cluster. For attributional styles (Attributional Styles Questionnaire), lower scores on internal positive attribution were found for the high all and high paranoid clusters compared to the low all and high paranormal clusters. The high paranormal cluster had higher scores than the high paranoid cluster on self‐serving bias. Differences in attributional style appeared to be driven by mental health diagnosis. Our results suggest different profiles of unusual beliefs are detectable in the general population that differ in their metacognitive beliefs and perceived causation of events in their environment. Future studies investigating delusional proneness need to consider multiple unusual beliefs as well as assessing mood state and distress.

Subclinical psychopathology and affective forecasting: Role of in-the-moment feelings

It is important for positive well-being and social engagement to understand how people predict future emotions, an ability known as affective forecasting. However, mechanisms underpinning the change to affective forecasting are not well understood in people with subclinical psychiatric symptoms. The current study differentiated components that comprise affective forecasting and investigated how non-clinical features relate to these. We recruited 319 participants to complete the social affective forecasting task and respond to questionnaires that captured schizotypal and autistic traits as well as depressive symptoms. Associations between affective forecasting and subclinical features were investigated using correlations, regression, and structure equation modeling. Results showed that interpersonal features of schizotypal traits negatively predicted anticipated emotions in positive social conditions via in-the-moment feelings but not via mental simulation. Findings highlight that in-the-moment feelings may be an intervention target to help people who have difficulties with social interactions to anticipate more pleasure for future social events.

Dyslexia: Links with schizotypy and neurological soft signs

Abnormalities in language processing, psychological distress, and subtle neurodevelopmental features called neurological soft signs (NSS) are expressed by people with dyslexia and those scoring highly on schizotypy. We investigated whether the expression of NSS, distress, and schizotypy predicted dyslexia status. Participants (N = 96, 48 dyslexic) selected to be age and sex matched, completed the Schizotypal Personality Questionnaire, General Health Questionnaire, Neurological Evaluation Scale, and the National Adult Reading Test (NART; a measure of verbal intelligence). Dyslexia status was predicted by higher total NSS and disorganized schizotypy scores in the absence of NART. However, even with the inclusion of NART, disorganized schizotypy remained a significant predictor. The findings suggest that disorganized features of schizotypy could be a significant factor for those with dyslexia. Conversely, more attention needs to be given to developmental language disorders in those who score highly on schizotypy.

The cross-lagged relationship between loneliness, social support, and psychotic-like experiences in young adults

BACKGROUND

Individuals with psychotic disorders often report feelings of loneliness, fewer social contacts and less satisfaction with their social support prior to diagnosis. However, temporal relationships between these variables remain unclear. The primary aim of this study was to examine whether subjective and objective social factors predict, or are predicted by, psychotic-like experiences (PLEs) in healthy young adults.

METHODS

196 undergraduates completed baseline and 3-month follow-up assessments for PLEs, loneliness, social support size, and satisfaction. Cross-lagged panel models were conducted to investigate the temporal relationships between these variables.

RESULTS

Higher loneliness scores, fewer social contacts, and being less satisfied with social support at both time points were significantly associated with higher endorsement of PLEs. Furthermore, after controlling for baseline levels, cross-lagged analyses revealed that individuals who reported feeling more lonely and having less social support at baseline, predicted higher PLEs three months later but not vice versa. No cross-lagged effect was found between the satisfaction of social support and PLEs.

CONCLUSION

The study highlights the significant relationships between loneliness, social support and PLEs. Higher levels of loneliness and smaller social support networks predicted future PLEs. These findings need to be given full consideration in future clinical practice and intervention for young adults with PLEs.

Schizotypy and help-seeking for anxiety

BACKGROUND

Delays in help-seeking for anxiety are common; however, earlier interventions improve long-term outcomes. This holds importance for high schizotypes since anxiety relates to psychotic symptom development. The study investigated whether schizotypal traits and anxiety itself influence help-seeking behaviour.

METHODS

A non-clinical student sample (N = 800) completed the Schizotypal Personality Questionnaire, Depression, Anxiety, Stress Scale and General Help-Seeking Questionnaire, vignette version online.

RESULTS

Recognizing another's help need was associated with lower anxiety scores. A trend was observed between lower schizotypy scores and better recognition of self-need for help. Actual help-seekers (N = 163) had significantly higher schizotypy and anxiety scores than non-help-seekers.

CONCLUSION

Schizotypal traits independently contribute to delays in help-seeking for anxiety. Approaching informal help sources whom also have anxiety symptoms can delay formal help-seeking, unless they have sought help themselves.

The Effects of Anhedonia in Social Context

Purpose of Review

Anhedonia is a transdiagnostic symptom comprising reduced subjective reward or pleasure. Anhedonia influences subjective anticipation and in-the-moment experiences. This review draws together affective learning and engagement evidence for anhedonia affecting subjective experiences of social environments.

Recent Findings

While social engagement is diminished consistently, subjective appraisals of social contexts vary across different mental health disorders. Low positive affect during social experiences or stimuli is reported in PTSD, mood, schizophrenia, and anxiety disorders. Diminished neural reward networks underpin the anticipation of social experiences in ADHD, schizophrenia spectrum, and autistic spectrum disorders. Multiple theories exist to explain how anhedonia might interfere with social environments.

Summary

Anhedonia is a barrier to engagement, motivation, and enjoyment of social contexts. While many studies characterize experiences during social contexts, learning theories provide the most promise for developing targeted interventions.

Not all stress is created equal: Acute, not ambient stress, impairs learning in high schizotypes

Learning from feedback is essential for daily functioning, with factors that impact learning having implications for healthy and clinical populations. Reinforcement learning appears impaired across the psychosis continuum, with deficits reported in patients with psychotic disorders as well as high schizotypes from the general population. Stress can impair learning, and sensitivity to stress is present along the psychosis continuum. The aim of the present study was to understand if stress impairs reinforcement learning in those at the lower end of the psychosis continuum. We investigated both naturalistic stress in everyday life using daily hassles (Study 1: n = 70; 31% male, M age = 22.67 years) and acute psychosocial stress using the Trier Social Stress Test (Study 2: n = 57; 32% male, M age = 22.43 years). In the presence of naturalistic stress, learning did not differ across schizotypes. However, under acute psychosocial stress, high schizotypes experienced impaired learning. Our results suggest trail-and-error learning is robust to the ebbs and flows of everyday stress for high schizotypes; however, acute stress is associated with decrements in learning. This indicates that the magnitude of stressors should be considered when designing cognitive and functional interventions for those along the psychosis continuum.

The intentionality bias in schizotypy: a social matter

INTRODUCTION

We aimed to investigate the association between schizotypy and intentionality bias, the tendency to interpret ambiguous actions as being intentional, for social and non-social actions separately. This bias contributes to interpersonal difficulties, and has been associated with psychotic symptoms, such as delusions. However, results have been inconsistent for an association between putative psychosis proneness, schizotypy, and intentionality bias. Further, the multidimensional nature of schizotypy has not been considered. Agreeableness was measured to examine the specificity of the relationship, and inhibition to examine its potential role as a mediator.

METHODS

Two online studies are reported (n = 280 and n = 163) in which participants made intentionality judgements about ambiguous actions described in sentences. They also completed questionnaire measures of schizotypy and agreeableness, and inhibitory efficiency (a sentence completion task).

RESULTS

Schizotypy was associated with perceiving ambiguous actions as intentional, particularly in social contexts, after controlling for agreeableness. The association with social intentionality was stronger for schizotypy subscales capturing paranoia and unusual beliefs. Inhibitory efficiency as not a significant predictor of intentionality bias.

CONCLUSION

These finding suggest intentionality biases for social and non-social events are distinguishable. In relation to schizotypy, social situations appear to generate perceptions of intentionality. Intentionality bias represents a phenotypic cognitive risk for psychosis which should be further investigated.

Role for Positive Schizotypy and Hallucination Proneness in Semantic Processing

Semantic processing underpins the organization of verbal information for both storage and retrieval. Deficits in semantic processing are associated with both the risk for and symptoms presented in schizophrenia. However, studies are mixed and could reflect the confounding effects of medication and symptom heterogeneity. Therefore, we considered whether two risk phenotypes, positive schizotypy and hallucinatory predisposition, present in the general population were associated with differential responding profiles for a semantic processing task. One hundred and eighty-three participants completed the Schizotypal Personality Questionnaire, Launay-Slade Hallucination Scale, National Adult Reading Test, a handedness measure, and a computerized semantic relatedness judgment task. Pairs of words were related through their dominant or subordinate meanings, or unrelated. Participants were divided into four groups using a mean split on cognitive-perceptual (positive) schizotypy and hallucination proneness. Significant differences between groups were found for reaction time on the semantic relatedness task, with the high cognitive-perceptual schizotypy groups responding significantly slower to all word pairs compared to their low scoring counterparts. There was some evidence that high hallucination proneness was associated with significantly faster reaction times which may reflect disinhibitive processes, however additional support is required. The results suggest that these two components of psychosis risk are associated with different patterns of responding to semantic processing. More diffuse activation of semantic information appeared to be associated with positive schizotypy, while those predisposed to hallucinations appeared to respond quicker. These results have significant implications in the re-conceptualization of hallucination proneness as distinct from positive schizotypy. Additional research is required to investigate the association between psychotic-like experiences separate from personality variables such as positive schizotypy and semantic processing.

Complex Scenes From the International Affective Picture System (IAPS)

Complex scenes from standardized stimuli databases such as the International Affective Picture System (IAPS) are organized dimensionally rather than discretely. Further, the potentially unique function of socially relevant scenes is often overlooked. This study sought to identify discrete categories of complex scenes from the IAPS and to explore if there were qualitative features that make the emotional content of some social scenes identifiable with higher levels of agreement. One hundred and three participants (53.4% female, mean age 24.4) judged 118 IAPS scenes as reflecting fear, happy, sad, or neutral. A second judgment study was conducted with a separate group of participants (N = 117; 79.2% female; mean age 30.41) to further characterize valid affective scenes across the full range of basic emotions. Sixty images received agreement on their emotional category from >70% of judges and were considered valid. IAPS identifier codes for these images are available for reference (along with the supplementary material from the second judgment study), organized by emotional and social content. An incidental observation was such that compared to nonsocial scenes, lower agreement rates were observed for social scenes across the board. Qualitative features of social scenes that were classified into emotional categories based on higher levels of agreement are discussed.

Effects of working memory training on emotion regulation: Transdiagnostic review

Working memory training is widely used transdiagnostically to improve cognition. However, more recently, studies using working memory training packages have targeted emotion-regulation outcomes to determine whether far transfer effects can be achieved. A narrative review is conducted of studies that have used standardized computerized working memory training packages across healthy volunteers, affect, anxiety, post-traumatic stress disorder (PTSD), and eating disordered populations with emotion-regulation outcomes. Working memory training has been used in children, adolescents, and adults to improve emotion regulation. Many studies have reported gains in mood as well as emotion-regulation strategies following working memory training, regardless of clinical indication and whether near transfer gains were achieved in cognitive domains. Significant emotion-regulation outcomes include: state and trait anxiety, rumination, brooding, positive appraisal, decreasing maladaptive emotion-regulation strategies, and decreasing intrusive thoughts. It is speculated that these far transfer outcomes from working memory training are possible due to the cognitive and neural overlap between cognitive and affective working memory, and emotion regulation. Working memory training could improve cognitive efficiency, which, in turn, increases the availability of cognitive resources during times when emotion regulation is taxed. Future studies need to consider the role of participant expectancy in predicting outcome measure performance, and including subjective and objective outcomes is paramount to study design. Furthermore, sample sizes require additional attention, given that the current review highlights that individual differences in non-clinical and clinical populations influence the outcomes from working memory training. Working memory training offers a possibility for improving emotion regulation transdiagnostically.

Stress and cognitive biases in schizotypy: A two-site study of bias against disconfirmatory evidence and jumping to conclusions

The dysfunctional cognitive and reasoning biases which underpin psychotic symptoms are likely to present prior to the onset of a diagnosable disorder and should therefore be detectable along the psychosis continuum in individuals with schizotypal traits. Two reasoning biases, Bias Against Disconfirmatory Evidence (BADE) and Jumping to Conclusions (JTC), describe how information is selected and weighed under conditions of uncertainty during decision making. It is likely that states such as elevated stress exacerbates JTC and BADE in individuals with high schizotypal traits vulnerable to displaying these information gathering styles. Therefore, we evaluated whether stress and schizotypy interacted to predict these reasoning biases using separate samples from the US (JTC) and England (BADE). Generally speaking, schizotypal traits and stress were not independently associated with dysfunctional reasoning biases. However, across both studies, the interaction between schizotypy traits and stress significantly predicted reasoning biases such that increased stress was associated with increased reasoning biases, but only for individuals low in schizotypal traits. These patterns were observed for positive schizotypal traits (in both samples), for negative traits (in the England sample only), but not for disorganization traits. For both samples, our findings suggest that the presence of states such as stress is associated with, though not necessarily dysfunctional, reasoning biases in individuals with low schizotypy. These reasoning biases seemed, in some ways, relatively immutable to stress in individuals endorsing high levels of positive schizotypal traits.

The importance of loneliness in psychotic-like symptoms: Data from three studies

Poor social connection or loneliness is a prominent feature of schizotypy and may exacerbate psychosis risk. Previous studies have examined the inter-relationships between loneliness and psychosis risk, but critically, they have largely been conducted in non-clinical samples or exclusively used laboratory questionnaires with limited consideration of the heterogeneity within schizotypy (i.e., positive, negative, disorganized factors). The present study examined links between loneliness and psychotic-like symptoms across the dimensions of schizotypy through cross-sectional, laboratory-based questionnaires (Study 1; N = 160), ambulatory assessment (Study 2; N = 118) in undergraduates, and ambulatory assessment in inpatients in a substance abuse treatment program (Study 3; N = 48). Trait positive schizotypy consistently predicted cross-sectional and state psychotic-like symptoms. Loneliness, assessed via cross-sectional and ambulatory means, was largely linked with psychotic-like symptoms. Importantly, psychotic-like symptoms were dynamic: psychotic-like symptoms largely increased with loneliness in individuals with elevated positive and disorganized schizotypal traits, though there were some inconsistency related to disorganized schizotypy and state psychotic-like symptoms. Negative schizotypy and loneliness did not significantly interact to predict psychotic-like symptoms, suggesting specificity to positive schizotypy. Ambulatory approaches provide the opportunity for ecologically valid identification of risk states across psychopathology, thus informing early intervention.

A Transdiagnostic Perspective on Social Anhedonia

Humans are highly social beings, yet people with social anhedonia experience reduced interest in or reward from social situations. Social anhedonia is a key facet of schizotypal personality, an important symptom of schizophrenia, and increasingly recognized as an important feature in a range of other psychological disorders. However, to date, there has been little examination of the similarities and differences in social anhedonia across diagnostic borders. Here, our goal was to conduct a selective review of social anhedonia in different psychological and life course contexts, including the psychosis continuum, depressive disorder, posttraumatic stress disorder, eating disorders, and autism spectrum disorders, along with developmental and neurobiological factors. Current evidence suggests that the nature and expression of social anhedonia vary across psychological disorders with some groups showing deficient learning about, enjoyment from, and anticipation of the pleasurable aspects of social interactions, while for others, some of these components appear to remain intact. However, study designs and methodologies are diverse, the roles of developmental and neurobiological factors are not routinely considered, and direct comparisons between diagnostic groups are rare-which prevents a more nuanced understanding of the underlying mechanisms involved. Future studies, parsing the wanting, liking, and learning components of social reward, will help to fill gaps in the current knowledge base. Consistent across disorders is diminished pleasure from social situations, subsequent withdrawal, and poorer social functioning in those who express social anhedonia. Nonetheless, feelings of loneliness often remain, which suggests the need for social connection is not entirely absent. Adolescence is a particularly important period of social and neural development and may provide a valuable window on the developmental origins of social anhedonia. Adaptive social functioning is key to recovery from mental health disorders; therefore, understanding the intricacies of social anhedonia will help to inform treatment and prevention strategies for a range of diagnostic categories.

The Network Structure of Schizotypal Personality Traits

Elucidating schizotypal traits is important if we are to understand the various manifestations of psychosis spectrum liability and to reliably identify individuals at high risk for psychosis. The present study examined the network structures of (1) 9 schizotypal personality domains and (2) 74 individual schizotypal items, and (3) explored whether networks differed across gender and culture (North America vs China). The study was conducted in a sample of 27001 participants from 12 countries and 21 sites (M age = 22.12; SD = 6.28; 37.5% males). The Schizotypal Personality Questionnaire (SPQ) was used to assess 74 self-report items aggregated in 9 domains. We used network models to estimate conditional dependence relations among variables. In the domain-level network, schizotypal traits were strongly interconnected. Predictability (explained variance of each node) ranged from 31% (odd/magical beliefs) to 55% (constricted affect), with a mean of 43.7%. In the item-level network, variables showed relations both within and across domains, although within-domain associations were generally stronger. The average predictability of SPQ items was 27.8%. The network structures of men and women were similar (r = .74), node centrality was similar across networks (r = .90), as was connectivity (195.59 and 199.70, respectively). North American and Chinese participants networks showed lower similarity in terms of structure (r = 0.44), node centrality (r = 0.56), and connectivity (180.35 and 153.97, respectively). In sum, the present article points to the value of conceptualizing schizotypal personality as a complex system of interacting cognitive, emotional, and affective characteristics.