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Brain structure correlates of obsessive-compulsive personality disorder (OCPD) remain poorly understood as limited OCPD assessment has precluded well-powered studies. Here, we tested whether machine learning (ML; elastic net regression, gradient boosting machines, support vector regression with linear and radial kernels) could estimate OCPD scores from personality data and whether ML-predicted scores are associated with indices of brain structure (cortical thickness and surface area and subcortical volumes). Among older adults (ns = 898–1,606) who completed multiple OCPD assessments, ML elastic net regression with Revised NEO Personality Inventory personality items as features best predicted Five-Factor Obsessive-Compulsive Inventory—Short Form (FFOCI-SF) scores, root-mean-squared error (RMSE)/SD = 0.66; performance generalized to a sample of college students (n = 175; RMSE/SD = 0.51). Items from all five-factor model personality traits contributed to predicted FFOCI-SF (p-FFOCI-SF) scores; conscientiousness and openness items were the most influential. In college students (n = 1,253), univariate analyses of cortical thickness, surface area, and subcortical volumes revealed only a positive association between p-FFOCI-SF and right superior frontal gyrus cortical thickness after adjusting for multiple testing (b = 2.21, p =.0014; all other |b|s < 1.04; all other ps >.009). Multivariate ML models of brain features predicting FFOCI, conscientiousness, and neuroticism performed poorly (RMSE/SDs > 1.00). These data reveal that all five-factor model traits contribute to maladaptive OCPD traits and identify greater right superior frontal gyrus cortical thickness as a promising correlate of OCPD for future study. Broadly, this study highlights the utility of ML to estimate unmeasured psychopathology phenotypes in neuroimaging data sets but that our application of ML to neuroimaging may not resolve unreliable associations and small effects characteristic of univariate psychiatric neuroimaging research. General Scientific Summary: Indices of obsessive-compulsive personality disorder (OCPD) and its underlying dimensions can be predicted by applying machine learning to personality data. OCPD traits have small correlations with brain structure; only a positive association with superior frontal gyrus cortical thickness was significant. Multivariate machine learning models using brain features to predict OCPD traits were not robust. [ABSTRACT FROM AUTHOR]

Objectives: Few studies have investigated the relationship between stress‐related mental health problems and obsessive‐compulsive personality disorder (OCPD). Similarly, little research has focused on the moderating effect of OCPD on recovery in clinical patients with stress‐related mental health problems. The general aim of this study was to investigate the prevalence of OCPD and the associations between OCPD and level of burnout, anxiety, and depression symptoms, during a 7‐years follow‐up in a clinical longitudinal sample of female patients with stress‐related exhaustion. Method: The included patients (n = 84) were referred to a specialist outpatient clinic for patients with stress‐related exhaustion between 2006 and 2011. Data was collected at the initial examination and during a 7‐year treatment follow‐up. Results: OCPD was the most common personality disorder in the present clinical sample, with 40% of patients fulfilling the criteria. There was a significant association between OCPD and the degree of burnout symptoms as well as the degree of depression, both at baseline and during the 7‐year follow‐up. No significant association between OCPD and levels of anxiety was observed. Conclusion: The results support the hypothesis that there might be an association between OCPD and stress‐related exhaustion, including preservation of symptoms over time. OCPD and its related traits, such as perfectionism, may be important factors to consider when constructing effective treatment and rehabilitation plans for these patients. [ABSTRACT FROM AUTHOR]

Background: Obsessive-compulsive personality disorder (OCPD) is a high-prevalence personality disorder characterized by subtle but stable interpersonal dysfunction. There have been only limited studies addressing the behavioral patterns and cognitive features of OCPD in interpersonal contexts. The purpose of this study was to investigate how behaviors differ between OCPD individuals and healthy controls (HCs) in the context of guilt-related interpersonal responses. Method: A total of 113 participants were recruited, including 46 who were identified as having OCPD and 67 HCs. Guilt-related interpersonal responses were manipulated and measured with two social interactive tasks: the Guilt Aversion Task, to assess how anticipatory guilt motivates cooperation; and the Guilt Compensation Task, to assess how experienced guilt induces compensation behaviors. The guilt aversion model and Fehr–Schmidt inequity aversion model were adopted to analyze decision-making in the Guilt Aversion Task and the Guilt Compensation Task, respectively. Results: Computational model-based results demonstrated that, compared with HCs, the OCPD group exhibited less guilt aversion when making cooperative decisions as well as less guilt-induced compensation after harming others. Conclusion: Our findings indicate that individuals with OCPD tend to be less affected by guilt than HCs. These impairments in guilt-related responses may prevent adjustments in behaviors toward compliance with social norms and thus result in interpersonal dysfunctions. [ABSTRACT FROM AUTHOR]

Good Psychiatric Management (GPM) is a generalist clinical management approach for borderline personality disorder that incorporates common ingredients of good standard care for any psychiatric diagnosis with what works from prevailing specialist psychotherapies. Similar to all validated therapies for BPD, it relies on a specified formulation of the disorder' symptoms as arising from interpersonal hypersensitivity, to dynamically describe typical patterns of daily self- and interpersonal issues that drive the instability that defines the general personality dysfunction characteristic of the disorder. Recent adaptations of GPM have been proposed for narcissistic personality disorder and obsessive- compulsive personality disorder, with development of similar dynamic models for both (intrapsychic coherence model and model of overcontrol). New dimensional models of personality disorder diagnosis have been developed to address limitations of categorical approach, but the incorporation of these models into usage in the delivery of clinical services (where categorical approach remains the most used) is limited. This paper describes an adaptation of GPM to two cases of personality disorder that illustrate the usefulness of GPM models for dynamic representation of complex daily fluctuations in internal psychic coherence and interpersonal functioning. Specialist psychotherapies will never meet the demands of public health needs to treat personality dysfunction, and incorporation of new dimensional models of diagnosis are needed for treatments that can provide a minimal standard of care for providers and patients. [ABSTRACT FROM AUTHOR]

Personality disorders are considered a possible factor affecting the relationship between therapeutic alliance and therapy outcome. The present study investigated the alliance-outcome effect in patient groups with borderline personality disorder (BPD) and obsessive-compulsive personality disorder (OCPD). Data derived from a sample of n = 66 patients, treated in a day care hospital setting with a dialectical-behavioral and schema therapeutic treatment concept. Patients rated their symptom severity at admission, early alliance after 4-6 therapy sessions and symptom severity as well as alliance at discharge. Results showed no significant differences between BPD and OCPD patients regarding symptom severity and alliance. Multiple regression analyses indicated that the alliance was a significant predictor of symptom-reduction, however only in the OCPD group. Our results showed an exceptionally strong alliance-outcome relationship in OCPD patients, suggesting that focusing on building a strong alliance and measuring it early in therapy may be especially beneficial for this patient group. For patients with BPD, a more regular screening of the therapeutic alliance might be helpful. [ABSTRACT FROM AUTHOR]

The construct of perfectionism has long been related to Obsessive-Compulsive Personality Disorder (OCPD), though research has not considered how OCPD could distinguish individuals with elevated perfectionism. The aim of this study was to evaluate clinical differences between those with and without OCPD in a sample of individuals with elevated perfectionism. Seventy-four university students with elevated perfectionism completed a diagnostic assessment and several self-report measures of clinical characteristics and were randomly assigned to complete an exposure-based treatment for perfectionism or waitlist. Thirty-four (45.95%) participants met DSM-IV diagnostic criteria for OCPD. Compared to those without OCPD, individuals with OCPD had higher levels of general and specific domains of perfectionism and higher levels of social anxiety. OCPD diagnosis was also associated with higher rates of current anxiety disorder. Importantly, those with and without OCPD showed comparable benefits from treatment. This study provides novel evidence of the role of OCPD in perfectionism and demonstrates the efficacy of a perfectionism-oriented treatment in individuals with OCPD. We examined the role of obsessive-compulsive personality disorder (OCPD) in a high perfectionism sample. OCPD was associated with higher perfectionism and personal standards. OCPD was also associated with higher social anxiety and higher rates of current anxiety disorder. Those with and without OCPD had comparable responses to an exposure-based treatment for perfectionism. [ABSTRACT FROM AUTHOR]

Good Psychiatric Management (GPM) is a generalist clinical management approach for borderline personality disorder that incorporates common ingredients of good standard care for any psychiatric diagnosis with what works from prevailing specialist psychotherapies. Similar to all validated therapies for BPD, it relies on a specified formulation of the disorder' symptoms as arising from interpersonal hypersensitivity, to dynamically describe typical patterns of daily self- and interpersonal issues that drive the instability that defines the general personality dysfunction characteristic of the disorder. Recent adaptations of GPM have been proposed for narcissistic personality disorder and obsessive-compulsive personality disorder, with development of similar dynamic models for both (intrapsychic coherence model and model of overcontrol). New dimensional models of personality disorder diagnosis have been developed to address limitations of categorical approach, but the incorporation of these models into usage in the delivery of clinical services (where categorical approach remains the most used) is limited. This paper describes an adaptation of GPM to two cases of personality disorder that illustrate the usefulness of GPM models for dynamic representation of complex daily fluctuations in internal psychic coherence and interpersonal functioning. Specialist psychotherapies will never meet the demands of public health needs to treat personality dysfunction, and incorporation of new dimensional models of diagnosis are needed for treatments that can provide a minimal standard of care for providers and patients.

Personality disorders are considered a possible factor affecting the relationship between therapeutic alliance and therapy outcome. The present study investigated the alliance-outcome effect in patient groups with borderline personality disorder (BPD) and obsessive-compulsive personality disorder (OCPD). Data derived from a sample of n = 66 patients, treated in a day care hospital setting with a dialectical-behavioral and schema therapeutic treatment concept. Patients rated their symptom severity at admission, early alliance after 4–6 therapy sessions and symptom severity as well as alliance at discharge. Results showed no significant differences between BPD and OCPD patients regarding symptom severity and alliance. Multiple regression analyses indicated that the alliance was a significant predictor of symptom reduction, however only in the OCPD group. Our results showed an exceptionally strong alliance-outcome relationship in OCPD patients, suggesting that focusing on building a strong alliance and measuring it early in therapy may be especially beneficial for this patient group. For patients with BPD, a more regular screening of the therapeutic alliance might be helpful.

Although there is increasing attention for the interrelationship between obsessive–compulsive personality disorder (OCPD) and obsessive–compulsive disorder (OCD), their shared characteristics in terms of childhood trait antecedents remain understudied. Perfectionism may be a viable candidate trait antecedent, given its role in the clinical manifestation of both OCPD and OCD in adulthood, and the evidence that perfectionism reflects a dispositional tendency observable from childhood onwards. However, little is known about childhood trajectories of perfectionism with prospective links to later OCPD versus OCD. Using latent growth curve modeling, this study explored the baseline and growth of childhood perfectionism in 485 community and referred children (55.5% girls, 7.17–14.78 years old, Mage = 10.74, SD = 1.50) across three waves. Adolescent OCPD traits and OCD symptoms were measured in Wave 4. An overall decreasing trend of perfectionism from childhood through adolescence appeared, without inter-individual differences in growth. Individual differences in baseline levels of childhood perfectionism were significant, and equally predicting adolescent OCPD and OCD outcomes. At a more specific level, childhood perfectionism predicted most strongly the rigid perfectionism component of OCPD, and the orderliness/cleanliness/perfectionism and obsession domain of OCD. This demonstrates the value of childhood perfectionism for understanding differential outcomes of adolescent OCPD traits and OCD symptoms. [ABSTRACT FROM AUTHOR]

This review article addresses the frequently noted comorbidity between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD). We begin by reviewing the recent empirical literature on the co-occurrence of these two conditions and the functional consequences of comorbid OCPD on OCD. We describe theoretical conceptualizations of the links between these disorders, including shared mechanisms that may drive the association between these two distinct conditions. We then provide an overview of diagnostic measures for OCPD and differential diagnosis. We also review data on the impact of comorbid OCPD on cognitive-behavioral treatment for OCD, including how to address potential treatment barriers through which OCPD may complicate OCD treatment. Lastly, we conclude with directions for future research. [ABSTRACT FROM AUTHOR]

Background: Obsessive-compulsive disorder (OCD) is often comorbid with obsessive-compulsive personality disorder (OCPD). The relationship between OCD and OCPD is complex, and the impact of comorbid OCPD on OCD remains underexplored, necessitating further research.. This study aims to investigate the clinical correlates and brain morphometries associated with comorbid OCPD in a large sample of unmedicated OCD patients., Methods: A total of 248 unmedicated patients diagnosed with OCD (45 comorbid with OCPD) were included in this study. All participants were assessed for OCD symptoms, OCPD traits, obsessive beliefs, depression and anxiety. Among them, 145 patients (23 comorbid with OCPD) volunteered to receive magnetic resonance imaging (MRI) brain scans., Results: Approximately 18% (45/248) of OCD patients were comorbid with OCPD. OCD comorbid with OCPD (OCD+OCPD) exhibited more severe OCD symptoms, obsessive beliefs, depression and anxiety than OCD comorbid without OCPD. Additionally, the severity of OCPD was positively correlated with OCD symptoms and obsessive beliefs. Furthermore, OCD+OCPD patients exhibited increased cortical complexity in the left superior parietal lobule and left precuneus, which mediated the relationship between OCPD and OCD symptoms only in OCD patients comorbid without OCPD., Conclusions: The co-occurrence of OCPD may contribute to the heightened severity of psychopathological symptoms and associated brain morphological alterations in OCD patients, indicating distinct but interrelated constructs between these two disorders., (Copyright © 2024. Published by Elsevier Inc.)

Background. The most significant features for clinical diagnosis of schizotypal personality disorder (SPD) are cognitive-perceptual and disorganized symptoms. Experimental study of visual perceptual processes is important to elucidate the psychological mechanisms of cognitive-perceptual impairment in SPD. Objective. To research the performance of visual perceptual tasks in SPD. Design. Series I and II presented the subjects with visual perceptual tasks with different types of instructions (vague, verbal, or visual perceptual cues). The Wechsler Adult Intelligence Scale (WAIS-R) was also administered. The participants were 39 SPD patients, 36 obsessive-compulsive personality disorder (OCPD) patients (F.21.8, F.60.5 in ICD-10, respectively), and 102 healthy controls. Results. SPD patients had a significantly lower number of correct answers in conditions of vague instruction and verbal cues in Series I of a visual-perceptual task in comparison with healthy subjects (р ≤ 0.01). With visual perceptual cues in Series II, patients with SPD had the same number of correct answers as controls, whereas OCPD patients had the same number of correct answers as controls with verbal cues in Series I. SPD patients had significantly lower scores in most verbal and nonverbal WAIS-R subtests in comparison with controls. SPD patients differed from OCPD patients in that they had lower scores in the “Information” (p ≤ 0.05) and “Comprehension” (p ≤ 0.05) subtests. Conclusion. With visual-perceptual cues, SPD patients were able to achieve normative results in the performance of visual-perceptual tasks, whereas patients with OCPD demonstrated lower productivity. In SPD patients, the basic impairments were associated with difficulties in inhibition of peculiar responses, stability of a subjective manner of performance and inability to revise it, low orientation to the model, and slipping into subjective associations with the stimuli.

Background Work addiction (WA) has been previously linked to several diseases and disorders, but there is scarce literature on its association with eating disorders (EDs). Both WA and EDs share similar etiological factors (notably rigid perfectionism) and clinical features. The aim of this study was to provide an initial overview of the literature on this potential comorbidity, and investigate the co-occurrence of EDs and WA, and their relationship with socio-demographic and work-related variables, health, and personality. Participants and procedure In a pen-and-pencil cross-sectional study, the Bergen Work Addiction Scale (BWAS), a question about a current or previous diagnosis of EDs and other mental disorders, personality questionnaires, and questions concerning demographic, health and work-related variables were administered to 723 Polish employees from various pro-fessions. Results Six females (0.8%) and none of the males declared having been diagnosed with EDs, which is, to a large ex-tent, congruent with the expected prevalence in the general population. Five out of these six females (83%) reached the cut-off score for WA. Of all women who reached this cut-off, 5.5% reported EDs. All these women were in their twenties, not married, having no children, working in non-managerial positions, with body mass index (BMI) in the normal range or below. Preliminary comparisons with matched comparison groups were conducted. Conclusions These initial results suggest that WA may be highly prevalent among professionally active women diagnosed with EDs. Functioning of individuals with EDs in the workplace is a vastly understudied issue which merits more attention owing to high suicide risk and mortality due to health complications, particularly cardiovascular dis-ease (CVD), related to EDs and overworking, a significant prevalence of subclinical EDs in female populations (especially among youth), and a typically worse prognosis for EDs comorbid with other disorders. Both prob-lematic behaviors are related to denial, which suggests that these may be much more prevalent problems than current estimates indicate.

Background: Obsessive‐compulsive personality disorder (OCPD) is characterized by pervasive and persistent traits including preoccupation with orderliness, perfectionism, and control. Relatively little is known about the potential relationship between OCPD traits and physical health. Methods: We investigated the association between OCPD traits and several self‐reported medical conditions in 249 individuals followed prospectively from 1981 until 2004/2005 as part of the Epidemiological Catchment Area. Results: The OCPD trait score was inversely related to hypertension in males, in models unadjusted (OR = 0.66; 95% CI, 0.45–0.90) and adjusted (OR = 0.70; 95% CI, 0.47–0.95) for sociodemographic variables. Perfectionism was inversely related to hypertension in the unadjusted models for men (OR = 0.34; 95% CI, 0.12–0.89). Indecisiveness was positively associated with heart conditions in adjusted models for women (OR = 3.46; 95% CI, 1.11–10.52). Conclusion: OCPD traits are associated with cardiovascular health in both sexes. Further studies are needed to understand the specificity of these relationships, as well as to determine the underlying mechanism. [ABSTRACT FROM AUTHOR]

BACKGROUND Work addiction (WA) has been previously linked to several diseases and disorders, but there is scarce literature on its association with eating disorders (EDs). Both WA and EDs share similar etiological factors (notably rigid perfectionism) and clinical features. The aim of this study was to provide an initial overview of the literature on this potential comorbidity, and investigate the co-occurrence of EDs and WA, and their relationship with sociodemographic and work-related variables, health, and personality. PARTICIPANTS AND PROCEDURE In a pen-and-pencil cross-sectional study, the Bergen Work Addiction Scale (BWAS), a question about a current or previous diagnosis of EDs and other mental disorders, personality questionnaires, and questions concerning demographic, health and work-related variables were administered to 723 Polish employees from various professions. RESULTS Six females (0.8%) and none of the males declared having been diagnosed with EDs, which is, to a large extent, congruent with the expected prevalence in the general population. Five out of these six females (83%) reached the cut-off score for WA. Of all women who reached this cut-off, 5.5% reported EDs. All these women were in their twenties, not married, having no children, working in non-managerial positions, with body mass index (BMI) in the normal range or below. Preliminary comparisons with matched comparison groups were conducted. CONCLUSIONS These initial results suggest that WA may be highly prevalent among professionally active women diagnosed with EDs. Functioning of individuals with EDs in the workplace is a vastly understudied issue which merits more attention owing to high suicide risk and mortality due to health complications, particularly cardiovascular disease (CVD), related to EDs and overworking, a significant prevalence of subclinical EDs in female populations (especially among youth), and a typically worse prognosis for EDs comorbid with other disorders. Both problematic behaviors are related to denial, which suggests that these may be much more prevalent problems than current estimates indicate. [ABSTRACT FROM AUTHOR]

Abstract Objective Recovery from stress‐related diagnoses can, in some cases, be long‐lasting, and several different factors could be related to such a lengthy recovery. One plausible aspect is obsessive–compulsive personality disorder (OCPD), which has previously been seen to be related to stress‐related mental health. Thus, the aim of this study was to investigate whether recovery from exhaustion disorder (ED) is associated with OCPD. Methods This study includes data from 147 patients (78% women, mean age 52.4 ± 9.8 years) who have been treated for ED. Clinical assessment was performed 7–10 years after first seeking care identifying patients with residual exhaustion. Symptoms of OCPD were concomitantly measured and several aspects of work‐ and private‐related stress exposure. Results The main result of this study is that patients with residual clinical ED report OCPD to a greater extent, compared with patients who no longer fulfill the clinical criteria for ED, 7–10 years after seeking care. Patients with OCPD that have not recovered report “excessive devotion to work” to a higher degree than patients with OCPD that have recovered. Conclusion The results indicate that factors related to OCPD may be of clinical importance for the patient's recovery from ED. However, prospective studies should be conducted and studies elucidating whether symptoms of exhaustion among patients with OCPD can be affected by therapeutic interventions.

Objective: Recovery from stress‐related diagnoses can, in some cases, be long‐lasting, and several different factors could be related to such a lengthy recovery. One plausible aspect is obsessive–compulsive personality disorder (OCPD), which has previously been seen to be related to stress‐related mental health. Thus, the aim of this study was to investigate whether recovery from exhaustion disorder (ED) is associated with OCPD. Methods: This study includes data from 147 patients (78% women, mean age 52.4 ± 9.8 years) who have been treated for ED. Clinical assessment was performed 7–10 years after first seeking care identifying patients with residual exhaustion. Symptoms of OCPD were concomitantly measured and several aspects of work‐ and private‐related stress exposure. Results: The main result of this study is that patients with residual clinical ED report OCPD to a greater extent, compared with patients who no longer fulfill the clinical criteria for ED, 7–10 years after seeking care. Patients with OCPD that have not recovered report "excessive devotion to work" to a higher degree than patients with OCPD that have recovered. Conclusion: The results indicate that factors related to OCPD may be of clinical importance for the patient's recovery from ED. However, prospective studies should be conducted and studies elucidating whether symptoms of exhaustion among patients with OCPD can be affected by therapeutic interventions. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Learning objectives: After participating in this activity, learners should be better able to: • Assess the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD) • Identify characteristics related to OCD with co-occurring OCPD The current literature discloses discrepant findings regarding the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD). In addition, it is not clear which characteristics are related specifically to OCD with co-occurring OCPD. We conducted the first systematic review and meta-analysis of the studies of the prevalence of OCPD in patients with OCD. We also investigated potential moderators of the prevalence, including OCD severity, age of onset of OCD, sex, current age, methodological quality, and publication date of the studies. Electronic databases and gray literature were searched by two independent reviewers. A PRISMA systematic review with a random-effect meta-analysis was conducted. Thirty-four studies were included. A significant mean effect size of 0.25 without publication bias indicated that OCPD was present in 25% of patients with OCD, suggesting that the two conditions are distinct clinical entities. This prevalence was higher than the rates found in the literature for any other personality disorders among OCD patients. OCPD that occurs in the context of OCD was more likely to be present in males and to be characterized by a later age of onset of OCD, older age at assessment, and less severe OCD symptoms. Clinicians should consider these findings when assessing and planning treatment of OCD with co-occurring OCPD. [ABSTRACT FROM AUTHOR]

Objective: Scrupulosity is a manifestation of obsessive‐compulsive disorder (OCD) characterized by religious or moral core fears. Clinicians often struggle to treat scrupulosity, which may be associated with several features known to predict poor treatment outcome. The purpose of this study was to examine these features in participants with scrupulous OCD, contamination OCD, and healthy controls. Method: A total of 68 participants (57.4% women, agemean = 34.01) completed diagnostic interviews, and measures of symptoms and quality‐of‐life. Results: Relative to comparison groups, scrupulous participants had higher rates of obsessive‐compulsive personality disorder, more severe schizotypal symptoms, and more severe symptoms of depression. In addition, OCD severity was strongly associated with poor insight in the scrupulous group. Both OCD groups reported poorer quality of life than did healthy controls. Conclusions: Clinicians working with scrupulous individuals may enhance the efficacy of treatment in this challenging population by assessing carefully for these features, and incorporating treatment elements that address them. [ABSTRACT FROM AUTHOR]

Gamma ventral capsulotomy (GVC) is a radiosurgical procedure which aims to create lesions in the ventral part of the anterior limb of the internal capsule (ALIC). It has been used as a treatment option for patients with intractable obsessive–compulsive disorder (OCD) who do not respond to several first-line treatments attempts. However, changes in personality disorder symptoms after GVC have not been investigated. The aims of this study are to investigate changes in personality disorder symptoms after GVC and to search for baseline personality disorder symptoms that may predict clinical response to GVC. Fourteen treatment-intractable OCD patients who underwent GVC completed the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) at baseline and one year after the procedure. Wilcoxon signed-rank test was performed to investigate personality disorder symptom changes before and after surgery. Linear regression models were utilized to predict treatment response, using baseline personality disorder symptoms as independent variables. We did not observe any quantitative changes in personality disorder symptoms after GVC, compared with baseline. Higher severity of obsessive-compulsive personality disorder symptoms at baseline was correlated with worse treatment response after GVC for OCD (β = −0.085, t-value = −2.52, p-value = 0.027). These findings advocate for the safety of the GVC procedure in this specific population of intractable OCD patients, in terms of personality disorder symptom changes. They also highlight the importance of taking into account the severity of obsessive–compulsive personality disorder symptoms when GVC is indicated for intractable OCD patients.

Psychotherapy for obsessive‐compulsive personality disorder (OCPD), where perfectionism is a defining criterion, is understudied. Despite a high prevalence few evidence‐based treatments are available for the presentation. Here we describe the course of a 6‐month program of metacognitive interpersonal therapy with an OCPD patient with prominent perfectionism and self‐criticism, which were considered primary outcomes of the case study. Therapy aimed initially at increasing awareness of maladaptive interpersonal schemas and promoting a healthy self. First, behavioral experiments were used to try and counteract perfectionism. Second, experiential techniques, such as guided imagery and rescripting, were used to help the client in connect with different, healthier aspects of the self, thus increasing personal and interpersonal wellbeing. Qualitative and quantitative outcomes at the intervention end and at 1‐month follow‐up are summarized. Finally, we reflect on how this case study can inform treatment of perfectionism in OCPD. [ABSTRACT FROM AUTHOR]

Misophonia is a chronic condition in which specific sounds cause intense negative emotions and autonomic arousal. Misophonia is considered a psychological disorder without any relationship with specific alterations of hearing receptors and independent from physical characteristics of the sound. Moreover if misophonia can be defined as a specific psychiatric disorder or a correlate of other conditions is still under debate. The patients were two women and one man. In this case series we first identified the presence of triggers sounds inducing misophonia as reported during the psychotherapy sessions. At a qualitative level all the three patients perceived that the others were intentionally acting with the purpose of underline their maladaptive interpersonal schemas. All the patients were evaluated with the use of questionnaires. Regarding personality disorders (PD) all three patients suffered from at least one PD. As regard depression, one had moderate depression and one had severe depression. Two patients had moderate/severe anxiety. All the three patients can be considered as highly problematic in the interpersonal domain. Our findings have clinical implications for the treatment of misophonia because it seems to be sustained by underlying PD or maladaptive interpersonal schemas. The qualitative analysis of these cases has highlighted how patients with misophonia tended to ascribe intentionality to the people who emit the sounds that trigger their negative emotional reactions. Further studies are necessary to evaluate which kind of interpersonal patterns occur in these patients. [ABSTRACT FROM AUTHOR]

Gamma ventral capsulotomy (GVC) is a radiosurgical procedure which aims to create lesions in the ventral part of the anterior limb of the internal capsule (ALIC). It has been used as a treatment option for patients with intractable obsessive–compulsive disorder (OCD) who do not respond to several first-line treatments attempts. However, changes in personality disorder symptoms after GVC have not been investigated. The aims of this study are to investigate changes in personality disorder symptoms after GVC and to search for baseline personality disorder symptoms that may predict clinical response to GVC. Fourteen treatment-intractable OCD patients who underwent GVC completed the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) at baseline and one year after the procedure. Wilcoxon signed-rank test was performed to investigate personality disorder symptom changes before and after surgery. Linear regression models were utilized to predict treatment response, using baseline personality disorder symptoms as independent variables. We did not observe any quantitative changes in personality disorder symptoms after GVC, compared with baseline. Higher severity of obsessive-compulsive personality disorder symptoms at baseline was correlated with worse treatment response after GVC for OCD (β = −0.085, t-value = −2.52, p-value = 0.027). These findings advocate for the safety of the GVC procedure in this specific population of intractable OCD patients, in terms of personality disorder symptom changes. They also highlight the importance of taking into account the severity of obsessive–compulsive personality disorder symptoms when GVC is indicated for intractable OCD patients. [ABSTRACT FROM AUTHOR]

This article proposes that the undifferentiated selfobject is the key to understanding the formation and treatment of disorders that are characterized by preoccupations with destructive thoughts and actions. The undifferentiated selfobject is a fundamental self-sustaining experience of knowing that there are ongoing and unknown happenings to be discovered throughout life that will be surprising, challenging, and self-sustaining. It is an extension of Heinz Kohut's contributions of selfobjects that are necessary to the development of the self. Commonly accepted knowledge that there have been traumatic events in the early life of disordered patients points to disruptions of the development of the undifferentiated selfobject. These disruptions lead to preoccupations that are considered disorders. A treatment example of an obsessive personality disorder clarifies how understanding the undifferentiated selfobject was critical in delinking the patient from his preoccupation and allowing him to perceive and implement new directions in his life. [ABSTRACT FROM AUTHOR]

• Obsessive-compulsive personality disorder (OCPD) might be related to OCD spectrum disorders neuroanatomically. • OCPD seems to be a neurocognitive function disorder rather than a personality disorder. • Hippocampus and amygdala regions seem to be important in the neuroanatomy of the obsessive-compulsive disorder and OCPD. Moving from the point that there might be an association between the neuroanatomy of obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder, we decided to examine the volumes of hippocampus and amygdala of patients with obsessive-compulsive personality disorder, which was previously evaluated in OCD patients by us. Volumes of the hippocampus, and amygdala were measured by magnetic resonance imaging (MRI) in patients with obsessive-compulsive personality disorder and healthy control subjects. Manual tracing was used. We detected that the mean left and right sides of hippocampus and amygdala volumes of the patients with obsessive-compulsive personality disorder were smaller than those of the healthy controls. Consequently, our present results suggest that hippocampal and amygdalar structural abnormalities may be related to the neuroanatomy of obsessive-compulsive personality disorder. However, it is required novel studies with larger sample. [ABSTRACT FROM AUTHOR]

People with epilepsy often suffer psychiatric symptoms or exhibit maladaptive personality characteristics which can impact them more than seizures. This case illustrates a selective association of a Theory of Mind dysfunction, including an impaired comparison of reality and others' behavior, with an obsessive-compulsive personality disorder in a patient with left temporal lobe epilepsy and crossed cognitive functions. The patient revealed visual memory deficits and impaired interpretation of other people's behavior, mental rigidity, and a tendency to formulate inflexible judgements. Moreover, she shows impairment in understanding and sharing the emotional states of others in reference to herself (Empathic Quotient); her social relations are limited to her parents. Patients with right temporal lobe epilepsy frequently report persistent and rigid actions and thoughts, and this can have substantial psychological and social consequences for everyday life. We suggest that this could be a case of crossed cognitive functions, in particular ToM, and crossed psychobehavioral functions linked to right-hemisphere damage. [ABSTRACT FROM AUTHOR]

BACKGROUND The Five-Factor Obsessive-Compulsive Inventory - Short Form (FFOCI-SF) is an instrument used to measure obsessive-compulsive personality disorder, which is one of the most widespread personality disorders. The FFOCI-SF is a shorter version of the FFOCI that was developed on the basis of the Five Factor Model of personality treated as a general framework for identifying different traits useful in describing maladaptive personality. This paper presents the psychometric parameters of the Polish adaptation of the FFOCI-SF. participants and procedure Our sample consisted of 328 respondents aged 18-75 (61% women) from Poland. The voluntary and anonymous procedure consisted of completing inventories in a selfreported, paper-and-pencil way. The respondents received the FFOCI-SF, the Personal Inventory for DSM-5 (PID-5) and the Big Five Inventory-2 (BFI-2). RESULTS The findings suggest that there is acceptable internal consistency for most of the scales and some problems with the differentiation between some scales in factor analysis. Additionally, we present the hierarchical structure of the facets included in the instrument with two factors analogous to the metatraits of personality (Alpha and Beta). The criterion validity of the inventory was established by correlations on the one hand with Big Five traits (BFI-2) and on the other hand with another measure of the obsessivecompulsive personality disorder traits, namely appropriate scales from the Personality Inventory for DSM-5 (PID-5). CONCLUSIONS This study confirms that the FFOCI-SF is a valid measure for scientific purposes. In order to use it for diagnostic purposes, further research is suggested on clinical samples. The findings also suggest that the FFOCI-SF can be useful in exploring new solutions in structure of the obsessivecompulsive personality disorder facets. [ABSTRACT FROM AUTHOR]

Traditional models of Obsessive-Compulsive Disorder (OCD) suggest that neutralizing behaviors are motivated by harm avoidance. However, some individuals with OCD report an experience of discomfort, rather than anxiety per se, as motivating their behavior. Incompleteness has been proposed as another potential motivator of compulsive behaviors. We examined the relative strength of harm avoidance and incompleteness in predicting OCD symptom dimensions in a nonclinical sample (n = 238). We also examined the relationship between incompleteness and symptoms of two conditions with phenotypic similarity to OCD—Obsessive-Compulsive Personality Disorder (OCPD) and Autism Spectrum Disorder (ASD). Each involves patterns of repetitive, rigid behavior. Hierarchical regressions returned that incompleteness significantly predicted OCD and OCPD symptoms after controlling for harm avoidance; in some cases, the magnitude of association was stronger for incompleteness than for harm avoidance. We suggest that a better understanding of incompleteness may help to advance conceptualization of OCD and other symptoms. • Incompleteness is less studied in the OCD literature than is harm avoidance. • Incompleteness and harm avoidance were examined in a student sample. • Via regression, incompleteness predicted OCD symptoms beyond harm avoidance. • Incompleteness also predicted symptoms of Obsessive-Compulsive Personality Disorder. • We recommend assessing both incompleteness and harm avoidance in OCD research. [ABSTRACT FROM AUTHOR]

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This study examined the association between self-reported obsessive-compulsive spectrum symptomatology and cognitive performance in a sample of patients with traumatic brain injury (TBI). Twenty-four adults with a moderate-severe TBI accessing a community brain injury rehabilitation service were recruited. Age ranged between 19 and 69 years. Participants completed a battery of neuropsychological tasks assessing memory, executive functioning, and speed of information processing. Self-report questionnaires assessing obsessive-compulsive (OC) symptoms and obsessive-compulsive personality disorder (OCPD) traits were also completed. Correlational analyses revealed that deficits in cognitive flexibility were associated with greater self-reported OC symptomatology and severity. Greater OC symptom severity was significantly related to poorer performance on a visual memory task. Verbal memory and speed of information processing impairments were unrelated to OC symptoms. Performance on tasks of memory, executive functioning, and speed of information processing were not associated with OCPD traits. Overall, results indicate that greater OC symptomatology and severity were associated with specific neuropsychological functions (i.e., cognitive flexibility, visual memory). OCPD personality traits were unrelated to cognitive performance. Further research is needed to examine the potential causal relationship and longer-term interactions between cognitive sequelae and obsessive-compulsive spectrum presentations post-TBI. [ABSTRACT FROM AUTHOR]

Background: According to the criteria of personality disorders, some disorders, especially the antisocial personality disorder, can be characterized by the hypo-morality and some disorders, especially the obsessive-compulsive personality disorder, can be characterized by the hyper-morality. It seems that both the hyper-morality and the hypo-morality have linkages to different aspects of psychopathology. Objectives: To better understand the issue, the current study aimed to compare individuals with high and low moral identity in the tendencies to all personality disorders and some other mental disorders. Methods: From a database that had been gathered from 212 undergraduate university students, 30 students that had the highest moral identity and 24 students that had the lowest moral identity were selected to complete Millon clinical multiaxial inventory-III. The data of the two groups were compared by the multiple analysis of variance statistical method. Results: The findings indicated that students with the highest moral identity had only higher tendency to the obsessive-compulsive personality disorder while students with the lowest moral identity had higher tendencies to the antisocial personality disorder, narcissistic personality disorders, andsomatoformdisorders. Nevertheless, in the tendencies to other disorders, a significant difference was not found. Conclusions: The findings indicated that both very low and very high moral identity might be related to some psychopathological traits. It is in coordination with the emphasis of some philosophers such as Aristotle on the importance of sobriety or the doctrine of the mean for constituting the virtues and the theories of some psychiatrists such as Freud about the role of inflammation of superego in shaping some neurotic reactions. There may be some implications for preventing from both wastage and extremism in educating the moral identity. [ABSTRACT FROM AUTHOR]

Personality disorders have a deleterious impact on individual quality of life, and are associated with a significant social burden. Despite a broad range of presentations across the various personality disorders, clinical research has shown a strong bias toward borderline personality disorder. In contrast to the emotional dysregulation of borderline personality disorder, a number of personality disorders are characterised by emotional inhibition and alexithymia. Research increasingly suggests that these deficits in emotional regulation may be symptomatic of problems with metacognition—the ability to identify, understand, and influence mental states. Research and specific treatment approaches are needed which target personality dysfunction characterised by emotional inhibition, rather than dysregulation. Emerging evidence suggests that metacognitive interpersonal therapy may be an effective treatment approach for personality disorders characterised by emotional inhibition. The current case study provides an in-depth examination of the application of metacognitive interpersonal therapy for a man diagnosed with comorbid avoidant personality disorder, and obsessive compulsive personality disorder. The patient described a history of bullying and unmet needs throughout his childhood, resulting in maladaptive interpersonal schemas and metacognitive deficits. Treatment focused on building the patient's ability to identify and understand his mental states, and targeted schema-driven behaviour. The patient reported experiencing the therapy as helpful, and stated that it contributed to a marked improvement in his quality of life. Results indicate that a 1 year intervention was successful in achieving diagnostic recovery and symptom reduction, supporting metacognitive interpersonal therapy as an effective intervention. [ABSTRACT FROM AUTHOR]

Objective: Obsessive-Compulsive Disorder (OCD) and Obsessive-Compulsive Personality Disorder (OCPD) have been reported to be associated with mood instability (MI), depression and suicide-related outcomes. We examined whether obsessive-compulsive symptoms and personality traits as well as obsessional thoughts of death, are associated with suicidal thoughts, non-suicidal self-injury and attempted suicide. Methods: We used data from 7,839 people from the 2000 British Adult Psychiatric Morbidity Survey that elicited symptoms of OCD with a computerized version of the Clinical Interview Schedule—Revised (CIS-R) and traits of OCPD with a self-completed version of the SCID-II. We created a series of logistic regression models, first entering only OCD symptoms and OCPD traits in separate models, to which depression and mood instability (MI) were added. We also examined the relation of obsessional thoughts about death with self-harm in a network analysis model that included the main symptoms of mood instability and depression. Results: OCD symptoms were associated with suicidal thoughts (OR: 1.23, 95% CI: 1.14–1.32), and suicide attempts (OR: 1.13, 95% CI: 1.04–1.24) in the fully-adjusted model. OCPD traits were associated with suicidal thoughts (OR: 1.14, 95% CI: 1.10–1.19), non-suicidal self-injury (OR: 1.14 95% CI: 1.03–1.26), and suicide attempts (OR: 1.09; 1.01–1.17). Depression and MI were both associated with all three suicide-related outcomes. In the network analysis, MI was the most prominent correlate of suicide-related outcomes, being associated with suicidal ideas (partial r = 0.15) and non-suicidal self-injury (partial r = 0.07). Limitation: This was a cross-sectional study that used a single-item measure for mood instability. Conclusions: Obsessive-compulsive symptoms and personality traits are related to suicide-related outcomes independently of depressive symptoms and mood instability. This relationship is not accounted for by obsessional thoughts of death alone. [ABSTRACT FROM AUTHOR]

Personality disorders are a common comorbidity in obsessive-compulsive disorder (OCD). The effect of comorbidity on the symptom presentation, course, and treatment outcome of OCD is being discussed here. OCD and obsessive-compulsive personality disorder (OCPD) though similar in their symptom presentation, are distinct constructs. Schizotypal disorder, OCPD, and two or more comorbid personality disorders have been found to be consistently associated with a poor course of illness and treatment response. Further research is needed to determine treatment strategies to handle the personality pathology in OCD. [ABSTRACT FROM AUTHOR]

Background and Aims: The purpose of the study was to examine the role of behavioral activation-inhibition, impulsivityand alexithymia in discriminating students with symptoms of obsessive-compulsive and paranoid personality disorders from normal controls. Methods: The studied sample includes all the students in University of Mohaghegh Ardabili, Iran, in 2011 (n = 8344). At the first stage, to identify the students with obsessive-compulsive and paranoid personality disorders, 368 students were selected through simple random sampling method and the Millon Clinical Multiaxial Inventory-III was completed for them. In the second stage, 25 students were selected for each group and the Gray-Wilson Personality Questionnaire, Barratt Impulsiveness Scale and the Toronto Alexithymia Scale were completed by them. Data were analyzed using descriptive statistics and discriminant analysis. Results: Behavioral activation-inhibition, impulsivity and alexithymia played significant role in discriminating students with symptoms of obsessive-compulsive and paranoid personality disorders and had the potential to predict the changes concerned with obsessive-compulsive and paranoid personality disorders. Conclusion: It seems that attention to and evaluation of the roles of behavioral activation-inhibition, impulsivity and alexithymia as effective factors in obsessive-compulsive and paranoid personality disorders is necessary.

Consistent with its classification by the American Psychiatric Association as one of ten personality disorders, nearly all etiologies assume Obsessive Compulsive Personality Disorder to be an environmentally instilled syndrome. However, a recent evolutionary etiology, better accounting for prevalence rates and heritability estimates, ecologically explains obsessive psychology as an adaptation to northern climates with express seasonality, low population density, and low social complexity. While this evolutionary etiology justifiably eschews assumptions of pathology, it does not explain why those assumptions were so long made. To this end, the concept of phylogenetic inertia, the decrease in fitness arising from incongruity between past and present selective pressures, is applied. The present paper considers how an evolved strategy could be mistaken for a detrimental disorder by examining the misalignment between evolved obsessive psychology and modernity's demands for flexible attention, communion and collaboration, openness and complexity. As discussed, however, empirical studies are divided, such that only some show evidence of dysfunction; moreover, any evidence of dysfunction is relativistic in that it does not impair survival or decrease reproduction. While suggestions for future research are made, from the weight of present evidence it appears that Obsessive Compulsive Personality Disorder, evolved in prehistory, remains adaptive in modernity and so phylogenetic inertia can only be invoked as a metaphorical heuristic.

The First Experimental Study of Transference Interpretation (FEST), conducted in Norway, is a dismantling, randomized clinical trial of the long-term effects of transference interpretation (TI). This article examines two case studies of women with poor quality of object relations (QOR), one who was rated as recovered after psychotherapy and one who was rated as not recovered. Both received TI. In general, women with poor QOR needed TI to recover, but some members of this group did not recover, even with TI. The therapist's negative countertransference and tendency to use controlling interventions was more pronounced with the pooroutcome patient. In addition, the poor-outcome patient had three subthreshold personality disorders in addition to obsessive-compulsive personality disorder. In childhood she had experienced substantial emotional abuse and some physical abuse. She was less motivated before therapy and more evasive during therapy than the good-outcome patient. The good-outcome patient also had obsessive-compulsive personality disorder but no subthreshold personality disorders, and her childhood home environment was more secure, although her parents were distant. She was more open to the therapist than the poor-outcome patient was. This article illustrates that different people require different techniques even though they belong to the same group (low QOR) that, in the FEST study, did well with TI. [ABSTRACT FROM AUTHOR]

Background and aims: Epidemiological data have suggested that the prevalence of co-occurring personality disorders is particularly high in people with gambling disorder (GD). Among the personality disorders, obsessive-compulsive personality disorder (OCPD) appears to be the most common problem. The objective of this study was to investigate the clinical presentation of GD with and without co-occurring OCPD. Methods: We studied 25 subjects with current GD and lifetime diagnosis of OCPD. They were matched for age and gender with 25 individuals with current GD but no lifetime diagnosis of any personality disorder. Results: Subjects with GD and OCPD demonstrated (a) lower severity of gambling symptoms, (b) slower progression from recreational gambling to full-blown GD, (c) preferred individual forms of betting, (d) identified more triggers to gambling (specially the availability of money and stress); and (e) reported less negative impact on relational problems due to GD. Conclusions: Our research provides further insight on GD co-occurring with OCPD, such as increasing social support and improvement of coping skills, especially to deal with financial difficulties and stress. Our findings may lead to more customized and effective therapeutic approaches to this frequent comorbidity. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study aimed to develop and validate the Distress Tolerance Scale‐Short Form (DTS‐SF), a modification of the original Distress Tolerance Scale, in a severe/complex sample of individuals with obsessive compulsive disorder (OCD). Currently, there are multiple self‐report measurements of distress tolerance (DT), highlighting the need for a more refined measure. Method: Participants included 222 individuals with a primary diagnosis of OCD (57% male, average age = 31) seeking intensive/residential treatment. Participants completed surveys at admission, discharge, and each week. Results: An exploratory factor analysis revealed a one‐factor solution representing overall DT ability. The DTS‐SF was found to be sensitive to treatment effects. Appropriate associations between the DTS‐SF and other measures were also found, with lower DT associated with greater OCD and depression severity and lower reported quality of life. Conclusion: The DTS‐SF was found to be a valid and reliable measure with high clinical utility for quickly and accurately measuring DT. [ABSTRACT FROM AUTHOR]

Because stability over time is central to the definition of personality disorder, aim of the current study was to determine the stability of the Pregnancy Obsessive-Compulsive Personality Disorder (OCPD) Symptoms Checklist ( N = 199 women). Strong positive correlations between assessments at 32 weeks of pregnancy and 2 and 3-3.5 years after childbirth were found ( r between .62-.72), and the group mean score did not change over time. The Pregnancy OCPD Symptoms Checklist assesses stable, trait-like symptoms of OCPD. [ABSTRACT FROM AUTHOR]

The Five-Factor Obsessive-Compulsive Inventory (FFOCI) is an assessment of obsessive-compulsive personality disorder (OCPD) that is based on the conceptual framework of the five-factor model (FFM) of personality. The FFOCI has 12 subscales that assess those five-factor model facets relevant to the description of OCPD. Research has suggested that the FFOCI scores relate robustly to existing measures of OCPD and relevant scales from general personality inventories. Nonetheless, the FFOCI’s length—120 items—may limit its clinical utility. This study derived a 48-item FFOCI–Short Form (FFOCI-SF) from the original measure using item response theory methods. The FFOCI-SF scales successfully recreated the nomological network of the original measure and improved discriminant validity relative to the long form. These results support the use of the FFOCI-SF as a briefer measure of the lower-order traits associated with OCPD. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Obsessive–compulsive personality disorder (OCPD) is formally operationalized in Section II of the DSM‐5 by a heterogeneous collection of 8 categorical criteria. Section III contains an alternative model operationalizing personality disorders via dimensional personality traits and associated impairment. The extent to which the personality traits used to define OCPD in Section III correspond with the Section II operationalization of the disorder is contested. The current study aims to contribute to the evidence base necessary to solidify the optimal trait profile for this disorder via a more fine‐tuned examination of OCPD. Method: The research questions were examined using a clinical sample of 142 Danish adults who completed the Structured Clinical Interview for DSM‐IV Axis II Disorders and the Personality Inventory for DSM‐5 to index both the Sections II and III (personality traits) operationalizations of OCPD, respectively. Results: Bivariate correlations supported Rigid Perfectionism and Perseveration as traits relevant to OCPD; however, hierarchical regression analyses indicated that of the 4 traits used in the Section III operationalization of OCPD, only Rigid Perfectionism uniquely predicted OCPD (p < .05). In addition to Rigid Perfectionism, the conceptually relevant traits of Submissiveness, Suspiciousness, and (low) Impulsivity were also found to uniquely predict OCPD and its specific symptoms in a regression model. Conclusions: These findings indicate that the traits proposed in Section III are only partially aligned with the traditional, Section II conceptualization of OCPD, and may be augmented by incorporating Submissiveness, Suspiciousness, and (low) Impulsivity. In light of the current findings and existing literature, a modified constellation of traits to operationalize OCPD is likely justified. [ABSTRACT FROM AUTHOR]