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Background: Obsessive-compulsive personality disorder (OCPD) is one of the most prevalent personality disorders in general population. However, neural mechanisms underlying OCPD remain elusive. The aim of this study is to use functional magnetic resonance imaging (fMRI) to examine whether OCPD patients will exhibit altered spontaneous brain activity as compared to healthy controls (HC)., Methods: Resting-state fMRI data were acquired in 37 OCPD patients and 37 matched HC. Amplitudes of low-frequency fluctuation (ALFF) were calculated and compared between the two groups. Correlation analysis was performed between regional ALFF values and OCPD severity scores., Results: Significant group differences in regional ALFF were found in multiple brain regions. Compared to HCs, OCPD subjects had increased ALFF in bilateral caudate, left precuneus, left insula, and left medial superior frontal gyrus, and decreased ALFF in the right fusiform gyrus and left lingual gyrus. The ALFF values in the left precuneus correlated with OCPD severity scores., Limitations: We excluded patients with comorbidity and did not conduct cognitive function assessments. Our findings are also limited to cross-sectional analysis., Conclusions: OCPD patients exhibit altered spontaneous neural activity as compared to healthy controls in multiple brain regions, which may reflect different characteristic symptoms of OCPD pathophysiology, including cognitive inflexibility, excessive self-control, lower empathy, and visual attention bias., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

To investigate the clinical manifestation, disease course, and prognosis of migraine patients with or without personality disorders. This cross-sectional study evaluated 61 patients with migraine diagnosed according to the criteria of the International Headache Society (IHS). Personality disorders were assessed with the Structured Clinical Interview for DSM-IV (SCID-II). Migraine severity was assessed with the Headache Impact Test-6 (HIT-6). We also used a structured clinical interview to diagnose comorbid mood disorders. Of the 61 patients, 20 (32.8%) had personality disorders. Personality disorders included obsessive-compulsive 14/61 (23.0%), avoidant 6/61 (9.8%), borderline 6/61 (9.8%), paranoid 6/61 (9.8%), schizoid 2/61 (3.3%), histrionic 1/61 (1.6%) and dependent 1/61 (1.6%) types. Compared to migraine patients without personality disorders, comorbidity with any personality disorders was associated with an increased frequency of chronic migraine (p < 0.001) and more severe headache as assessed by the HIT-6 (p < 0.001). Comorbidity with personality disorders was associated with more severe forms of migraine symptoms.

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.

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]

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]

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]

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: 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]

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]

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]

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.

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]

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]

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 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]

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]

Background: Cultural and personality factors might contribute to the clinical differences of psychiatric patients all over the world including China. One cultural oriented Chinese Adjective Descriptors of Personality (CADP) designed to measure normal personality traits, might be specifically associated with different personality disorder functioning styles. Methods: We therefore have invited 201 healthy volunteers and 67 personality disorder patients to undergo CADP, the Parker Personality Measure (PERM), and the Plutchik-van Praag Depression Inventory (PVP) tests. Results: Patients scored significantly higher on PVP scale and all 11 PERM personality disorder functioning styles, as well as CADP Emotional and Unsocial traits. The PVP was significantly correlated with some CADP traits and PERM styles in both groups. In healthy volunteers, only one CADP trait, Unsocial, prominently predicted 11 PERM styles. By contrast in patients, CADP Intelligent predicted the PERM Narcissistic and Passive-Aggressive styles; CADP Emotional the PERM Paranoid, Borderline, and Histrionic styles; CADP Conscientious the PERM Obsessive-Compulsive style; CADP Unsocial the PERM Schizotypal, Antisocial, Narcissistic, Avoidant, Dependent, and Passive-Aggressive styles; CADP Agreeable the PERM Antisocial style. Conclusion: As a preliminary study, our results demonstrated that, in personality disorder patients, all five CADP traits were specifically associated with almost all 11 personality disorder functioning styles, indicating that CADP might be used as an aid to diagnose personality disorders in China. [ABSTRACT FROM AUTHOR]

We assessed correlates of obsessive–compulsive (OCPD), schizotypal (SPD) and borderline (BPD) personality disorders in 110 obsessive–compulsive disorder (OCD) patients. We found OCD patients with OCPD (20.9%) to exhibit higher rates of hoarding and bipolar disorders, increased severity of hoarding and symmetry, lower prevalence of unacceptable thoughts involving sex and religion and less non-planning impulsivity. Conversely, OCD patients with SPD (13.6%) displayed more frequently bipolar disorder, increased severity of depression and OCD neutralization, greater prevalence of “low-order” behaviors (i.e., touching), lower low-planning impulsivity and greater “behavioral” compulsivity. Finally, in exploratory analyses, OCD patients with BPD (21.8%) exhibited lower education, higher rates of several comorbid psychiatric disorders, greater frequency of compulsions involving interpersonal domains (e.g. reassurance seeking), increased severity of depression, anxiety and OCD dimensions other than symmetry and hoarding, more motor and non-planning impulsivity, and greater “cognitive” compulsivity. These findings highlight the importance of assessing personality disorders in OCD samples. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The core symptoms of obsessive–compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. This study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive–compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others, whereas OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported less empathic perspective taking relative to healthy controls. Finally, we found that OCPD males reported a higher drive to analyze and derive rules for systems than OCPD females. Overall, results suggest that there are interpersonal deficits associated with OCPD and the clinical implications of these deficits are discussed. [ABSTRACT FROM PUBLISHER]

An 'Alternative DSM-5 Model for Personality Disorders' was published in Sect. III of DSM-5, while the identical categories and criteria from DSM-IV for the personality disorders (PDs) are in Sect. II. Given strong shifts from categorical diagnoses toward dimensional representations in psychiatry, how did the PDs end up 'stuck in neutral,' with the flawed DSM-IV model perpetuated? This article reviews factors that influenced the development of the new model and data to encourage and facilitate its use by clinicians. These include recognizing 1) a dimensional structure for psychopathology for which personality may be foundational; 2) a consensus on the structure of normal and abnormal personality; 3) the clinical significance of personality; 4) PD-specific severity required to establish disorder; 5) disruption, discontinuity, and perceived clinical utility of the Alternative Model may not be problems; and 6) a way forward involving collaborative research on neurobiological and psychosocial processes, treatment planning, and outcomes. [ABSTRACT FROM AUTHOR]

Despite the long-held view that hoarding is a symptom of both obsessive-compulsive disorder and obsessive-compulsive personality disorder, increased evidence has emerged during the last 20 years suggesting that hoarding represents a distinct form of psychopathology. This study reflects the discussions on the nosological status of hoarding carried out by the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders. The distinctiveness of hoarding is based on its having core symptoms that differ from those of other disorders, as well as distinctive neurobiological correlates and treatment responses. Furthermore, data showing the clinical utility, global applicability, and appropriateness of the concept of hoarding disorder outside specialty mental health settings suggest that this condition should be included in ICD-11. Finally, given the focus of ICD-11 on primary care and public health, the Working Group suggests that poor insight and severe domestic squalor may be considered as specifiers for hoarding disorder in ICD-11. [ABSTRACT FROM AUTHOR]

Background: Although the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has long been debated, clinical samples of OCD (without OCPD) and OCPD (without OCD) have never been systematically compared. We studied whether individuals with OCD, OCPD, or both conditions differ on symptomatology, functioning, and a measure of self-control: the capacity to delay reward. Methods: Twenty-five OCD, 25 OCPD, 25 comorbid OCD + OCPD, and 25 healthy control subjects completed clinical assessments and a validated intertemporal choice task that measures capacity to forego small immediate rewards for larger delayed rewards. Results: OCD and OCPD subjects both showed impairment in psychosocial functioning and quality of life, as well as compulsive behavior, but only subjects with OCD reported obsessions. Individuals with OCPD, with or without comorbid OCD, discounted the value of delayed monetary rewards significantly less than OCD and healthy control subjects. This excessive capacity to delay reward discriminates OCPD from OCD and is associated with perfectionism and rigidity. Conclusions: OCD and OCPD are both impairing disorders marked by compulsive behaviors, but they can be differentiated by the presence of obsessions in OCD and by excessive capacity to delay reward in OCPD. That individuals with OCPD show less temporal discounting (suggestive of excessive self-control), whereas prior studies have shown that individuals with substance use disorders show greater discounting (suggestive of impulsivity), supports the premise that this component of self-control lies on a continuum in which both extremes (impulsivity and overcontrol) contribute to psychopathology. [ABSTRACT FROM AUTHOR]

BackgroundExperts have proposed removing obsessive–compulsive disorder (OCD) from the anxiety disorders section and grouping it with putatively related conditions in DSM-5. The current study uses co-morbidity and familiality data to inform these issues.MethodCase family data from the OCD Collaborative Genetics Study (382 OCD-affected probands and 974 of their first-degree relatives) were compared with control family data from the Johns Hopkins OCD Family Study (73 non-OCD-affected probands and 233 of their first-degree relatives).ResultsAnxiety disorders (especially agoraphobia and generalized anxiety disorder), cluster C personality disorders (especially obsessive–compulsive and avoidant), tic disorders, somatoform disorders (hypochondriasis and body dysmorphic disorder), grooming disorders (especially trichotillomania and pathological skin picking) and mood disorders (especially unipolar depressive disorders) were more common in case than control probands; however, the prevalences of eating disorders (anorexia and bulimia nervosa), other impulse-control disorders (pathological gambling, pyromania, kleptomania) and substance dependence (alcohol or drug) did not differ between the groups. The same general pattern was evident in relatives of case versus control probands. Results in relatives did not differ markedly when adjusted for demographic variables and proband diagnosis of the same disorder, though the strength of associations was lower when adjusted for OCD in relatives. Nevertheless, several anxiety, depressive and putative OCD-related conditions remained significantly more common in case than control relatives when adjusting for all of these variables simultaneously.ConclusionsOn the basis of co-morbidity and familiality, OCD appears related both to anxiety disorders and to some conditions currently classified in other sections of DSM-IV. [ABSTRACT FROM PUBLISHER]

The validity of the Axis II Obsessive-Compulsive Personality Disorder (OCPD) category and its position within the Cluster C personality disorder (PDs) section of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, APA ) continues to be a source of much debate. The present study examines the associations between general and maladaptive personality traits and OCPD symptoms, prior to and after controlling for co-occurring PD variance, in a general population sample of 274 Flemish adolescents and further explores the incremental validity of two different maladaptive trait measures beyond general traits. The results demonstrate that the number of (general and maladaptive) personality-OCPD associations decreases after controlling for a general personality pathology factor, with the FFM factor Conscientiousness and its maladaptive counterpart Compulsivity as remaining correlates of OCPD. The findings further suggest to complement the general NEO-PI-R (Costa and McCrae 1992) scales with more maladaptive items to enable a more comprehensive description of personality pathology variance. Implications for understanding and assessing OCPD in the developmental context of adolescence are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This study sought to confirm a multi-factor model of Obsessive-compulsive personality disorder (OCPD) in a Hispanic outpatient sample and to explore associations of the OCPD factors with aggression, depression, and suicidal thoughts. One hundred and thirty monolingual, Spanish-speaking participants were recruited from a community mental health center and were assessed by bilingual doctoral-level clinicians. OCPD was highly prevalent (26%) in this sample. Multi-factor models of OCPD were tested and the two factors – perfectionism and interpersonal rigidity – provided the best model fit. Interpersonal rigidity was associated with aggression and anger while perfectionism was associated with depression and suicidal thoughts. [Copyright &y& Elsevier]

This article provides a focused review of the literature on compulsive hoarding and presents a number of options and preliminary recommendations to be considered for DSM-V. In DSM-IV-TR, hoarding is listed as one of the diagnostic criteria for obsessive–compulsive personality disorder (OCPD). According to DSM-IV-TR, when hoarding is extreme, clinicians should consider a diagnosis of obsessive–compulsive disorder (OCD) and may diagnose both OCPD and OCD if the criteria for both are met. However, compulsive hoarding seems to frequently be independent from other neurological and psychiatric disorders, including OCD and OCPD. In this review, we first address whether hoarding should be considered a symptom of OCD and/or a criterion of OCPD. Second, we address whether compulsive hoarding should be classified as a separate disorder in DSM-V, weighing the advantages and disadvantages of doing so. Finally, we discuss where compulsive hoarding should be classified in DSM-V if included as a separate disorder. We conclude that there is sufficient evidence to recommend the creation of a new disorder, provisionally called hoarding disorder. Given the historical link between hoarding and OCD/OCPD, and the conservative approach adopted by DSM-V, it may make sense to provisionally list it as an obsessive–compulsive spectrum disorder. An alternative to our recommendation would be to include it in an Appendix of Criteria Sets Provided for Further Study. The creation of a new diagnosis in DSM-V would likely increase public awareness, improve identification of cases, and stimulate both research and the development of specific treatments for hoarding disorder. Depression and Anxiety, 2010.© 2010 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Objective: To examine 1-, 2-, and 3-factor model structures through confirmatory analytic procedures for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) obsessive-compulsive personality disorder (OCPD) criteria in patients with binge eating disorder (BED).Method: Participants were consecutive outpatients (n = 263) with binge eating disorder and were assessed with semi-structured interviews. The 8 OCPD criteria were submitted to confirmatory factor analyses in Mplus Version 4.2 (Los Angeles, CA) in which previously identified factor models of OCPD were compared for fit, theoretical relevance, and parsimony. Nested models were compared for significant improvements in model fit.Results: Evaluation of indices of fit in combination with theoretical considerations suggest a multifactorial model is a significant improvement in fit over the current DSM-IV single- factor model of OCPD. Though the data support both 2- and 3-factor models, the 3-factor model is hindered by an underspecified third factor.Conclusion: A multifactorial model of OCPD incorporating the factors perfectionism and rigidity represents the best compromise of fit and theory in modelling the structure of OCPD in patients with BED. A third factor representing miserliness may be relevant in BED populations but needs further development. The perfectionism and rigidity factors may represent distinct intrapersonal and interpersonal attempts at control and may have implications for the assessment of OCPD. [ABSTRACT FROM AUTHOR]

Abstract: Most research on relations between Obsessive–Compulsive Disorder (OCD) and personality addresses only comorbidity rates between OCD and Obsessive–Compulsive Personality Disorder (OCPD). We first investigated empirical OCD–OCPD relations, but then also examined patterns of dimensional traits in OCD patients versus students and general outpatients. Results did not support a specific OCD–OCPD relation and the implications of this conclusion are discussed. Regarding traits, OCD patients shared with other patients elevated negative affectivity and lower positive affectivity. Differences on several lower order dimensions, including lower scores on manipulativeness, mistrust, and disinhibition distinguished the personality profile of OCD patients from others. Also noteworthy was a pattern of very low self-image for OCD patients, as suggested by the combination of low self-esteem and low entitlement scores. Overall, OCD patients showed a more specific pattern of personality pathology than did general outpatients, who were elevated more generally across personality disorders and negative affectivity scales. [Copyright &y& Elsevier]

Objective Perfectionism and obsessionality are core features of eating disorders (ED), yet the nature of their relation remains unknown. Understanding the relation between these traits may enhance our ability to identify relevant behavioral endophenotypes for ED. Method Six-hundred seven individuals with anorexia and bulimia nervosa from the International Price Foundation Genetic Study were assessed for perfectionism, obsessive-compulsive personality disorder (OCPD), and obsessive-compulsive disorder (OCD). Results No differences were found across ED subtypes in the prevalence of OCPD and OCD, nor with the association between OCD and OCPD. Perfectionism scores were highest in individuals with OCPD whether alone or in combination with OCD. Conclusion Perfectionism appears to be more closely associated with obsessive-compulsive personality symptoms rather than OCD. The pairing of perfectionism with OCPD may be a relevant core behavioral feature underlying vulnerability to ED. © 2005 by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Grilo CM, Skodol AE, Gunderson JG, Sanislow CA, Stout RL, Shea MT, Morey LC, Zanarini MC, Bender DS, Yen S, McGlashan TH. Longitudinal diagnostic efficiency of DSM-IV criteria for obsessive–compulsive personality disorder: a 2-year prospective study. Acta Psychiatr Scand 2004: 110: 64–68. © Blackwell Munksgaard 2004. To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for obsessive–compulsive personality disorder (OCPD). At baseline, criteria and diagnoses were determined using diagnostic interviews, and blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, using the independent OCPD diagnosis at follow-up as the standard. Longitudinal diagnostic efficiencies for the OCPD criteria varied; findings suggested the overall predictive utility of ‘preoccupied with details’, ‘rigid and stubborn’, and ‘reluctant to delegate’. These findings suggest the predictive validity of three cognitive-interpersonal OCPD criteria. [ABSTRACT FROM AUTHOR]