Personality Disorder Support Community

Personality Disorder Support Community

Obsessive Compulsive Personality Disorder


Obsessive Compulsive Personality Disorder (OCPD) should not be confused with Obsessive Compulsive Disorder (OCD). People who suffer from OCPD are usually preoccupied with perfectionism, orderliness, and detail and tend to be inflexible and controlling of other people. They usually find it difficult to relax and find security in planning things to the minutest detail. This disorder tends to afflict more males than females and occurs in around 1% of the general population.

People with OCPD tend to:

  • Be preoccupied with details and rules and regulations.

  • Have a compulsion to make lists and schedules.

  • Have a rigid and inflexible attitude.

  • Be perfectionists.

  • Suffer from depression or a pessimistic outlook.

  • Have very extreme views of 'right' or 'wrong' that are inflexible.


There seems to be a higher rate of OCPD in people who also suffer from OCD (23% to 32%). There are also higher incidences of hoarding in people with OCPD.

Sometimes people with OCPD become violent because they feel angry or frustrated from placing such rigidity on themselves and other people.

In order to be diagnosed with OCPD, you will have to meet four or more of the following characteristics listed in the DSM-IV-TR (2000):

  1. Is occupied with details, rules, lists, order, organization, or agenda to the point that the key part of the activity is gone.

  2. Demonstrates perfectionism that hampers with completing tasks.

  3. Is extremely dedicated to work and efficiency to the elimination of spare time activities.

  4. Is meticulous, scrupulous, and rigid about etiquettes of morality, ethics, or values.

  5. Is not capable of disposing worn out or insignificant things even when they have no sentimental meaning.

  6. Is unwilling to pass on tasks or work with others except if they surrender to exactly their way of doing things.

  7. Takes on a stingy spending style towards self and others.

  8. Shows stiffness and stubbornness.


The ICD-10 uses the term Anankastic Personality Disorder, and requires the person to fulfil the general personality disorder first and has at least three of the following:

  1. Feelings of excessive doubt and caution.

  2. Preoccupation with details, rules, lists, order, organization or schedule.

  3. Perfectionism that interferes with task completion.

  4. Excessive conscientiousness, scrupulousness, and undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships.

  5. Excessive pedantry and adherence to social conventions.

  6. Rigidity and stubbornness.

  7. Unreasonable insistence by the individual that others submit exactly to his or her way of doing things, or unreasonable reluctance to allow others to do things.

  8. Intrusion of insistent and unwelcome thoughts or impulses.


Includes:

  • Compulsive and obsessional personality (disorder)

  • Obsessive-compulsive personality disorder


Excludes:

  • Obsessive-compulsive disorder


Cause of OCPD

There are two schools of thought with regards to OCPD. One is biologically based and the other environmental. Under the biological theory, there have been studies that look for a genetic link in families of OCPD sufferers. A particular form of the DRD3 gene is said to be the basis for developing OCPD, coupled with psychological trauma or any kind of emotional, mental, physical or sexual abuse.

The environmental theory puts forward that people with OCPD learned the rigid and inflexible behaviours from others (usually the main carer).

Treatment

With OCPD, the majority of sufferers do not see themselves as having a disorder, or see the disorder as a problem, mainly because they see things as either right or wrong, and to them, their way of doing things is right.
Treatment, however, usually involves psychotherapy, and includes cognitive behavioural therapy as well as cognitive analytic therapy, to cope with the obsessive symptoms.
Since there is also an element of depression within this disorder, sometimes medication will also help, mainly anti-depressants. Anxiety can also be present, in which case, anti-anxiety medication may help.

Millon's Subtypes

Conscientious Compulsive

This sub type is characterised by dependent features. Conscientious compulsives are not just rule bound, they are also duty bound. They are inflexible, meticulous and make painstaking efforts to adhere to the rules but are plagued by indecision and self doubt. They are also earnest and hard working.

Bureaucratic Compulsive

Bureaucratic compulsives are officious and high handed. They are also petty, nosy and meddlesome, close minded and intrusive. They have narcissistic features and are empowered in formal organisations. The rules of the group that they identify with provide them with security.

Parsimonious Compulsive

This subtype is characterised by miserly, hoarding and tight fisted features. They are niggardly and uncaring, and do not like to share. Their fears, however, are the driving force behind their behaviours, because they seek to protect themselves against loss, as well as intrusions into their hidden world. They have schizoid features and constantly fear the exposure of private indiscretions or urges.

Puritanical Compulsive

Puritanical compulsives are prudish, self righteous and austere. They are also judgemental and uncompromising. They are strict with themselves, and constantly endeavour to repress any urges they consider disgusting or offensive. This subtype has paranoid features.

Bedevilled Compulsive

Bedevilled compulsives are characterised by negativistic or passive aggressive features. They are indecisive and are tormented by internal conflicts within themselves. Their compulsions and obsessions direct their conflicted emotions.

OCPD vs OCD

There is a difficulty in distinguishing the disorders because the symptoms overlap but basically, while sufferers of OCD see their obsessions and compulsions as something that is loathsome and outside of themselves, people with OCPD do not get the same kind of anxiety associated with their obsessions and compulsions. OCD symptoms are therefore ego-dystonic (or inconsistent and repulsive to the self) whereas the symptoms of OCPD are ego-syntonic (or consistent and acceptable to the self).

© PDChat 2013

References:

Obsessive-Compulsive Personality Disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)


Anankastic Personality Disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)

Millon, Theodore (2006). "Personality Subtypes Summary”. The Official Website for Theodore Millon, Ph.D., D.Sc.. DICANDRIEN, Inc. http://millon.net/taxonomy/summary.htm

Pinto, Anthony; Jane Eisen, Maria Mancebo, Steven Ramussen (2008). Obsessive-Compulsive Personality Disorder. Elsevier Ltd.. pp. 246-263. http://www.sciencedirect.com/science/ar ... 7018500164

Back