Obsessive-compulsive Personality Disorder Research Articles

Volumetric MRI study of orbito-frontal cortex and thalamus in obsessive-compulsive personality disorder

ObjectivesObsessive compulsive personality disorder (OCPD) is currently thought to bear a close relationship with obsessive-compulsive disorder (OCD), and other compulsive disorders such as eating disorder and autistic spectrum disorder, as well as with the personality disorders, focusing on some important dimensions like phenomenology, heritability, environmental risk factors, comorbidity, course of illness, neurocognitive endophenotypes, and treatment response. In the present study, when we have taken into consideration the knowledge aforementioned, we aimed to examine OFC and thalamus volumes in patients with OCPD. MethodsWe comparatively measured orbito-frontal cortex (OFC) and thalamus volumes of patients with OCPD and healthy control subjects. ResultsPatients with OCPD had considerably smaller left and right OFC volumes compared to those of healthy control subjects. We also found that thalamus volumes of patients were statistically significantly greater than those of healthy comparisons for both sides of region of interest. ConclusionsWe consider that volumetric alterations determined in the present study may be involved in the pathophysiology of the OCPD, considering that OCPD might be related to OCD spectrum disorders neuroanatomically.

Mental Health Literacy of OCD and OCPD in a Rural Area

This study examined the mental health literacy of Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Personality Disorder (OCPD) among the rural public. 89 volunteer participants (ages 19-86) completed this study using vignette methodology and a questionnaire. Results supported the hypothesis that mental health literacy would be low, specifically for OCPD. In addition, the majority of participants viewed the disorders similarly. The findings suggest that the current understanding of OCD may not reflect the disorders true diagnostic criteria and that participants viewed both disorders similarly in regards to treatment and stigma. Implications and further recommendations are discussed.

Mental Health Literacy of OCD and OCPD in a Rural Area

This study examined the mental health literacy of Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Personality Disorder (OCPD) among the rural public. 89 volunteer participants (ages 19-86) completed this study using vignette methodology and a questionnaire. Results supported the hypothesis that mental health literacy would be low, specifically for OCPD. In addition, the majority of participants viewed the disorders similarly. The findings suggest that the current understanding of OCD may not reflect the disorders true diagnostic criteria and that participants viewed both disorders similarly in regards to treatment and stigma. Implications and further recommendations are discussed.

Feelings of incompleteness explain symptoms of OCD and OCPD beyond harm avoidance

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.

Investigating the Spectra constellations of the Hierarchical Taxonomy of Psychopathology (HiTOP) model for personality disorders based on empirical data from a community sample

Objective:The Hierarchical Taxonomy of Psychopathology (HiTOP) posits that psychopathology is hierarchically structured. For personality disorder (PD) traits, there are five spectra: internalizing, thought disorder, disinhibited externalizing, antagonistic externalizing, and detachment. Empirical findings suggest a sixth group, compulsivity. In this research, we tried to recover the five HiTOP spectra, plus compulsivity, specifically for PD traits.Methods:The sample was composed of 4,868 Brazilians (54.9% women, age ranging from 18 to 70; mean = 25.7; SD = 9.64). All participants answered the Dimensional Clinical Personality Inventory 2 (IDCP-2), a self-report inventory for adults, developed in Brazil, for assessment of pathological personality traits.Results:Parallel analysis yielded up to nine factors. On exploratory structural equation modeling (E-SEM), the balance between interpretability and fit index suggested the six-factor solution as the best solution. The fit indexes for the confirmatory factor analysis were slightly less adjusted in comparison to the empirical model.Conclusion:The hypothesis was confirmed, as we did find the groups proposed at the spectrum level of the HiTOP. We also found a compulsivity factor, encompassing the main traits from the conscientiousness dimension of IDCP-2, which is related to obsessive-compulsive PD. Finding the six groupings of traits in the HiTOP model contributes to the validity of this model, and confirms the existence of proposed spectra.

Is problematic exercise really problematic? A dimensional approach.

Though moderate exercise has numerous health benefits, some individuals may become excessively preoccupied with exercise, endorsing features akin to "addiction." The aim of this study was to evaluate the relationships between problematic exercise (viewed dimensionally), quality of life, and psychological measures. Young adults were recruited from an established population-based cohort in the United Kingdom and completed an online survey. The factor structure of the Exercise Addiction Inventory (EAI) was characterized. Relationships between dimensional EAI factor scores and other variables (impulsivity, compulsivity, emotional dysregulation) were elicited. Six hundred and forty-two individuals took part in the study (mean age 23.4 years, 64.7% female). The EAI yielded two factors - a "general factor" and a "relationship conflict factor." Both EAI factor scores were associated with disordered eating, impulsivity (UPPS), and compulsivity (CHI-T). Only the relationship conflict factor score was significantly associated with impaired quality of life (all domains) and with maladaptive personality traits (emotional dysregulation and obsessive-compulsive personality disorder traits). Few participants met conventional threshold for full exercise addiction (1.1%). Higher problematic exercise scores, in a sample largely free from exercise addiction, were associated with impulsive and compulsive personality features, emotional dysregulation, and disordered eating. Further research is needed to examine whether these results generalize to other populations (such as gym attendees) and are evident using more rigorous in-person clinical assessment rather than online assessment. Longitudinal research is needed to examine both positive and negative impacts of exercise, since moderate exercise may, in fact, be useful for those with impulsive/compulsive tendencies, by dampening negative emotional states or substituting for other more damaging types of repetitive habit.

Relationship between attachment models, personality types and obsessive compulsive personality formation

Objectives: This study aims to examine the relationship between attachment models, personality features, and obsessive compulsive personality formation.

Meta-analysis to derive an empirically based set of personality facet criteria for the alternative DSM-5 model for personality disorders.

The alternative model for personality disorders (AMPD) is outlined in Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This model includes 25 dimensional trait facets that are used as criteria for six personality disorders in addition to impairment in functioning. Numerous previous studies have examined the degree to which the proposed trait facets converge with the Section II personality disorders (PDs) they are meant to capture, but the results from these various studies have been inconsistent. The current investigation sought to provide a meta-analysis of published and unpublished data, and in particular, to develop empirically derived trait criterion profiles for each of the six AMPD PDs. A total of 25 independent data sets utilizing diverse samples and methods that included measurement of AMPD traits and at least one Section II PD derived from both published and unpublished work were considered for this review. The findings indicated general support for the traits proposed for each of the six PDs within the AMPD, with obsessive-compulsive PD the notable exception. The discriminant validity, however, was questionable for several of the PDs; several nonproposed traits also correlated with the Section II PD counterparts at moderate to large degrees. Intraclass correlations used to model the agreement across the empirically derived trait profiles for each of the six PDs, however, revealed that most of the disorders were relatively distinct from one another. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychological impact of fibromyalgia: current perspectives.

Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread and persistent musculoskeletal pain and other frequent symptoms such as fatigue, insomnia, morning stiffness, cognitive impairment, depression, and anxiety. FMS is also accompanied by different comorbidities like irritable bowel syndrome and chronic fatigue syndrome. Although some factors like negative events, stressful environments, or physical/emotional traumas may act as predisposing conditions, the etiology of FMS remains unknown. There is evidence of a high prevalence of psychiatric comorbidities in FMS (especially depression, anxiety, borderline personality, obsessive-compulsive personality, and post-traumatic stress disorder), which are associated with a worse clinical profile. There is also evidence of high levels of negative affect, neuroticism, perfectionism, stress, anger, and alexithymia in FMS patients. High harm avoidance together with high self-transcendence, low cooperativeness, and low self-directedness have been reported as temperament and character features in FMS patients, respectively. Additionally, FMS patients tend to have a negative self-image and body image perception, as well as low self-esteem and perceived self-efficacy. FMS reduces functioning in physical, psychological, and social spheres, and also has a negative impact on cognitive performance, personal relationships (including sexuality and parenting), work, and activities of daily life. In some cases, FMS patients show suicidal ideation, suicide attempts, and consummated suicide. FMS patients perceive the illness as a stigmatized and invisible disorder, and this negative perception hinders their ability to adapt to the disease. Psychological interventions may constitute a beneficial complement to pharmacological treatments in order to improve clinical symptoms and reduce the impact of FMS on health-related quality of life.

Suicidality in People With Obsessive-Compulsive Symptoms or Personality Traits.

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.

The role of personality disorders in obsessive-compulsive disorder.

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.

Co-Occurring Substance Use Disorders, Mental Health Conditions and Offending Patterns among Local Jail Detainees

Co-Occurring Substance Use Disorders, Mental Health Conditions and Offending Patterns among Local Jail Detainees Albert M. Kopak, Ph.D; Alyssa L. Raggio, M.A; Norman G. Hoffmann, Ph.D. Abstract Basic prevalence data have documented the high rates of behavioral health needs among adults in jail, but much of this work is ambiguous, often glossing over specific conditions such as personality disorders and certain types of substance use disorders (SUD) (e.g. alcohol use disorder, opiate use disorder, etc.). The work in this area has also asserted multiple conditions are “the rule, not the exception” (Scott, Lewis, & McDermott, 2006), but there is still a limited amount of information available regarding the relationship between specific combinations of mental health conditions, SUDs, and offending patterns among jail detainees. The current study drew on data collected with the Comprehensive Addictions and Psychological Evaluation – 5 (CAAPE–5) over the course of a year from a random sample of adults detained in a local jail. The sample consisted of 258 adults with nearly three quarters (74%) of the sample meeting criteria for a mental health condition in combination with a minimum of one SUD. Additionally, nearly one third (31%) met criteria for multiple severe SUDs. Bivariate results indicated detainees with a combination of mental health and SUD were more likely to be booked into the jail for felony (χ2 (2) = 6.35, p = .042) offenses and property (χ2 (2) = 6.56, p = .038) offenses relative to detainees who did not meet similar criteria. A series of multivariate logistic regression analyses demonstrated detainees who met criteria for specific mental health conditions (i.e. PTSD, depression, antisocial personality disorder (ASPD), or obsessive compulsive personality disorder (OCPD)) in conjunction with multiple SUDs were significantly more likely to be charged with a felony offense. Detainees with PTSD and multiple SUDs were also more likely to be booked into the jail on multiple prior occasions. These results demonstrate the need for systematic comprehensive behavioral health assessments in local detention facilities in the effort to reduce repeat jail admissions. Full Text: PDF DOI: 10.15640/jlcj.v7n1a1

The concurrent validity of a Web-based self-report assessment for personality disorders.

Incorporating online tools in clinical practice could help improve routine assessments of personality disorders and their co-occurring clinical disorders. TeleScreen, a Web-based self-report questionnaire for DSM-IV disorders, has not yet been compared with well-validated structured interviews for clinical and personality disorders. Patients with personality disorders (n = 89) were assessed with TeleScreen and independently interviewed with Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I) and personality disorders (SCID-II). The concurrent validity was examined using sensitivity, specificity, and positive and negative predictive values. Five personality disorders had a prevalence rate higher than 4% and could be examined in the analyses: borderline, obsessive-compulsive, dependent, avoidant and paranoid personality disorders. TeleScreen showed moderate to good validity for borderline personality disorder and obsessive-compulsive personality disorder but suboptimal validity for the dependent, avoidant and paranoid personality disorders. Clinical disorders showed moderate to good values, except for social phobia, dysthymia and eating disorders. These findings provide preliminary evidence for the concurrent validity of TeleScreen for some personality disorders, such as the borderline personality disorder, and pave the way for larger studies to confirm these results. © 2018 John Wiley & Sons, Ltd.

TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Sergio'

This study is the fifth of a series of seven and belongs to the second Italian systematic replication of findings from previous series that investigatedthe effectiveness of a manualized Transactional Analysistreatment for depression through Hermeneutic Single-Case Efficacy Design.The therapist was a white Italian woman with 5years of clinical experience and the patient, Sergio, was a 39-year old white Italian man who attended sixteen sessions of transactional analysis psychotherapy. Sergio satisfied DSM 5 criteria for Persistent Depressive Disorder (Dysthymia) with melancholic features, Post-Traumatic Stress Disorder (PTSD) with Obsessive Personality traits. The treatment focused on the permission to enjoy and on self-protection. The focus on both depressive symptoms and obsessive traits allowed a remission of his dysthymia within the end of therapy. The judges evaluated the case as a good outcome: the depressive and anxious symptomatology clinically and reliably improved over the course of the therapy and these improvements weremaintained at the followups. Furthermore, the patient reported significant change in his post-treatment interview and these changes were directly attributed to the therapy. Citation - APA format: Benelli, E., Gentilesca, G., Boschetti, D., Piccirillo, C., Calvo, V., Mannarini, S., Palmieri, A. and Zanchetta, M. (2018). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - Sergio. International Journal of Transactional Analysis Research & Practice, 9(2), 23-41 https://doi.org/10.29044/v9i2p23

Assessing mentalization in psychotherapy: first validation of the Mentalization Imbalances Scale.

The aim of this study was to provide data on the preliminary validation of a clinician-report multidimensional assessment measure of mentalization (Mentalization Imbalances Scale, MIS). A random national sample of psychotherapists (N=190) completed the MIS to identify mentalization imbalances, and the Personality Disorder Checklist to assess the personality disorders (PDs) of randomly selected patients currently in their care. Factor analysis confirmed the presence of six factors that represented different imbalances of mentalization: cognitive, affective, automatic, external, imbalance toward others, and imbalance toward self. We found several significant relationships between patients’ mentalization imbalances and personality pathology. Paranoid, schizoid, and schizotypal PDs were predicted by an imbalance toward self, an imbalance the patients shared with histrionic, avoidant, and obsessive compulsive PDs, whereas dependent, borderline, and histrionic PDs were related to an imbalance toward others. Cognitive imbalance was related to schizoid, narcissistic, and obsessive compulsive PDs, whereas affective imbalance predicted antisocial, borderline, narcissistic and histrionic PDs. Automatic imbalance was related to schizotypal, antisocial, and borderline PDs. MIS represents a reliable and valid measure that can help clinicians at understanding patients’ specific difficulties of mentalization.

Cross-cultural studies on the prevalence of personality disorders

This article reviews cross-cultural research on personality disorders. The concept of personality disorders is discussed in terms of whether they are universal phenomena or specific to Western society. Then, research on the prevalence of personality disorders in North America, South America, Europe, Asia, Africa, and Australia is reviewed. The overall rates of the prevalence of personality disorders range from 2.40% to 20.00%. The data document that the prevalence of borderline and obsessive-compulsive personality disorders is the highest, especially in high-income countries. The cross-cultural differences in the prevalence of the specified personality disorders are explained by its influencing factors such as race, ethnicity, social requirements, and the dimension of individualism-collectivism. The occurrence of personality disorders across cultures suggests some degree of psychological unity, and in turn, similarities in the neurobiological mechanisms of personality disorders.

Orthorexia nervosa: A behavioral complex or a psychological condition?

Background and aimsNumerous studies have provided evidence for orthorexia nervosa (ON), an eating pattern characterized by an almost manic obsession for and fixation on healthy eating, to be of epidemiological relevance. However, there is scientific debate on whether it is merely a behavioral or lifestyle phenomenon as compared to a mental disorder. Aim of this cross-sectional study was to explore whether ON is of epidemiological and clinical relevance, and whether ON can be distinguished from other mental health disorders and healthy lifestyle features.MethodsAn online survey including a measure of orthorexic behaviors [Duesseldorf Orthorexia Scale (DOS)], well-being and distress, eating behaviors, pathological eating, anxiety and depression, addictive behaviors, obsessive–compulsive symptoms, personality, and health behaviors was completed by 713 subjects (79.8% women, 18–75 years, median age: 25 years).ResultsTwenty-seven subjects (3.8%, 21 women) showed significant orthorexic eating (DOS ≥ 30). ON cases reported lower well-being, lower satisfaction with life, and higher current stress levels than non-ON cases. The highest percentage of variation in ON was explained by pathological eating (R2 = .380), followed by eating style, Mediterranean diet, compulsive symptoms, and subjective social status. Importantly, ON provided hardly any additional predictive value for well-being when also considering pathological eating.Discussion and conclusionsOur data confirmed the epidemiological and clinical relevance of orthorexic behaviors, but the strong conceptual overlap with other mental health problems and pathological eating raise initial doubts as to whether ON is a distinct mental health disorder category. This co-occurrence, unique symptoms, and underlying processes need further exploration by comparing ON cases with patients with other mental disorders.

Problematic overstudying: Studyholism or study addiction?

This commentary addresses Griffiths et al. (2018)’s sixth myth about work addiction. We agree that work addiction could also be spread in the school context, although we propose that problematic overstudying may be more similar to an obsession than to an addiction toward the study. We refer to the DSM-5 diagnostic criteria related to the obsessive–compulsive disorder (OCD) and the substance-use disorder, presenting some theoretical considerations related to the similarities and differences between problematic overstudying and these two diagnoses. Finally, we focus on the obsessive–compulsive personality disorder. We conclude that problematic overstudying might better be conceptualized as an OCD-related disorder.

Prevalence Rates of Personality Disorder and Its Association With Methamphetamine Dependence in Compulsory Treatment Facilities in China.

Methamphetamine use is popular and rapidly increasing in China, and the co-occurrence of personality disorders has an impact on treatment outcomes and may increase vulnerability of developing dependence. The aim of the present study was to investigate the prevalence rates of personality disorders in methamphetamine users and further explore the association between personality disorders and methamphetamine use status. Five hundred and seventy-seven male methamphetamine users were recruited. The self-developed questionnaire was used for demographics, and a Structural Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (SCID-I/II) was performed covering psychiatric diagnosis. Our study found the prevalence of antisocial personality disorder in male methamphetamine users was 71.4%, followed by borderline (20.2%) and obsessive-compulsive (17.9%) personality disorder. Borderline and antisocial personality disorders were found to be risk factors of methamphetamine dependence (adjusted odds ratio = 2.891, p = 0.007 and adjusted odds ratio = 1.680, p = 0.042). These findings suggested personality disorders were highly prevalent in male methamphetamine users, and the comorbidity of antisocial and borderline personality disorders are especially associated with methamphetamine dependence.

Personality Disorders among Individuals Seeking Cosmetic Botulinum Toxin Type A (BoNTA) Injection, a Cross-Sectional Study

Body dysmorphic disorder, narcissistic personality disorder, and histrionic personality disorders are the most frequent personality disorders in patients seeking cosmetic interventions. Botulinum toxin type A (BoNTA) injection for cosmetic purpose is the most popular among non-surgical cosmetic procedures and is also the second common aesthetic treatment in Iran. The current study aimed to assess personality disorders in people who were referred for BoNTA injection in Ardabil, Iran. To the best of our knowledge, this is the first study on personality disorders in applicants for cosmetic BoNTA injection in Iran. In a descriptive cross-sectional study, 200 eligible applicants for cosmetic BoNTA injection were selected by non-probability sampling. Firstly, the participants' demographic data were recorded in data gathering forms. Then their personality characteristics were evaluated via the Milton Clinical Multiaxial Inventory 3rd edition, which is a standardized self-report questionnaire for the assessment of personality disorders and clinical syndromes. Narcissistic personality trait was the most common (34.5%) followed by histrionic personality trait (27%), and obsessive personality trait was the least common personality trait (4%) in patients seeking BoNTA injection. Anxiety disorder had the highest frequency of clinical syndromes (46%) among the participants in this study, somatization had 25.5%, and dysthymia had the lowest frequency (11%). The current study concluded that narcissistic and histrionic personality traits and anxiety and somatization symptoms are higher in applicants for cosmetic BoNTA injection.