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Obsessive-Compulsive Personality Disorder
Complete yet concise, Obsessive-Compulsive Personality Disorder provides an up-to-date analysis of this widespread, multi-faceted disorder. Estimated to be twice as common as any other personality disorder, OCPD is nevertheless both underrepresented in the literature and frequently misunderstood by clinicians and the patients who grapple with its effects. Misdiagnosis, failure to diagnose, and ignorance of treatment options are common. This text represents the collective contributions of some of the foremost authorities in the field under the leadership of editors who are determined to raise awareness and educate practitioners and patients alike about the phenomenology, neurobiology, and psychology of this disorder. The book begins with the history and epidemiology of the disorder before proceeding to the clinical features, which are presented using case examples. From there, the text addresses the developmental aspects of OCPD and then considers other related personality disorders that frequently co-occur with or may be mistaken for OCPD. Additional chapters address the developmental aspects of OCPD, the neurobiology and cognitive underpinnings of OCPD, and available treatment approaches.
The following coverage is especially noteworthy:
Four chapters focus on common mental health disorders that can be difficult to differentiate from OCPD, with the most common misdiagnoses being obsessive-compulsive disorder and hoarding disorder. OCPD has also been linked with eating disorders, impulse disorders, and aggression, and the book helps the reader understand the relationship between and among these disorders.
Gender and/or cultural factors may influence the presentation of psychiatric disorders, including OCPD, and the book explores the potentially heterogeneous etiology of the disorder and the danger of assuming that one size fits all in terms of treatment.
Both psychotherapeutic and pharmacological treatment approaches are examined in detail, including cognitive-behavioral therapies (the rationale behind their use, estimated effectiveness, and limitations of current interventions) and the current state of drug treatment.
OCPD can be trying for family members and others who care about the patient, and the book offers a chapter examining what loved ones can do to help, including how to recognize when a personality trait within the OCPD criteria rises to the level of a disorder.
Although OCPD can be disabling, there can be positive aspects to having an obsessional personality, and the book discusses the situations under which these traits can be advantageous.
Down-to-earth, clinically rich, and unique, Obsessive-Compulsive Personality Disorder will help clinicians navigate the thorny OCPD assessment, diagnosis, and treatment path while providing information and comfort to patients and their families.
The following coverage is especially noteworthy:
Four chapters focus on common mental health disorders that can be difficult to differentiate from OCPD, with the most common misdiagnoses being obsessive-compulsive disorder and hoarding disorder. OCPD has also been linked with eating disorders, impulse disorders, and aggression, and the book helps the reader understand the relationship between and among these disorders.
Gender and/or cultural factors may influence the presentation of psychiatric disorders, including OCPD, and the book explores the potentially heterogeneous etiology of the disorder and the danger of assuming that one size fits all in terms of treatment.
Both psychotherapeutic and pharmacological treatment approaches are examined in detail, including cognitive-behavioral therapies (the rationale behind their use, estimated effectiveness, and limitations of current interventions) and the current state of drug treatment.
OCPD can be trying for family members and others who care about the patient, and the book offers a chapter examining what loved ones can do to help, including how to recognize when a personality trait within the OCPD criteria rises to the level of a disorder.
Although OCPD can be disabling, there can be positive aspects to having an obsessional personality, and the book discusses the situations under which these traits can be advantageous.
Down-to-earth, clinically rich, and unique, Obsessive-Compulsive Personality Disorder will help clinicians navigate the thorny OCPD assessment, diagnosis, and treatment path while providing information and comfort to patients and their families.
275 pages, Paperback
Published January 1, 2020
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Displaying 1 - 5 of 5 reviews
March 29, 2021
• OCPD is characterized by stable neurocognitive traits such as perfectionism, rigidity, and a focus on detail, with associated behavioral tendencies—such as behaviors aimed at achieving intrapersonal or interpersonal control, hoarding, and miserliness—that adversely affect psychosocial function and impair quality of life.
• The nosological status of OCPD remains uncertain because the disorder is noted to share diagnostic traits and clinical overlap with certain obsessive-compulsive and related disorders, including OCD, body dysmorphic disorder, and hoarding disorder, and with neurodevelopmental disorders such as autism spectrum disorder.
A miserly spending style, where money is viewed as something to be hoarded for future catastrophes, seems to be more likely to be a characteristic of individuals who hail from less economically developed countries or societies characterized by political and economic instabilities
OCPD is defined as an enduring pattern that leads to clinically significant distress or functional impairment due to four or more of the following: preoccupation with details and order, self-limiting perfectionism, excessive devotion to work and productivity, inflexibility about morality and ethics, inability to discard worn-out or worthless items, reluctance to delegate tasks, miserliness toward self and others, and rigidity and stubbornness. Cognitive and behavioral features associated with OCPD include indecision (often related to the fear of making the wrong choice and often manifested through excessive research of decision options), difficulty coping with change in one’s schedule or routine, being excessively rule-bound and wedded to routines, difficulty relating to and sharing emotions, anger outbursts when one’s sense of control is threatened, and procrastination (usually linked to high standards of perfectionism).
individuals with OCPD often suffer from impaired interpersonal functioning, as well as high levels of internal distress
impaired interpersonal functioning is a hallmark feature of OCPD. Clinical descriptions indicate that interpersonal conflicts frequently occur among individuals with OCPD, often triggered by their impossibly high standards for the behavior of others, difficulty acknowledging differing viewpoints, and rigidity. individuals with OCPD may be uncompromising and demanding, and OCPD has been linked with outbursts of anger and hostility, both at home and at work
individuals with OCPD reported hostile-dominant interpersonal problems and a tendency to be overly controlling and cold in their relationships. OCPD was also associated with having a less empathic perspective
individuals with OCPD “might have the capacity to experience sympathy and concern for others and might be able to intuit the appropriate affective response to another person…but are limited in their ability to subsequently demonstrate the appropriate emotional response in a social situation or adopt the other person’s point of view”
Of the core features of OCPD, perfectionism has been highlighted in research and clinical reports as a major contributing factor to life impairment. Maladaptive perfectionism—the belief that anything less than perfect performance is unacceptable—has been linked to the development of depression
On the basis of my clinical observations, there appear to be distinct OCPD subgroups. I have identified at least two such subgroups and refer to them as the hostile-dominant type and the anxious type.
Psychodynamic treatment for OCPD involves an insight-oriented approach that attempts to reveal how the OCPD symptoms function to defend the individual against internal feelings of insecurity and uncertainty. When patients gain this insight, they then work to change their inflexible patterns of behavior and give up their rigid demands for perfection in favor of a more reasonable outlook.
Cognitive-behavioral therapy (CBT) typically involves a combination of both cognitive and behavioral techniques. The general cognitive therapy approach to treating OCPD involves identifying and restructuring the dysfunctional thoughts underlying maladaptive behaviors
patients would be taught to challenge “all-or-nothing” thinking by considering the range of possibilities that might be acceptable. Similarly, therapists might teach patients to recognize instances in which they overestimate the consequences of mistakes (catastrophizing) by examining the realistic significance of minor errors.
cognitive-behavioral approach consists of four aims developed originally by Fairburn et al. (2003): 1) identifying perfectionism as a problem and understanding maintaining mechanisms, including rigidity, overworking or overtraining, behavioral avoidance, dichotomous thinking, and cognitive biases; 2) conducting behavioral experiments to learn more about the nature of perfectionism and alternative ways of living; 3) psychoeducation and cognitive restructuring (in combination with behavioral experiments) to modify personal standards, self-criticism, rigid rules, and cognitive biases (e.g., selective attention to perceived failures); and 4) broadening the individual’s scheme for self-evaluation by examining existing methods of evaluating the self and then identifying and adopting alternative cognitions and behaviors.
the nature of OCPD itself can be a barrier to research because many individuals with OCPD find the traits ego-syntonic and are not particularly interested in changing their ways and/or do not see a need for treatment.
Attachment theory is a term coined by British psychologist John Bowlby (1969) to describe the role of a parent to initially provide a sense of security and foundation from which the child may find confidence and eventually take excursions into the outside world.
The causal relationship between abusive experiences and personality disorders may be bidirectional. In this chapter that examines the impact of parental personality disorder, it is worth noting that physical and sexual abuse are thought to be strong predictors for development of personality disorders
A longitudinal study in 793 mothers and their offspring showed that children who experienced maternal verbal abuse during childhood were more than three times as likely as those who did not experience verbal abuse to have borderline, narcissistic, obsessive-compulsive, and paranoid personality disorders during adolescence or early adulthood
Personality disorders are thought to arise from the interplay of genetic and environmental risk factors—including dysfunctional child rearing and child maltreatment—both of which may be transmitted from parent to child. People with personality disorders are commonly individuals who experienced a form of abuse as children and are at risk to replicate malpractice as a parent. This may contribute to the heritability of personality disorder, which is thought to be moderate to high according to genetic studies on twins and families
Although it is important to understand the etiology and cyclical nature of personality disorders, clinicians should prioritize children’s safety over sympathy for the parent in cases of child abuse and neglect.
Parents’ own experiences of abuse and neglect and their histories of dysfunctional or violent relationships may also be considered as risk factors for hostility toward their own children
Parents with personality disorder may find it difficult to adhere to principles of good parenting, such as being empathetic and sympathetic to vulnerability in children and being able to manage their own and their family members’ negative emotions.
OCPD is one of the most common personality disorders in married and working individuals; therefore, the ramifications of parental OCPD for child development should be an important consideration for clinicians.
No one likes to be criticized, but you may have an amplified response to reasonable feedback if you were criticized a lot as a child,
• The nosological status of OCPD remains uncertain because the disorder is noted to share diagnostic traits and clinical overlap with certain obsessive-compulsive and related disorders, including OCD, body dysmorphic disorder, and hoarding disorder, and with neurodevelopmental disorders such as autism spectrum disorder.
A miserly spending style, where money is viewed as something to be hoarded for future catastrophes, seems to be more likely to be a characteristic of individuals who hail from less economically developed countries or societies characterized by political and economic instabilities
OCPD is defined as an enduring pattern that leads to clinically significant distress or functional impairment due to four or more of the following: preoccupation with details and order, self-limiting perfectionism, excessive devotion to work and productivity, inflexibility about morality and ethics, inability to discard worn-out or worthless items, reluctance to delegate tasks, miserliness toward self and others, and rigidity and stubbornness. Cognitive and behavioral features associated with OCPD include indecision (often related to the fear of making the wrong choice and often manifested through excessive research of decision options), difficulty coping with change in one’s schedule or routine, being excessively rule-bound and wedded to routines, difficulty relating to and sharing emotions, anger outbursts when one’s sense of control is threatened, and procrastination (usually linked to high standards of perfectionism).
individuals with OCPD often suffer from impaired interpersonal functioning, as well as high levels of internal distress
impaired interpersonal functioning is a hallmark feature of OCPD. Clinical descriptions indicate that interpersonal conflicts frequently occur among individuals with OCPD, often triggered by their impossibly high standards for the behavior of others, difficulty acknowledging differing viewpoints, and rigidity. individuals with OCPD may be uncompromising and demanding, and OCPD has been linked with outbursts of anger and hostility, both at home and at work
individuals with OCPD reported hostile-dominant interpersonal problems and a tendency to be overly controlling and cold in their relationships. OCPD was also associated with having a less empathic perspective
individuals with OCPD “might have the capacity to experience sympathy and concern for others and might be able to intuit the appropriate affective response to another person…but are limited in their ability to subsequently demonstrate the appropriate emotional response in a social situation or adopt the other person’s point of view”
Of the core features of OCPD, perfectionism has been highlighted in research and clinical reports as a major contributing factor to life impairment. Maladaptive perfectionism—the belief that anything less than perfect performance is unacceptable—has been linked to the development of depression
On the basis of my clinical observations, there appear to be distinct OCPD subgroups. I have identified at least two such subgroups and refer to them as the hostile-dominant type and the anxious type.
Psychodynamic treatment for OCPD involves an insight-oriented approach that attempts to reveal how the OCPD symptoms function to defend the individual against internal feelings of insecurity and uncertainty. When patients gain this insight, they then work to change their inflexible patterns of behavior and give up their rigid demands for perfection in favor of a more reasonable outlook.
Cognitive-behavioral therapy (CBT) typically involves a combination of both cognitive and behavioral techniques. The general cognitive therapy approach to treating OCPD involves identifying and restructuring the dysfunctional thoughts underlying maladaptive behaviors
patients would be taught to challenge “all-or-nothing” thinking by considering the range of possibilities that might be acceptable. Similarly, therapists might teach patients to recognize instances in which they overestimate the consequences of mistakes (catastrophizing) by examining the realistic significance of minor errors.
cognitive-behavioral approach consists of four aims developed originally by Fairburn et al. (2003): 1) identifying perfectionism as a problem and understanding maintaining mechanisms, including rigidity, overworking or overtraining, behavioral avoidance, dichotomous thinking, and cognitive biases; 2) conducting behavioral experiments to learn more about the nature of perfectionism and alternative ways of living; 3) psychoeducation and cognitive restructuring (in combination with behavioral experiments) to modify personal standards, self-criticism, rigid rules, and cognitive biases (e.g., selective attention to perceived failures); and 4) broadening the individual’s scheme for self-evaluation by examining existing methods of evaluating the self and then identifying and adopting alternative cognitions and behaviors.
the nature of OCPD itself can be a barrier to research because many individuals with OCPD find the traits ego-syntonic and are not particularly interested in changing their ways and/or do not see a need for treatment.
Attachment theory is a term coined by British psychologist John Bowlby (1969) to describe the role of a parent to initially provide a sense of security and foundation from which the child may find confidence and eventually take excursions into the outside world.
The causal relationship between abusive experiences and personality disorders may be bidirectional. In this chapter that examines the impact of parental personality disorder, it is worth noting that physical and sexual abuse are thought to be strong predictors for development of personality disorders
A longitudinal study in 793 mothers and their offspring showed that children who experienced maternal verbal abuse during childhood were more than three times as likely as those who did not experience verbal abuse to have borderline, narcissistic, obsessive-compulsive, and paranoid personality disorders during adolescence or early adulthood
Personality disorders are thought to arise from the interplay of genetic and environmental risk factors—including dysfunctional child rearing and child maltreatment—both of which may be transmitted from parent to child. People with personality disorders are commonly individuals who experienced a form of abuse as children and are at risk to replicate malpractice as a parent. This may contribute to the heritability of personality disorder, which is thought to be moderate to high according to genetic studies on twins and families
Although it is important to understand the etiology and cyclical nature of personality disorders, clinicians should prioritize children’s safety over sympathy for the parent in cases of child abuse and neglect.
Parents’ own experiences of abuse and neglect and their histories of dysfunctional or violent relationships may also be considered as risk factors for hostility toward their own children
Parents with personality disorder may find it difficult to adhere to principles of good parenting, such as being empathetic and sympathetic to vulnerability in children and being able to manage their own and their family members’ negative emotions.
OCPD is one of the most common personality disorders in married and working individuals; therefore, the ramifications of parental OCPD for child development should be an important consideration for clinicians.
No one likes to be criticized, but you may have an amplified response to reasonable feedback if you were criticized a lot as a child,
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July 20, 2020The most misunderstood, under researched and highly prevalent disorder serves as a backdrop to the internal conflicts in modern psychiatry: psychoanalysis vs. neurobiology
Eponymously titled from derivative psychoanalytical history that has mostly withstood the iterations of the DSM. Current evidence pushes towards a neurocognitive functional disorder with observed impairments in executive dysfunction, cognitive inflexibility yet intact decision making. Characteristically, there is an increasing capacity to delayed rewards that is clinically associated with attributes of rigidity and perfectionism. Reassessed as a dimensional psychobiological construct there is increased neuroticism, increased conscientiousness and poor agreeability.
More than a lipstick-on-a-pig descriptor for containment of stigmatization; this latter (non-psychoanalytic) perspective offers clues towards an neurological etiology highlighting population genetics (RE: haplotype expression). Heritability in twin studies is around 27-78% alongside high concordance of trait penetration in probands and first degree relatives.
Still this last wash does little to mollify the psychoanalytical stronghold of environmental “exposure theories” alongside clinical and public misattribution towards similar sounding, derivative disorders (to be fair, shared OCD comorbidity is estimated at 40-70% again with high trait penetration in first degree relatives)
This, of course, is all just fancy talk to impress my wife, after secretly stealing and reading one of her clinical textbooks.
Eponymously titled from derivative psychoanalytical history that has mostly withstood the iterations of the DSM. Current evidence pushes towards a neurocognitive functional disorder with observed impairments in executive dysfunction, cognitive inflexibility yet intact decision making. Characteristically, there is an increasing capacity to delayed rewards that is clinically associated with attributes of rigidity and perfectionism. Reassessed as a dimensional psychobiological construct there is increased neuroticism, increased conscientiousness and poor agreeability.
More than a lipstick-on-a-pig descriptor for containment of stigmatization; this latter (non-psychoanalytic) perspective offers clues towards an neurological etiology highlighting population genetics (RE: haplotype expression). Heritability in twin studies is around 27-78% alongside high concordance of trait penetration in probands and first degree relatives.
Still this last wash does little to mollify the psychoanalytical stronghold of environmental “exposure theories” alongside clinical and public misattribution towards similar sounding, derivative disorders (to be fair, shared OCD comorbidity is estimated at 40-70% again with high trait penetration in first degree relatives)
This, of course, is all just fancy talk to impress my wife, after secretly stealing and reading one of her clinical textbooks.
November 25, 2023
While a lot of worthwhile content is included, I was surprised that the overlap and diagnostic differentiation between OCPD and ASD was not explored. Initial chapters acknowledged familial links between OCPD, OCD, and ASD, and that some question whether OCPD inflexibility is not just ASD rigidity taken to the extreme. Repeated mention of flat affect and diminished social relationships was also made, yet there was no chapter investigating the differentiation between OCPD and ASD. I'm assuming this might be due to a dearth of research on the topic, but it seemed an oversight to not at least attempt to explore this given the known overlap.
March 8, 2021
Up to date info for 2020 - good source material for further research.
Suffers from ugly academic tropes like reiteration of "what is ocpd?" In each chapter and some theorizing/padding where there are no studies.
Solid papers on the state of medications, and interesting data on overlap with other PDs and spectrum behaviors.
Suffers from ugly academic tropes like reiteration of "what is ocpd?" In each chapter and some theorizing/padding where there are no studies.
Solid papers on the state of medications, and interesting data on overlap with other PDs and spectrum behaviors.
May 3, 2025
Stellar resource, and incredibly well researched. Unfortunately, it seems there is a lack of good studies on OCPD to draw definitive data from, in several of the topic areas. While rich on the existing information, this book is of limited use for a layperson doing self-discovery.
Displaying 1 - 5 of 5 reviews