Obsessive-compulsive Personality Disorder: Signs and Treatment

Obsessive-compulsive personality disorder (OCPD) is the third and last cluster of C personality disorder (PD). The key characteristics of this PD are rigidness, inflexibility, and preoccupation with details. OCPD should not be confused with obsessive-compulsive disorder (OCD).

Key takeaways:
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    OCPD is not the same as OCD.
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    OCPD’s main characteristics include preoccupation with details, rules, and extreme perfectionism.
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    There are three main theories for developing OCPD.
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    Treatment for OCPD consists of psychological, pharmacological approaches or the combination of the two.
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    Left untreated, OCPD can worsen.

OCD is a neuropsychological disorder that involves involuntary obsessive, intrusive thoughts that manifest in repetitive behaviors. On the other hand, OCPD causes individuals to be overly preoccupied with details or rules, to the point where the task itself remains uncompleted.

How many people are affected?

Medical professionals have suggested that OCPD is one of the most prevalent PDs. The estimates indicate that prevalence rates range from 3–8% in the general population. A recent study investigating a US sample reported that 7.8% of individuals meet the diagnostic criteria for OCPD. As with most PDs, comorbid conditions are widespread.

Most commonly, individuals diagnosed with OCPD also suffer from bipolar disorder (38.9%), panic disorders (38.7%), and social phobia (32.9%). Additionally, less common but still highly prevalent conditions include mood and anxiety disorders (24%) and substance use disorders (13%).

OCPD occurs in similar numbers in men and women. Interestingly, statistics show a higher prevalence in less educated groups. Also, because symptoms can worsen with age if not treated, it is more common in older individuals. Studies show that OCPD is less common in young individuals and in Asian and Hispanic communities.

What causes OCPD?

OCPD case studies note three main theories on the causes of this PD. Unfortunately, there is a limited amount of data; therefore, many of the assumptions and opinions are merely speculative.

Psychological theories, including psychoanalytic theory and attachment theory, suggest that OCPD characteristics form as a response or coping mechanism to parental or caregiver dominance. Behavior traits affecting individuals include overly intrusive, micromanaging, and/or controlling authority figures — to the point of producing psychological harm. Attachment theory also stipulates that individuals with OCPD have never formed productive personal bonds or experienced a secure attachment. They may have also lacked concern, compassion, or a nurturing feeling from a parent or childcare worker but instead were exposed to controlling and overprotective care. This type of behavior may have caused a disruption in emotional and empathetic development.

Biological theories investigate the underlying genetic mechanism that causes the development of OCPD. Studies show that OCPD may be inherited; however, to what extent is yet unclear. Furthermore, researchers have gathered varying results — with data showing reported rates of between 30%–78% supporting inheritability. This kind of data variability suggests that there’s still much to be learned and that more genetic studies are needed.

Finally, it is theorized that OCPD traits develop as a compensatory mechanism for pre-existing cognitive deficits. This theory takes on an evolutionary approach and suggests that the lack of empathy is a deficit in the empathizing system. This is an evolutionary system developed to understand the initial behaviors and motivations of others. In contrast, the systemizing mechanism, which is responsible for understanding lawful and non-intentional events (e.g., rules, facts), seems to be more active in individuals with OCPD.

What are the symptoms of OCPD?

As mentioned before, OCPD individuals tend to be idealistic. However, their extreme focus on small details often derails them from the initial target. Individuals with OCPD may exhibit several of the following behaviors:

  • Preoccupation with details and rules — to the point of negatively affecting their initial goal or targets in personal and/or professional settings.
  • Perfectionism – Individuals exhibit an unhealthy degree of perfectionism, which may become a self-limiting trait.
  • Excessive devotion — Individuals will dedicate an extreme amount of time and effort to simple or routine tasks at the expense of other areas of their life.
  • They tend to be over-conscientiousness.
  • They tend to have difficulty letting go (throwing out) of worn-out or worthless items.
  • They tend to refuse to share or delegate workloads.
  • A tendency to feel or exhibit a high degree of miserliness toward themselves or others.
  • Rigidity and stubbornness – sensitivity to any deviation from established rules, protocols, routes, and behaviors regardless of their appropriateness or effectivity, reluctance to change.

Treatment and help for OCPD

Unfortunately, current OCPD treatments are limited to medication and therapy. However, there are few options and only a small amount of literature available for treating OCPD with drug therapy. Therefore, many of the prescribed medications are used to treat various other psychological conditions as well.

The most common psychological approaches include interpersonal psychotherapy, cognitive therapy, and cognitive-behavioral therapy. A dedicated clinician will offer the most suitable therapy, or a combination of psychological and pharmacological therapies based on the individual’s symptom severity and other medical conditions. Fortunately, successful therapy has shown significant improvement in an individual’s daily life, coping mechanisms, and related behaviors.

If you believe that a loved one may be suffering from OCPD, encourage them to contact their physician, who will refer them to a dedicated mental health professional.


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