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Obsessive compulsive personality disorder

Obsessions are recurrent, persistent, unwanted ideas, thoughts, images or impulses that are experienced involuntarily, appear to be senseless, and feel out of control. They commonly intrude when you are trying to focus on thinking or doing other things. Obsessions are often accompanied by uncomfortable feelings, such as fear, disgust, doubt, or a sensation that things have to be done in a way that is "just so." Some common obsessions include:

Obsessive-compulsive (OCPC) is the most common type of personality disorder among U.S. citizens, according to a population-based study of seven personality disorders, affecting almost 8 percent of adults (16.4 million people).
  • Fear of danger to oneself or others
  • fear of contamination
  • A need for exactness or order
  • Sexually explicit or repugnant thoughts

A compulsion is a repetitive behavior - a ritual - irrational need to perform some action, often despite negative consequences, that one feels driven to do, and seemingly cannot stop doing. Compulsions occur as a result of obsessions and represent one's attempts to manage his incessant thoughts by doing something to try to settle them. For example, if an obsessive worry is whether or not the door was locked, then a compulsive response might be to check the lock repeatedly. Some common compulsive behaviors are:

  • Excessive checking
  • Counting
  • Silent repetition of words
  • Hand washing
  • Cleaning
  • Crdering / arranging
  • Touching
  • Praying
  • Hoarding

Obsessions and compulsions range from mild checking behavior (did I lock the door?) to severe cases where one is unable to function based on compulsions having taken over normal life functioning. If we think of obsessive-compulsive traits and behaviors on a continuum of varying degrees and intensities, most people experience them with little or no negative consequence on their daily lives and relationships.

However, when obsessions, compulsions, and perfectionist behaviors go overboard, they take up excessive time and significantly interfere with one's daily life and relationships. When this occurs, the repetitive and seemingly out-of-control behaviors of obsession and compulsion may be indicative of a disorder that should be addressed with the help of a licensed professional.

It is important to distinguish between OCPD and obsessive-compulsive disorder (OCD), which is an anxiety disorder characterized by the presence of intrusive or disturbing thoughts, impulses, images or ideas (obsessions), accompanied by repeated attempts to suppress these thoughts through the performance of irrational and ritualistic behaviors or mental acts (compulsions). It is unusual but possible, however, for a patient to suffer from both disorders, especially in extreme cases of hoarding behavior. In some reported cases of animal hoarding, the people involved appear to have symptoms of both OCD and OCPD.

Causes

No single specific cause of OCPD has been identified. Men appear to be more susceptible to OCPD than women; and a possible genetic cause has been suggested, as OCPD often runs in families. Family dynamics and parenting styles may also explain the frequency of the disorder in some families.

Genetic contributions to OCPD have not been well documented. Cultural influences may, however, play a part in the development of OCPD. That is, cultures that are highly authoritarian and rule-bound may encourage child-rearing practices that contribute to the development of OCPD. On the other hand, simply because a culture is comparatively strict or has a strong work ethic does not mean it is necessarily unhealthful. In Japanese societies, for example, excessive devotion to work, restricted emotional expression, and moral scrupulosity are highly valued characteristics that are rewarded within that culture.

One theory suggests that as children, people with obsessive compulsive personality disorder were consistently punished for negative behavior, failure, and rule-breaking, while receiving no praise for success and compliance. To avoid punishment, the child develops a habit of rigidly following rules that lasts into adulthood. This theory also explains why people with obsessive-compulsive personality disorder believe that their preoccupations are appropriate, tending to be high achievers and having a sense of urgency about their actions.

Current studies have tended to support the importance of early life experiences, finding that healthy emotional development largely depends on two important variables: parental warmth and appropriate responsiveness to the child's needs. When these qualities are present, the child feels secure and appropriately valued. By contrast, many people with personality disorders did not have parents who were emotionally warm toward them. Patients with OCPD often recall their parents as being emotionally withholding and either overprotective or over-controlling.

Impact

In the US alone, 8 percent of its residents suffer from OPCD. That translates to roughly 16 million people having careful rules and procedures for conducting many aspects of their everyday lives! It is no doubt that OPCD has far-reaching, even devastating impacts.

Symptoms

According to the National Institute of Mental Health, obsessive-compulsive personality disorder is a condition characterized by a chronic preoccupation with rules, orderliness, and control. A person with OCPD is obsessed with:

This doctor had a patient who would go to the rest room, whether at home or when he was out, and he would use a paper towel to hold onto his genitalia to urinate.
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  • Perfectionism (a belief that anything less than perfect is unacceptable)
  • Orderliness (a focus on routine, patterns, and order)
  • Control (the need to control others and oneself)

The standards of perfectionism for a person suffering from OCPC often interfere with his ability to complete a given task because they are so rigid and impossible to uphold. Often, people with OCPD don't think they have a problem; on the other hand, it is more commonly noticed first by family members or friends.

Obsessive compulsive personality disorder symptoms tend to appear early in adulthood and are defined by inflexibility, close adherence to rules, anxiety when rules are transgressed, and unrealistic perfectionism. A person with obsessive compulsive personality disorder exhibits several of the following symptoms:

  • Abnormal preoccupation with lists, rules, and minor details
  • Excessive devotion to work, to the detriment of social and family activities
  • Miserliness or a lack of generosity
  • Perfectionism that interferes with task completion, as performance is never good enough
  • Refusal to throw anything away (pack-rat mentality)
  • Rigid and inflexible attitude towards morals or ethical code
  • Unwilling to let others perform tasks, fearing the loss of responsibility
  • Upset and off-balance when rules or established routines are disrupted

Diagnosis

1. Do you wash your hands after you feel you have come to close to an animal or dirty object?
2. Do you reposition tablecloths or rugs because you think they are not exactly right?
3. Are there days when you have to think about certain words or images so much that you are unable to do anything else?
4. Is it often impossible for you to stop repeating (if only to yourself) a sentence already spoken?
5. During the day do you think several times about work you have already finished?
6. Do you find that you cannot stop counting during certain activities?
7. Do you sometimes try to distract yourself from a thought about your partner doing something he or she would not want you to know about?
8. Are there any activities you cannot finish before having counted to a certain number?
9. Do you sometimes consciously distract yourself from the thought of hurting or killing yourself?
10. During the course of the day, do you often remember a certain word, picture, or sentence?
11. Do you check the cleanliness of public seats, such as those in buses or taxis, before you sit down?
12. Do you sometimes repeat aloud what has been already spoken, although you try to prevent yourself from doing it?
13. Having left your home, do you constantly have to think about whether everything is in order there?
14. Before starting to dress, do you think about exactly how to do it?
15. Did you ever find yourself counting things for no reason?
16. Was there ever a day when you could not think about anything else except hurting or killing yourself?
17. Do you wash your hands after reading the newspaper?
18. Did you ever notice that you touch things several times before or after you have used them?
19. Have you ever touched switches on electric devices several times and counted despite trying not to?
20. Do you check books or magazines for dog-ears and straighten them immediately?
21. Do you fold newspapers back to the original way after reading them?
22. Does the thought often occur to you that you might get sick or go blind or crazy?
23. Are there days when you can think only about hurting or killing someone?
24. After going to bed, do you get up again to check all electrical devices?
25. Does counting the number of times you touch switches of electrical devices interfere with your everyday activities?
26. Do you rearrange objects on your desk, in your cupboard, or other places repeatedly, even though nothing's been touched since you last arranged them?
27. Do you check the return address immediately before you mail a letter?

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