Overlap of obsessive–compulsive personality disorder and autism spectrum disorder traits among OCD outpatients: an exploratory study

Abstract

Background: Whereas the phenomenology of obsessive-compulsive personality disorder (OCPD) shows similarities to that of obsessive compulsive and related disorders (OCRDs) as well as with autism spectrum disorder (ASD), the relationship between these disorders is poorly understood. Aims: Within a clinical sample, we aimed to investigate the distribution of OCD, OCPD and ASD symptoms and traits and their interrelationship, as well as to evaluate insight and treatment refractoriness. Method: Consecutive adult OCD outpatients were assessed for OCPD traits (Compulsive Personality Assessment Scale (CPAS)), OCD symptoms (Yale-Brown Obsessive Compulsive Scale (Y-BOCS)), ASD traits (Autism Spectrum Quotient (AQ)), insight (Brown Assessment of Beliefs Scale (BABS)) and treatment resistance (clinical records). Those scoring highly on the AQ underwent a diagnostic interview for ASD. Results: 67 consenting individuals completed the CPAS, BABS and AQ, and 65 completed the Y-BOCS. 24 patients (35.8%) were diagnosed with OCPD. Patients with OCPD were less likely to be employed (p=.04). They demonstrated elevated AQ scores (p=.004) and rates of ASD diagnosis (54.2%) (p <.001). OCPD traits (CPAS) showed a highly significant correlation with ASD traits (AQ) (p<.001), and no association with Y-BOCS, BABS or treatment resistance. Conclusion: In an OCD cohort limited by small size, OCPD associated strongly with unemployment and ASD, with implications for diagnosis, treatment and outcome.

Individual obsessive-compulsive traits are associated with poorer adjustment to the easing of COVID-19 restrictions

“…Individuals with perfectionism might be expected to show difficulty tolerating the relaxation of societal rules governing safety and continue to avoid social activities owing to the ongoing uncertainty and the perceived incompleteness and inconsistency of the information they have received about risks. In contrast, those with preoccupation with details, rules, lists and so on, possibly reflecting poor “central coherence” ( Gadelkarim et al, 2019 ), might be expected to value more and therefore hold onto, previously reinforced rules around safety-behaviours, such as washing and disinfecting.…”

“…OCPD traits were assessed with the self-rated version of the CPAS, which is an 8-item self-rated (or observer-rated) instrument measuring the severity of individual traits of DSM-5 OCPD. The CPAS has been found to differentiate individuals with OCPD both in a university student sample ( Fineberg et al, 2015 ), where it was validated against an objective measure of cognitive inflexibility (ID-ED task), and among various clinical groups of patients ( Gecaite-Stonciene et al, 2020 ; Gadelkarim et al, 2019 ).…”

Genetic and epigenetic architecture of Obsessive-Compulsive Disorder: In search of possible diagnostic and prognostic biomarkers

“…Moreover, a gender-related expression of symptoms has been reported, with increased contamination/cleaning factors in females and increased sexual/religious and symmetry/ordering factors in males (Labad et al, 2008). OCRDs commonly co-occur and are often comorbid with other psychiatric conditions, in particular anxiety disorders, mood disorders (Dell'osso et al, 2020;Ruscio et al, 2010), obsessive-compulsive personality disorder (Starcevic et al, 2013), neurodevelopmental disorders (Gadelkarim et al, 2019), and tic disorders (de Alvarenga et al, 2012). Comorbidity with tic disorder has been emphasized in the DSM-5, through the addition of a tic specifier to OCD definition (American Psychiatric Association, 2013).…”

Reply to commentaries to willpower with and without effort

“…The overuse of resolve seen in compulsiveness is a whole other topic (Ainslie, 2001, pp. 143–160), but it provides an example uncorrelated with future simulation: The rigid self-control seen in obsessive-compulsive personality disorder (OCPD) and closely correlated, autism spectrum disorder (Gadelkarim et al, 2019) occurs despite reduced episodic simulation (Crane et al, 2013), but its motivation has not been characterized.…”