The Quality of the DSM-IV Obsessive-Compulsive Personality Disorder Construct as a Prototype Category

Abstract

The study evaluated the quality of the DSM-IV obsessive-compulsive personality disorder (OCPD) construct as a prototype category. A sample of 2237 patients from the Norwegian Network of Psychotherapeutic Day Hospitals was examined by a variety of psychometric analyses. A high number of OCPD patients (77%) had co-occurrent PDs, but only the co-occurrence with paranoid was significantly higher than expected. Exploratory factor analysis of the PD criteria indicated that OCPD consists of 2 dimensions. The first dimension, perfectionism, was constituted by OCPD criteria only and was significantly related to obsessive-compulsive disorder. The second dimension, aggressiveness, included 2 OCPD criteria, reluctance to delegate and stubbornness, but was also defined by criteria from paranoid, antisocial, and borderline PD. Confirmatory factor analysis of the OCPD criteria indicated a poor fit of both a unitary model and a 3-dimensional model. Overall, the OCPD criteria had poor psychometric properties. Although it seems that the quality of the DSM-IV OCPD as a prototype construct is insufficient, it may be improved by deleting the criteria hoarding behavior and miserliness. Alternative criteria could be related to problems in close relationships involving the need for predictability. Such revisions may add a third dimension to the 2 dimensions of perfectionism and aggressiveness.

Migration Load, Ecological Opportunity, and Obsessive Compulsive Personality Disorder Etiology: Obsessive Character as an Adaptation to Seasonality

“…Nearly all etiologies of obsessive character are psychoanalytic or psychosocial in nature; consequently, nearly all etiologies are untenable. Even in the vanishingly rare instances in which obsessive biology is considered (Millon and Davis 1996;Hummelen et al 2008), psychoanalytic language is used and psychoanalytic assumptions are conserved (Hertler 2014b). …”

Hoarding disorder: a new diagnostic category in ICD-11?

“…[54][55][56] Also, it has been suggested that deleting hoarding and miserliness items from the set of OCPD criteria may improve the validity of the OCPD diagnosis. 57,58 Similarly, in longitudinal studies, only non-hoarding OCPD criteria, such as preoccupation with details, rigidity and stubbornness, and reluctance to delegate, were predictive of the diagnosis of OCPD two years later. 59 Therefore, most studies suggest that the association between hoarding and OCPD is due to overlapping item content, i.e., because hoarding was assumed to be one of the eight criteria of OCPD.…”

Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification

“…43 A study in a different cohort considered miserliness and hoarding to be unsatisfactory for the diagnosis. 44 Notwithstanding the above, the DSM-5 retained all eight DSM-IV criteria. Compulsive hoarding was recognized as a separate disorder, classified within the OCRD category.…”

“…67 Studies that have examined the internal consistency and factor structure within OCPD have suggested that the hoarding and miserliness criteria might be less indicative of OCPD, and that the OCPD construct may be improved with their exclusion. 42,44 Three studies that recruited large samples of individuals with compulsive hoarding [68][69][70] noted the lack of any specific relationship between hoarding and OCPD and considered that the link could largely be explained by overlapping item content. On the other hand, other studies have shown that patients with OCD and comorbid OCPD are characterized by an increased frequency of hoarding symptoms compared to noncomorbid OCD.…”