OCPD

What is OCPD characterised by?

Persistent pattern of preoccupation w orderliness, perfectionism, and mental and interpersonal control, as characterised by 4 or more of the following

\
* Overly preoccupied with order or organization
* Perfectionism interferes w task completion
* Excessively devoted to work and productivity
* Over conscientious and inflexible about matters of morality or ethics
* Unable to discard worthless objects w no sentimental value
* Needs everything done “their way”
* Miserly spending (hoards money for future catastrophes)
* Rigidity and stubbornness

What is the prevalence of OCPD?

8%, out of which 31% is among individuals with a depressive disorder

What is OCPD often comorbid with?

OCD, MDD, anxiety disorders and hoarding disorder, BD, eating disorders, autism, personality disorders and alcohol abuse

How is the relationship between the therapist and a patient with OCPD often?

The person sees the therapist as an authority figure, meaning there is overcompliance, covert resistance and often aggression and avoidance of emotion

What is the treatment of choice for OCPD?

Psychodynamic psychotherapy or CBT with adjunctive psychotherapy. Schema therapy also works well to decrease depressive disorders and increasing social and occupational functioning

What did Freud say about the origins of an obsessive-compulsive personality?

he associated this personality style with problems in the anal stage, specifically the control struggles with children and parents in that stage.

What do modern psychoanalytic theories believe about the emergence of OCPD?

They have evolved from a one-person to a two-person model that also focuses on the therapeutic relationship between the therapist and the patient

What is the biological understanding of OCPD?

OCPD is etiologically different from other cluster C disorders

There is no evidence for shared sex or environmental effects

\
OCPD is increasingly conceptualized as a neurocognitive disorder: enhanced visual acuity, smaller pineal gland volume, occurrence rate of 40% in Parkinson’s disease

What are some psychosocial factors of OCPD?

They tend to be firstborn, marry histrionic individuals and display anhedonic temperaments

Personality lane model

Personality is understood along two dimensions: developmental and internal/external preoccupation. If people proceed across the lane without a disturbance, then the development of PD is not very likely.

\
A disturbance or deficit in establishment of the boundary between self and other may influence severity and type of PD

How is the boundary between self and other established?

In three phases:

1) Self from non-self: You start experiencing your mother as a unique identity

2) Attachment: Your connection with your cg grows. If there is physical safety, there is an internalized experience of the cg in the presence of their absence

3) Object constancy: Capacity to know that attachment with people remains constant and intact despite seperation, setbacks and conflict

What is internal vs external preoccupation and what disorders have which?

Internal: focus on thought, feelings

External: Focus on relationships, concern with judgement

\
PDs with internal preoccupation are schizoid, paranoid, narcissistic, avoidant, OCPD

PDs with external preoccupation are antisocial, borderline, histrionic, dependent, (hysterical)

How do people with OCPD often present?

In a meticulously groomed way and communicate with great attention to detail → might be hard to gather information about their emotions