To date, no study has examined interpersonal functioning in a clinical population with a principal diagnosis of OCPD. Henderson and Horowitz argued that others' interpersonal behaviors are irritating to individuals because they frustrate interpersonal motives Horowitz et al. For example, individuals who tend to value independence, autonomy, and social distance would be expected to be the most frustrated by those who are clingy and dependent, while individuals who value assertiveness would be the most frustrated by passivity in others.
For example, individuals who are warm and loving were most bothered by others who were cold and withdrawn. They also found that in a sample of undergraduate students, individuals reporting high antisocial personality traits were most bothered by warm, submissive interpersonal behavior, while individuals reporting high dependency traits were most bothered by cold, dominant interpersonal behavior in others.
The specific interpersonal sensitivities associated with OCPD have not yet been explored. Another method for exploring interpersonal functioning in OCPD is to examine the systemizing mechanism SM and capacity for empathy. Baron-Cohen describes SM as a way of understanding and predicting the law-governed inanimate world.
It is the drive to analyze the variables in a system, to derive the underlying rules that govern the system, to predict the behavior of the system, and finally to control the system. Systemizing allows the brain to predict that event X will likely occur with probability P. In contrast, empathizing is a more fluid way of understanding and predicting the social world. It is the drive to identify another person's emotions and thoughts and to respond with the appropriate emotion Baron-Cohen, Previous research has shown that women spontaneously empathize to a greater extent than males Wakabayashi et al.
The authors concluded that these core features of OCPD might be related to the systemizing mechanism and argued that OCPD individuals are high on systemizing and low on empathizing. The conclusions of Hummelen et al. However, to date, no study has examined the link between systemizing, empathy, and OCPD.
Prevalence data support a relationship between these disorders, with elevated rates of OCPD Based on previous research investigating interpersonal functioning in OCPD, the current study had three main aims. First, we wanted to explore the specific types of interpersonal problems associated with OCPD. Based on the findings of Cain and Villemarette-Pittman et al.
Second, we wanted to investigate the types of interpersonal sensitivities associated with OCPD. Given the predicted interpersonal hostility and coldness associated with OCPD, we hypothesized that OCPD patients would report interpersonal sensitivity to warm interpersonal behavior by others. Finally, we predicted that individuals with OCPD would score higher on the systemizing mechanism and lower on empathy than healthy controls.
They were recruited by advertisements, the program's website, clinician referral, and word of mouth. Eligible subjects had no significant medical problems and no current or past neurological disorder. Participants were excluded for prominent suicidal ideation, drug or alcohol abuse in the last six months, lifetime mania, psychosis, and substance dependence, and if they declined participation.
A total of individuals were screened for OCPD with and without comorbid OCD and 50 individuals were screened for inclusion in the healthy control group. A final sample of 75 volunteers participated, grouped by principal diagnosis: HC subjects were recruited who matched the other groups on age, sex, race, and years of education; none reported a history of OCD or OCPD in first-degree relatives as assessed by the Family History Screen Weissman et al.
The institutional review board approved the study and participants provided written informed consent before testing. All study procedures occurred on one day. After a phone screening, individuals interested in the study received an in-person intake clinical interview by a senior clinician MD or PhD.
If discrepancies occurred between the intake clinical interview and the structured diagnostic interviews, they were discussed and a consensus diagnosis was reached. Trainee and senior interviewers derive diagnoses independently. Before serving as a diagnostic interviewer in the current study, the trainee had to agree with the senior interviewer on three consecutive interviews on the principal diagnosis and on the presence of all additional current and lifetime diagnoses, thus demonstrating high inter-rater reliability with senior interviewers.
Respondents are asked to indicate their degree of distress associated with the problem on a 5-point scale ranging from 0 not at all to 4 extremely. The alpha coefficients in this sample ranged from. The ISC is a item measure that contains items describing a range of interpersonal behaviors enacted by others that may bother a respondent across eight themes emerging around the dimensions of dominance and warmth: Respondents are asked to indicate their general interpersonal sensitivity when another person engages in the item's behavior on an 8-point scale ranging from 0 never, not at all to 7 extremely, always bothers me.
The IRI is a item self-report measure that consists of four 7-item subscales each of which assesses a different aspect of empathy: Each item is rated on a 5-point scale ranging from 0 does not describe me well to 4 describes me very well. The subscales of the IRI have been shown to have high test-retest reliability and internal consistency. The SQ-short is a item self-report measure designed to assess the drive to analyze variables in a system as well as the drive to derive the underlying rules that govern the behavior of that system.
It was developed to be a shorter version of the item Systemizing Quotient Scale Baron-Cohen et al. Each item is rated on a 4-point scale ranging from 1 strongly disagree to 4 strongly agree. The alpha coefficient in this sample was. The goodness-of-fit of the modeled curve to actual scores can be evaluated by calculating an R 2 value, which quantifies the degree to which the interpersonal profile conforms to prototypical circumplex expectations i.
To the extent that a group's interpersonal profile exhibits non-trivial amplitude i. Following the methods and guidelines recommended by Wright et al. The circular mean represents the average of the angular displacements for each individual within the group. The angle as defined by a circular mean will differ slightly from the angular displacement given by the structural summary method. The reason is that circular means are calculated using only angular location, not taking into account profile differentiation, thus all angles are afforded equal weight in the equation.
The circular variance refers to the dispersion of the angular displacements of individuals within a given group around the circular mean. Circular CIs are calculated as a way of identifying reliable differences in group's circular means, allowing for a direct statistical comparison between groups, with the expectation that CIs will not overlap. Because previous research has demonstrated gender differences in systemizing and empathizing Baron-Cohen, et al. Demographic and clinical characteristics for the three groups are presented in Table 1.
There were no significant differences between the three groups on age, gender, race, marital status, employment status, and highest level of education. As expected, there were significant differences between the three groups on clinical characteristics. Different alphabetical superscripts indicate significant differences in post hoc Bonferroni analyses. These results support assertions that there are distinct interpersonal profiles associated with each group.
These findings also support the assertion that distinct types of sensitivities characterize the groups. The structural summary method models circumplex data as an interpersonal profile using a cosine curve function, while circular statistics allow for direct between-group statistical comparisons of circumplex data. We then compared the three groups on the subscales of the IRI to investigate differences in perspective taking, fantasy, empathic concern, and personal distress while controlling for gender Table 3.
There were no significant differences between the three groups on empathic concern. Finally, we investigated group differences in level of systemizing SQ-short. We then explored gender differences on the SQ-short within each group. The current study represents an important first step in understanding interpersonal functioning in OCPD by systematically examining measures of interpersonal problems, interpersonal sensitivities, empathy, and systemizing in a clinical sample with a principal diagnosis of OCPD, with and without comorbid OCD.
First, we found that individuals with OCPD reported hostile dominant interpersonal problems and high interpersonal distress. However, as noted earlier, OCPD was not the principal diagnosis in these mixed samples, which may be one reason for the discrepant findings. Our finding that individuals with OCPD report hostile dominant interpersonal problems is consistent with the research of Cain as well as previous research linking the core features of OCPD, such as perfectionism and rigidity, to interpersonal aggression Ansell et al.
OCPD individuals in the current study reported being overly controlling, vindictive, and cold in their interpersonal relationships.
Previous research has shown that disorders with marked anxiety, such as OCD, are generally associated with more avoidant, nonassertive, and exploitable interpersonal problems e. In addition, recent research by Przeworski and Cain showed that OCD individuals report interpersonal problems with being nonassertive, exploitable, and intrusive. Our results highlight the importance of a multifaceted diagnostic assessment at the start of treatment in order to fully assess OCPD with and without comorbid OCD. Second, consistent with the research of Hopwood et al.
These individuals report being controlling and cold in their interpersonal relationships and are sensitive to individuals who are enacting controlling, but warm interpersonal behavior. It may be that warmth in others may frustrate the interpersonal motives of OCPD individuals, which involve being more emotionally restrained, rigid, and in control in relationships Hummelen et al. Perspective taking is the ability to spontaneously adopt the psychological viewpoint of others. OCPD individuals report difficulties with being able to see things from another's point of view, consistent with previous research associating OCPD with rigidity and stubbornness Hummelen et al.
In contrast, we found no differences between OCPD individuals, with and without OCD, and healthy controls on the empathic concern subscale. Empathic concern involves sympathy and concern for the unfortunate circumstances of others, a more affective component of empathy Davis, Our findings suggest that individuals with OCPD may have the capacity to experience sympathy and concern for others and may be able to intuit the appropriate affective response to another person, similar to healthy controls, but are limited in their ability to subsequently demonstrate the appropriate emotional response in a social situation or adopt the other person's point of view.
In addition, we found that individuals with OCPD, with and without OCD, also reported high levels of personal distress as compared to healthy controls. Personal distress on the IRI measures a more self-oriented aspect of empathy, feelings of personal anxiety and unease in tense, difficult interpersonal relationships.
Interestingly, individuals with pure OCPD reported higher levels of fantasy on the IRI, which involves the tendency to transpose themselves imaginatively into the feelings and actions of fictional characters. The fantasy subscale of the IRI encompasses cognitive empathy, which is considered to be a more intellectualized reaction to others rather than an emotional reaction Davis, , thus it is likely that OCPD individuals use a more cognitive, intellectualized style to cope with interpersonal situations by escaping into fantasy rather than taking another's perspective McWilliams, Our findings showing that OCPD individuals report an interpersonal profile that is controlling, hostile, sensitive to interpersonally warm behavior by others, and low on perspective taking is consistent with the research on systemizing.
In fact, Hummelen et al. However, contrary to our expectations, individuals with OCPD, with and without comorbid OCD, did not report more systemizing than healthy controls. We did find that men in the OCPD group reported more systemizing than women in the OCPD group, which is line with previous research showing higher rates of systematizing in males Baron-Cohen et al. One possible explanation for our findings may be that the interpersonal control and dominance associated with OCPD may manifest in different ways in males and females. In OCPD males, interpersonal control may be more related to deriving rules, analyzing, and making predictions about another's behavior, which is consistent with increased systemizing.
As this is the first study to assess systemizing in OCPD, further research is needed on this interpersonal dimension. Despite evidence showing individuals diagnosed with OCPD frequently seek individual psychotherapy Bender et al. The current study suggests that targeting the interpersonal profile associated with OCPD may offer a useful avenue for developing treatment interventions for this clinical population. In particular, we found that individuals with OCPD report hostile dominant interpersonal problems. This is consistent with previous research investigating the interpersonal style associated with maladaptive perfectionism, a hallmark symptom of OCPD.
In the depression treatment literature, perfectionism has also been shown to impede successful treatment regardless of modality Blatt, ; Blatt et al. Our current results combined with previous research suggest the importance of designing treatment interventions tailored to target the interpersonal hostility and dominance associated with OCPD, such as skills training to promote emotional awareness and relationship flexibility. We also found that individuals with OCPD may be able to experience empathic concern for others, but lack the skills to appropriately respond to or fully understand the affective experience of another person low perspective taking.
Treatment interventions aimed to increase perspective taking and the capacity to respond to emotion in a fluid and appropriate manner may improve treatment outcome for this population Dimaggio et al. Similarly, in the current study, individuals with OCPD seemed to report higher use of intellectualized coping strategies when faced with interpersonal situations high fantasy on the IRI. Interventions aimed at reducing this reliance on intellectualization as a coping skill may also improve treatment outcome for OCPD individuals.
Finally, we found that OCPD individuals, with and without OCD, reported increased sensitivity to interpersonal warmth enacted by others, which may also have implications for psychotherapy.
12 Ways Life Can be Difficult Living with Someone with OCPD
It is quite possible based on our results that a patient with OCPD may become frustrated, irritated, or even angry by any perception of interpersonal warmth by the therapist, which will in turn inhibit the development of the therapeutic alliance. Through a thorough understanding of interpersonal functioning in OCPD, the therapist can begin to anticipate and predict the effects of therapeutic behaviors on the OCPD patient in order to facilitate a working alliance and improve treatment outcome Tracey, The current study and its conclusions have several limitations.
Second, our findings may not generalize to OCPD individuals who do not respond to advertisements for research or who refuse to participate in research. While this is consistent with previous research e. Finally, our outcome data is limited by its reliance on self-report data. Future studies should include informant ratings e. In conclusion, this study provided the necessary first step toward clarifying interpersonal functioning in OCPD.
Overall, our results suggest that interpersonal deficits are an important feature of OCPD pathology, consistent with the greater emphasis on interpersonal dysfunction in the DSM5 proposed model for personality disorders included in section 3 of the DSM5. Finally, this study points to new treatment directions for OCPD. Interventions tailored to target the interpersonal profile of OCPD may be beneficial, such as skills-based approaches to increase perspective taking and the capacity for understanding and responding to emotion.
National Center for Biotechnology Information , U. From what I've read you can have both. And I asked if I had misunderstood. I was being completely honest when I told her that I found it by accident but that when I read the symptoms that is when I felt like I had misunderstood which one she had told me. That did not make any difference to her, she was still mad. After she calmed down I asked her if she would have ever told anyone before they ever went out on a date that she didn't like anyone to touch her or kiss her and she said no, that she would have never told me that to begin with.
Mental Disorders • View topic - How to talk to someone with OCPD
She was crying when she told me this. I felt like I had to be perfectly honest with her by telling her that I would have never went out with her to begin with if she had told me that. I tried to reassure her that I love her and cared about her and her daughter. I told her that I wished we could go back and recapture what we had the first month and a half. I suggested that "we both" go and find someone who could help us sort this out. That I loved her enough to go get help.
She said she wanted some time to think about it and she would call me. That she didn't understand why people would have to show others affection or be able to talk about it. She said I was trying to change her.
Interpersonal Functioning in Obsessive-Compulsive Personality Disorder
I might have went about it the wrong way but I truly had her best interest at heart. I still love her and I know without a doubt I will always miss her. I tried to call but she want answer her phone. I left several messages trying to get her to talk to me. I hate that it has ended like this. It has been very hard. I'm hoping one day she will look back and realize what has happened and seek some help. If by any chance I have planted a seed of doubt in her head, maybe later on even after another failed relationship she will seek help. That would really make me feel good.
She has a wonderful daughter that really needs her love. Maybe that will be the turning point. I felt like I did the right thing. You know, looking back you always second guess yourself. One of the hard things about all this is that she works at the place where I swim each day after work. I swim for the knee problems I have and its the only pool in 50 miles! I have to go, I'm just going to have to find a way to cope with all this. Like I said I still love her and I know it would be a bumpy road but when you care about someone enough you will try to help.
I do realize that if they want except help you have to turn away. They'll only do it when there ready. Thank you for your response and I wish you the best. Thanks also for the support, its very well appreciated. I have been living with a woman with these traits for years and after 10 years or so of being characterized as a total monster, it finally dawned on me that Someone asked a question about perfection and a household that looks like an episode of Hoarders OCPD is all about this trait.
The perfectionism leads to an inability to delegate or complete anything. Our household is a total dump. We've not had a visitor in years. One trait that I do not see mentioned often is the ritualistic repeating of "the proper answers" to her questions or issues.