obsessive–compulsive personality disorder obsessive–compulsive personality disorder obsessive–compulsive personality disorder (ocpd) is a cluster c personality disorder marked by a spectrum of obsessions with rules, lists, schedules, and order, among other things. symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. the cause of ocpd is thought to involve a combination of genetic and environmental factors, namely problems with attachment. "ocpd" redirects here. not to be confused with obsessive–compulsive disorder. for other uses, see ocpd (disambiguation). obsessive–compulsive personality disorderother namesanankastic personality disordera symptom of ocpd is a great attention to detail.specialtypsychiatrysymptomsobsession with rules and order; perfectionism; excessive devotion to productivity; inability to delegate tasks; zealotry on matters of morality; rigidity and stubbornnessusual onsetadolescence to early adulthoodrisk factorsnegative life experiences, geneticsdifferential diagnosisobsessive–compulsive disorder, personality disorders, substance use disorder, personality disorder due to another medical conditiontreatmentpsychotherapyfrequency3% personality disorders cluster a (odd) paranoid schizoid schizotypal cluster b (dramatic) antisocial borderline histrionic narcissistic cluster c (anxious) avoidant dependent obsessive–compulsive not otherwise specified depressive depressive cyclothymic others passive–aggressive masochistic sadistic psychopathy haltlose immature post-traumatic organic this is a distinct disorder from obsessive–compulsive disorder (ocd), and the relation between the two is contentious. some studies have found high comorbidity rates between the two disorders but others have shown little comorbidity. both disorders may share outside similarities, such as rigid and ritual-like behaviors. ocpd is highly comorbid with other personality disorders, autism spectrum, eating disorders, anxiety, mood disorders, and substance use disorders. the disorder is the most common personality disorder in the united states, and is diagnosed twice as often in males as in females; however, there is evidence to suggest the prevalence between men and women is equal. signs and symptoms obsessive–compulsive personality disorder (ocpd) is marked by an excessive obsession with rules, lists, schedules, and order; a need for perfectionism that interferes with efficiency and the ability to complete tasks; a devotion to productivity that hinders interpersonal relationships and leisure time; rigidity and zealousness on matters of morality and ethics; an inability to delegate responsibilities or work to others; restricted functioning in interpersonal relationships; restricted expression of emotion and affect; and a need for control over one's environment and self. some of ocpd's symptoms are persistent and stable, whilst others are unstable. the obsession with perfectionism, reluctance to delegate tasks to others, and rigidity and stubbornness are stable symptoms. on the other hand, the symptoms that were most likely to change over time were the miserly spending style and the excessive devotion to productivity. this discrepancy in the stability of symptoms may lead to mixed results in terms of the course of the disorder, with some studies showing a remission rate of 58% after a 12-month period, whilst others suggesting that the symptoms are stable and may worsen with age. attention to order and perfection people with ocpd tend to be obsessed with controlling their environments; to satisfy this need for control, they become preoccupied with trivial details, lists, procedures, rules, and schedules. this preoccupation with details and rules makes the person unable to delegate tasks and responsibilities to other people unless they submit to their exact way of completing a task because they believe that there is only one correct way of doing something. they stubbornly insist that a task or job must be completed their way, and only their way, and may micromanage people when they are assigned a group task. they are frustrated when other people suggest alternative methods. a person with this disorder may reject help even when they desperately need it as they believe that only they can do something correctly. people with ocpd are obsessed with maintaining perfection. the perfectionism and the extremely high standards that they establish are to their detriment and may cause delays and failures to complete objectives and tasks. every mistake is thought of as a major catastrophe that will soil their reputation for life. for example, a person may write an essay and, believing that it fell short of perfection, continues rewriting it, missing the deadline or even failing to complete the task. the subject may remain unaware that others become frustrated and annoyed by repeated delay and inconvenience so caused. work relationships may then become a source of tension. devotion to productivity individuals with ocpd devote themselves to work and productivity at the expense of interpersonal relationships and recreation. economic necessity, such as poverty, cannot account for this behavior. they may believe that they do not have sufficient time to relax because they have to prioritize their work above all. they may refuse to spend time with friends and family because of that. they may find it difficult to go on a vacation, and even if they book a vacation, they may keep postponing it until it never happens. they may feel uncomfortable when they do go on a vacation and will take something along with them so they can work. they choose hobbies that are organized and structured, and they approach them as a serious task requiring work to perfect. the devotion to productivity in ocpd, however, is distinct from work addiction. ocpd is controlled and egosyntonic, whereas work addiction is uncontrolled and egodystonic, and the affected person may display signs of withdrawal. rigidity individuals with ocpd are overconscientious, scrupulous and rigid, and inflexible on matters of morality, ethics and other areas of life. they may force themselves and others to follow rigid moral principles and strict standards of performance. they are self-critical and harsh about their mistakes. these symptoms should not be accounted for or caused by a person's culture or religion. their view of the world is polarised and dichotomous; there is no grey area between what is right and what is wrong. whenever this dichotomous view of the world cannot be applied to a situation, this causes internal conflict as the person's perfectionist tendencies are challenged. people with this disorder are so obsessed with doing everything the "right and correct" way that they have a hard time understanding and appreciating the ideas, beliefs, and values of other people, and are reluctant to change their views, especially on matters of morality and politics. restricted emotions and interpersonal functioning individuals with this disorder may display little affection and warmth; their relationships and speech tend to have a formal and professional approach, and not much affection is expressed even to loved ones, such as greeting or hugging a significant other at an airport or train station. they are extremely careful in their interpersonal interactions. they have little spontaneity when interacting with others, and ensure that their speech follows rigid and austere standards by excessively scrutinising it. they filter their speech for embarrassing or imperfect articulation, and they have a low bar for what they consider to be such. they lower their bar even further when they are communicating with their superiors or with a person of high status. communication becomes a time-consuming and exhausting effort, and they start avoiding it altogether. others regard them as cold and detached as a result. their need for restricting affection is a defense mechanism used to control their emotions. they may expunge emotions from their memories and organize them as a library of facts and data; the memories are intellectualized and rationalized, not experiences that they can feel. this helps them avoid unexpected emotions and feelings and allows them to remain in control. they can view self-exploration as a waste of time and have a patronising attitude towards emotional people. interpersonal control individuals with ocpd are at one extreme of the conscientiousness continuum. while conscientiousness is a desirable trait generally, its extreme presentation for those with ocpd leads to interpersonal problems. ocpd individuals present as over-controlled and this extends to the relationships they have with other people. individuals with ocpd are referential to authority and rules. ocpd individuals may therefore punish those who violate their strict standards. the inability to accept differences in belief or behaviors from others often leads to high conflict and controlling relationships with coworkers, spouses, and children. cause the cause of ocpd is thought to involve a combination of genetic and environmental factors. there is clear evidence to support the theory that ocpd is genetically inherited; however, the relevance and impact of genetic factors vary with studies placing it somewhere between 27% and 78%. a twin study of personality disorders, a study over multiple personality disorders and the influence that genetics play on causing these disorders, found that ocpd had a .78 heritability correlation. therefore, determining that the development of ocpd in an individual can be strongly linked to genetics. other studies have found links between attachment theory and the development of ocpd. according to this hypothesis, those with ocpd have never developed a secure attachment style, had overbearing parents, were shown little care, and/or were unable to develop empathetically and emotionally. diagnosis dsm-5 the fifth edition of the diagnostic and statistical manual of mental disorders, a widely used manual for diagnosing mental disorders, places obsessive-compulsive personality disorder under section ii, under the "personality disorders" chapter, and defines it as: "a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts". a diagnosis of ocpd is only received when four out of the eight criteria are met. the eight criteria of ocpd described in the dsm-5 (of which four are required to be present in a patient for a diagnosis) are: preoccupation with details perfectionism interfering with task completion rigidity and stubbornness reluctance to delegate excessive conscientiousness and pedantry (excessive concern with minor details and rules) workaholic behavior miserliness (excessive desire to save money) inability to discard worn-out or worthless objects the list of criteria for the icd-10 is similar, but does not include the last three criteria in the above list, and additionally includes the symptoms "intrusive thoughts" and "excessive doubt and caution" as criteria for diagnosis. alternative model for diagnosis the dsm-5 also includes an alternative set of diagnostic criteria as per the dimensional model of conceptualizing personality disorders. under the proposed set of criteria, a person only receives a diagnosis when there is an impairment in two out of four areas of one's personality functioning, and when there are three out of four pathological traits, one of which must be rigid perfectionism. the patient must also meet the general criteria c through g for a personality disorder, which state that the traits and symptoms being displayed by the patient must be stable and unchanging over time with an onset of at least adolescence or early adulthood, visible in a variety of situations, not caused by another mental disorder, not caused by a substance or medical condition, and abnormal in comparison to a person's developmental stage and culture/religion. differential diagnosis there are several mental disorders in the dsm-5 that are listed as differential diagnoses for ocpd. they are as follows: obsessive–compulsive disorder. ocd and ocpd have a similar name which may cause confusion; however, ocd can be easily distinguished from ocpd: ocpd is not characterized by true obsessions or compulsions. hoarding disorder. a diagnosis of hoarding disorder is only considered when the hoarding behavior exhibited is causing severe impairment in the functioning of the person, such as an inability to access rooms in a house due to excessive hoarding. narcissistic personality disorder. individuals with a narcissistic personality disorder usually believe that they have achieved perfection (especially compared to other people) and cannot get better, whereas those with ocpd do not believe that they have achieved perfection, and are self-critical. those with npd tend to be stingy and lack generosity; however, they are usually generous when spending on themselves, unlike those with ocpd who hoard money and are miserly on themselves and others. antisocial personality disorder. similarly, individuals with antisocial personality disorder are not generous, but miserly around others, although they usually over-indulge themselves and are sometimes reckless in spending. schizoid personality disorder. schizoid personality disorder and obsessive-compulsive personality disorder may both display restricted affectivity and coldness; however, in ocpd, this is usually due to a controlling attitude, whereas, in spd, it occurs due to a lack of ability to experience emotion and display affection. other personality traits. obsessive-compulsive personality traits may be particularly useful and helpful, especially in