Obsessive–compulsive personality disorder facts for kids

Kids Encyclopedia Facts

Obsessive–compulsive personality disorder (OCPD) is a type of personality disorder. It means someone is extremely focused on rules, lists, schedules, and keeping things in perfect order. These traits usually show up by the time a person is an adult and can be seen in many parts of their life. Experts believe OCPD might be caused by a mix of genes and early life experiences, especially how a person learned to connect with others.

OCPD is different from obsessive–compulsive disorder (OCD). Even though their names sound similar, they are not the same. Some studies show people can have both, but others find little connection. Both might involve strict, ritual-like behaviors. OCPD often occurs with other personality disorders, autism spectrum conditions, eating disorders, anxiety, mood disorders, and problems with certain habits.

This disorder is the most common personality disorder in the United States. It is diagnosed more often in males than females. However, some evidence suggests it might affect men and women equally.

What are the signs of OCPD?

Obsessive–compulsive personality disorder (OCPD) involves a very strong focus on rules, lists, schedules, and order. People with OCPD often need things to be perfect. This can make it hard for them to finish tasks or be efficient. They might spend too much time working, which can hurt their friendships and free time.

They can be very strict about what is right and wrong. It might be hard for them to let others help or share work. They might also find it hard to show their feelings. People with OCPD often feel a strong need to control their surroundings and themselves.

Some signs of OCPD stay the same over time. These include needing perfection, not wanting to let others do tasks, and being very strict or stubborn. Other signs, like being overly careful with money or working too much, might change. This can make it seem like the disorder gets better for some people. For others, the signs might stay steady or even get worse with age.

Focus on order and perfection

People with OCPD often want to control everything around them. To do this, they pay a lot of attention to small details, lists, steps, rules, and schedules.

This focus on details and rules makes it hard for them to let others do tasks. They believe there is only one correct way to do something. They might insist that a job must be done exactly their way. They might even watch others very closely when working in a group. They can get upset if someone suggests a different method. A person with OCPD might refuse help, even when they really need it. This is because they think only they can do things perfectly.

People with OCPD are very focused on being perfect. The very high standards they set can actually hurt them. It might cause delays or stop them from finishing goals and tasks. They see every mistake as a huge problem that will ruin their reputation. For example, someone might keep rewriting an essay. They believe it is not perfect, so they miss the deadline or never finish it. They might not realize that others get frustrated by these delays. This can make work relationships difficult.

Focus on work

People with OCPD spend a lot of time on work and being productive. They often do this instead of spending time with friends or having fun. This is not because they need money. They might feel they do not have enough time to relax because work is their top priority. They might refuse to spend time with friends and family for this reason.

It can be hard for them to go on vacation. Even if they plan a trip, they might keep putting it off until it never happens. If they do go on vacation, they might feel uncomfortable. They often bring work with them so they can keep busy. They choose hobbies that are very organized and structured. They approach these hobbies like serious tasks that need to be perfected. This focus on work in OCPD is different from being addicted to work. OCPD is controlled and feels right to the person. Work addiction, however, feels out of control and wrong, and the person might feel bad if they stop working.

Being strict and inflexible

People with OCPD are very careful, strict, and unwilling to change. This applies to their ideas about right and wrong, and other parts of life. They might make themselves and others follow very strict rules and high standards. They are very hard on themselves when they make mistakes. These behaviors should not be confused with a person's culture or religion.

They often see the world in black and white. There is no middle ground between right and wrong. When a situation does not fit this view, it can cause inner conflict. This challenges their need for perfection.

People with this disorder are so focused on doing everything the "right" way. This makes it hard for them to understand and value other people's ideas, beliefs, and values. They are often unwilling to change their own views, especially on moral or political topics.

Limited emotions and social interactions

People with OCPD might not show much warmth or affection. Their relationships and conversations tend to be formal and professional. They might not show much affection even to close family, like hugging a loved one at an airport.

They are very careful when talking to others. They do not act on impulse and make sure their speech follows strict rules. They check their words carefully to avoid anything they see as embarrassing or imperfect. They are even more careful when talking to bosses or important people. This makes talking to others a tiring effort, and they might start avoiding it. Others might see them as cold and distant.

Their need to limit affection is a way to control their feelings. They might store emotions as facts or data, like a library. They think about feelings logically, rather than truly experiencing them. This helps them avoid unexpected emotions and stay in control. They might see exploring feelings as a waste of time. They can also have a superior attitude toward people who are emotional.

Controlling others

People with OCPD are at one extreme of being very careful and organized. While being careful is usually a good trait, for those with OCPD, it can cause problems with others. People with OCPD are very controlling. This extends to their relationships. They respect authority and rules very much.

People with OCPD might punish those who do not follow their strict rules. Their inability to accept different beliefs or behaviors often leads to many arguments. They can have controlling relationships with coworkers, spouses, and children.

What causes OCPD?

Experts believe OCPD is caused by a mix of genes and things that happen in a person's environment. There is evidence that OCPD can be passed down in families. The impact of genes varies in studies, from 27% to 78%.

One study looked at how genes affect different personality disorders. It found that OCPD had a strong link to genetics, with a correlation of 0.78. This suggests that genes play a big role in whether someone develops OCPD.

Other studies have found links between attachment theory and OCPD. This idea suggests that people with OCPD might not have developed a secure way of connecting with others. They might have had parents who were too strict or did not show much care. This could have made it hard for them to develop empathy and emotional skills.

How is OCPD diagnosed?

DSM-5 criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a guide for diagnosing mental disorders. It describes obsessive-compulsive personality disorder as a widespread pattern of being very focused on order, perfection, and control. This happens at the cost of being flexible, open, or efficient. These signs usually start in early adulthood and are present in many different situations. A person is diagnosed with OCPD if they meet at least four out of eight specific criteria.

The eight criteria for OCPD in the DSM-5 are:

Being very focused on details.
Perfectionism that stops tasks from being finished.
Being strict and stubborn.
Not wanting to let others do tasks.
Being overly careful and focused on small rules.
Working too much.
Being overly careful with money.
Not being able to throw away old or useless things.

The list of criteria from the ICD-10 (another diagnostic guide) is similar. However, it does not include the last three points above. It also adds "intrusive thoughts" and "excessive doubt and caution" as criteria.

Other ways to diagnose

The DSM-5 also has another way to diagnose personality disorders. In this model, a person is diagnosed if they have problems in two out of four areas of their personality. They also need to have three out of four specific unhealthy traits. One of these traits must be rigid perfectionism.

The person must also meet general rules for a personality disorder. These rules say that the traits and signs must be steady over time. They must have started in the teen years or early adulthood. They must be seen in many situations. They cannot be caused by another mental disorder, a substance, or a medical condition. Also, they must be unusual compared to a person's age and culture.

Similar conditions

It is important to tell OCPD apart from other mental disorders. Here are some conditions that can seem similar:

Obsessive–compulsive disorder (OCD). OCD and OCPD have similar names, which can be confusing. However, OCD involves true obsessions (unwanted thoughts) or compulsions (repeated actions). OCPD does not have these.
Hoarding disorder. This is diagnosed when hoarding causes serious problems in a person's life. For example, if rooms in their house cannot be used because of too much stuff.
Narcissistic personality disorder. People with this disorder usually think they are already perfect. Those with OCPD do not believe they are perfect and are hard on themselves. People with Narcissistic Personality Disorder might be stingy with others but spend a lot on themselves. People with OCPD are careful with money for themselves and others.
Schizoid personality disorder. Both this disorder and OCPD can involve limited emotions or seeming cold. In OCPD, this is usually because they want to be in control. In Schizoid Personality Disorder, it is because they have trouble feeling or showing emotions.
Other personality traits. Being organized and careful can be helpful traits. OCPD is only diagnosed when these traits become extreme. They must cause significant problems in many parts of a person's life.
Personality changes due to medical conditions. OCPD must be different from personality changes caused by a medical problem. Some medical conditions can affect the brain and change behavior.
Problems with certain habits. Some habits can cause obsessive-compulsive traits. It is important to know if these traits are due to a habit or are a lasting part of a person's behavior.

ICD-10 criteria

The World Health Organization's ICD-10 uses the term anankastic personality disorder (F60.5). At least four of these signs must be present:

Feelings of doubt.
Perfectionism.
Being overly careful.
Checking things and being very focused on details.
Stubbornness.
Being overly cautious.
Being strict and unwilling to change.
Strong, unwanted thoughts or urges that are not as severe as in OCD.

OCPD and other conditions

OCPD and OCD

OCPD is often confused with obsessive-compulsive disorder (OCD). Despite similar names, they are two different disorders. Some people with OCPD also have OCD. Both can sometimes be found in the same family, along with eating disorders.

About 15–28% of people with OCD also have OCPD. However, with the new diagnosis of hoarding disorder in the DSM-5, this number might be lower.

OCD and OCPD have similar signs, which can make it hard to tell them apart. For example, perfectionism is a sign of OCPD. It is also a sign of OCD if it involves needing tidiness, symmetry, or organization. Hoarding is a compulsion in OCD and a sign of OCPD in the DSM-5.

However, there are clear differences between OCD and OCPD. OCD is often described as upsetting and stressful. The unwanted thoughts and habits in OCD are done to reduce stress. People with OCD often feel that their symptoms are not part of who they are. This causes more mental anxiety.

In contrast, the signs of OCPD are repeated behaviors, but they are not linked to upsetting thoughts or urges. People with OCPD usually feel that their traits and behaviors are right and suitable. However, their need for perfection and inflexibility can still cause them a lot of suffering.

Having OCPD along with OCD has been linked to worse outcomes for OCD treatment. This might be because OCPD traits feel right to the person. This can make their unwanted thoughts seem like their own values. However, perfectionism might also help treatment. This is because patients are likely to complete tasks with determination.

When OCD and OCPD occur together, symptoms can be more severe. It might start at a younger age. There can be more problems in daily life. People might have less understanding of their condition. There can also be more depression and anxiety.

OCPD and autism spectrum disorder

There are many similarities between autism spectrum disorder (ASD) and OCPD. Both can involve making lists, strictly following rules, and having strong interests. However, ASD can be different, especially in how people show feelings. People with ASD might have worse social skills. They might also have trouble understanding what others are thinking. They can have very strong interests, like remembering every detail about a hobby. A 2009 study found that 32% of adults with ASD also met the criteria for OCPD.

OCPD and eating disorders

Perfectionism has been linked to anorexia nervosa for many years. In 1949, a researcher described the typical "anorexic girl" as "rigid" and "hyperconscious." They noted a tendency for "neatness, meticulousness, and a stubbornness not open to reason." These traits are so common in people with anorexia that they are called "classical childhood features."

Even if someone with an eating disorder does not have full OCPD, having OCPD traits like perfectionism is linked to more problems. It can also lead to worse outcomes for treatment. However, OCPD and perfectionistic traits were linked to a higher acceptance of treatment.

People with anorexia nervosa who exercise too much often show more OCPD traits. These traits include self-imposed perfectionism, being rule-bound, and being cautious since childhood. It might be that people with OCPD traits use exercise and food restriction to ease fears about weight gain. They might also use it to reduce anxiety or thoughts about weight. People who had childhood traits of being strict, very cautious, and perfectionistic had more severe food restriction and exercised more. They also stayed underweight for longer periods. This suggests that OCPD traits might mean a more severe form of anorexia nervosa that is harder to treat.

OCPD and gambling problems

Many people with lifelong gambling problems also have a personality disorder. The most common one among them is obsessive-compulsive personality disorder. OCPD has a strong link to individuals who have gambling problems. A study from 2001-2002 looked at gambling problems and other mental health conditions. It found that 60.8% of people with gambling problems also had a personality disorder. OCPD was the most common, at 30%. About 300,000 people in the U.S. have both a gambling problem and OCPD. However, there is not much research on this link. More research is needed to understand the causes and develop treatments for these patients.

OCPD and mental tiredness

In 2020, a link between mental tiredness and OCPD was first published. Mental tiredness has been connected to OCPD traits like working too much and perfectionism before.

Other conditions

OCPD is often diagnosed with anxiety disorders, problems with certain habits, and mood disorders. OCPD is also very common with Cluster A personality disorders, especially paranoid and schizotypal personality disorders.

OCPD is also linked to hypochondriasis (excessive worry about having a serious illness). Some studies estimate that up to 55.7% of people with hypochondriasis also have OCPD.

OCPD has also been found to be common in some medical conditions. These include Parkinson's disease and a type of Ehler-Danlos syndrome. This might be because of the need for control that comes from muscle and bone problems early in life. For Parkinson's disease, it might be due to problems in certain brain circuits.

Mental health condition	How often OCPD is found (in 12 months)
Problems with certain habits	12–25%
Mood disorders	24%
Major depressive disorder	23–28%
Bipolar disorder	26–39%
Anxiety disorders	23–24%
Generalised anxiety disorder	34%
Panic disorder	23–38%
Social anxiety disorder	33%
Specific phobia	22%

How is OCPD treated?

The most proven treatment for OCPD is cognitive therapy (CT) or cognitive behavioral therapy (CBT). Studies show that these therapies improve personality problems and reduce anxiety and depression. Group CBT can also help people become more outgoing and agreeable, and less anxious. Interpersonal psychotherapy has shown even better results for reducing signs of depression.

How common is OCPD?

About 3% of the general population is estimated to have OCPD. This makes it the most common personality disorder. It is not yet clear if OCPD is more common in men than women, or if it affects both sexes equally. It is estimated to occur in 8.7% of people seen in mental health clinics.

A study from 2001-2002 looked at seven personality disorders. It found that OCPD was the most common personality disorder in the surveyed group, at 7.88%. This study also found no gender differences in how common it was. It also said that OCPD did not predict disability.

History of OCPD

Sigmund Freud, 1921

In 1908, Sigmund Freud first described the main features of this personality type. He noted a strong focus on order, being very careful with money, and being stubborn. This idea fit his theory of how people develop psychologically.

OCPD was included in the first edition of the Diagnostic and Statistical Manual of Mental Disorders in 1952. It was called "compulsive personality." It was described as a lasting and extreme focus on rules and moral standards. Other signs included being strict, overly careful, and having trouble relaxing.

The DSM-II (1968) changed the name to "obsessive-compulsive personality." It also suggested the term "anankastic personality" to avoid confusion with OCD. However, this new name was removed from later editions. The signs described in the DSM-II were very similar to those in the first DSM.

In 1980, the DSM-III was released. It changed the name back to "compulsive personality disorder." It also added new signs: limited expression of feelings and not being able to let others do tasks. Working too much, perfectionism, and being unable to make decisions were also included. The DSM-III-R (1987) changed the name again to "obsessive-compulsive personality disorder," which it has been called ever since. A diagnosis of OCPD was given if 5 out of 9 signs were met. These signs included perfectionism, focus on details, insisting others do things your way, indecisiveness, devotion to work, limited emotions, being overly careful, not being generous, and hoarding.

With DSM-IV, OCPD was put into the 'Cluster C' group of personality disorders. There was some debate about whether OCPD should be grouped with anxiety disorders. Even though the DSM-IV tried to tell OCPD and OCD apart, OCPD traits can easily be mistaken for the thoughts or values that are part of OCD. This disorder is an area of research that has not been studied enough.