Hostname: page-component-5db6c4db9b-s6gjx Total loading time: 0 Render date: 2023-03-23T10:30:26.150Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true
  • English

The neuropsychology of obsessive-compulsive personality disorder: a new analysis

Published online by Cambridge University Press:  17 March 2015

Naomi A. Fineberg ,
Grace A. Day ,
Nica de Koenigswarter ,
Samar Reghunandanan ,
Sangeetha Kolli ,
Kiri Jefferies-Sewell ,
Georgi Hranov  and
Keith R. Laws
Naomi A. Fineberg*
Affiliation:
National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership University NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK Postgraduate Medical School, University of Hertfordshire, Hatfield, Hertfordshire, UK
Grace A. Day
Affiliation:
School of Life & Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
Nica de Koenigswarter
Affiliation:
School of Life & Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
Samar Reghunandanan
Affiliation:
National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership University NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK
Sangeetha Kolli
Affiliation:
National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership University NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK
Kiri Jefferies-Sewell
Affiliation:
School of Life & Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
Georgi Hranov
Affiliation:
National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership University NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK Department of Psychiatry, University Hospital of Active Treatment in Neurology and Psychiatry "St. Naum," Sofia, Bulgaria
Keith R. Laws
Affiliation:
National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership University NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK School of Life & Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
*
*Address for correspondence: Naomi A. Fineberg, Prof., Dept. of Psychiatry, Hertfordshire Partnership NHS Foundation Trust QEII Hospital, Howlands, Welwyn Garden City, AL7 4HQ, UK. (Email: naomi.fineberg@hpft.nhs.uk)
Get access Rights & Permissions[Opens in a new window]

Abstract

Background

Obsessive compulsive personality disorder (OCPD) is characterized by perfectionism, need for control, and cognitive rigidity. Currently, little neuropsychological data exist on this condition, though emerging evidence does suggest that disorders marked by compulsivity, including obsessive-compulsive disorder (OCD), are associated with impairment in cognitive flexibility and executive planning on neurocognitive tasks.

Aim

The current study investigated the neurocognitive profile in a nonclinical community-based sample of people fulfilling diagnostic criteria for OCPD in the absence of major psychiatric comorbidity.

Method

Twenty-one nonclinical subjects who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for OCPD were compared with 15 healthy controls on selected clinical and neurocognitive tasks. OCPD was measured using the Compulsive Personality Assessment Scale (CPAS). Participants completed tests from the Cambridge Automated Neuropsychological Test Battery including tests of set shifting (Intra-Extra Dimensional [IED] Set Shifting) executive planning (Stockings of Cambridge [SOC]), and decision making (Cambridge Gamble Task [CGT]).

Results

The OCPD group made significantly more IED-ED shift errors and total shift errors, and also showed longer mean initial thinking time on the SOC at moderate levels of difficulty. No differences emerged on the CGT.

Conclusions

Nonclinical cases of OCPD showed significant cognitive inflexibility coupled with executive planning deficits, whereas decision-making remained intact. This profile of impairment overlaps with that of OCD and implies that common neuropsychological changes affect individuals with these disorders.

Keywords

Cognitive flexibility deficitscompulsive personality disorderexecutive planning deficitsobsessiveoverlapping with disorder criteriareclassification of OCPD
Type
Original Research
Information
CNS Spectrums , Volume 20 , Issue 5 , October 2015 , pp. 490 - 499
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

We thank the European College of Neuropsychopharamacology, Obsessive Compulsive and Related Disorders Research Network, the National Institute for Health Research, and the Clinical Research Group for Optimising Treatment of Obsessive Compulsive and Related Disorders for providing networking opportunities for this research.

References

1.Butcher, JN, Mineka, S, Hooley, JM. Abnormal Psychology. 14th ed.Boston: Pearson Education, Inc.; 2010.Google Scholar
2.Murphy, DL, Timpano, KR, Wheaton, MG, Miguel, EC, Greenberg, BD. Obsessive-compulsive disorder and its related disorders: a reappraisal of obsessive-compulsive spectrum concept. Dialogues Clin Neurosci. 2010; 12(2): 131–148.Google Scholar
3.Fineberg, NA, Sharma, P, Sivakumaran, T, Sahakian, B, Chamberlain, S. Does obsessive compulsive personality disorder belong within the obsessive-compulsive spectrum? CNS Spectr. 2007; 12(6): 467–482.CrossRefGoogle ScholarPubMed
4.Grant, BF, Hasin, DS, Stinson, FS, et al. Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2004; 65(7): 948–958.CrossRefGoogle ScholarPubMed
5.Torgersen, S, Kringlen, E, Cramer, V. The prevalence of personality disorders in a community sample. Arch Gen Psychiatry. 2001; 58(6): 590–596.CrossRefGoogle Scholar
6Grant, JE, Mooney, ME, Kushner, MG. Prevalence, correlates, and comorbidity of DSM-IV obsessive-compulsive personality disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Psychiatr Res. 2012; 46(4): 469–475.CrossRefGoogle ScholarPubMed
7.Pinto, A, Mancebo, MC, Eisen, JL, Pagano, ME, Rasmussen, SA. The Brown Longitudinal Obsessive Compulsive Study: clinical features and symptoms of the sample at intake. J Clin Psychiatry. 2006; 67(5): 703–711.CrossRefGoogle ScholarPubMed
8Coles, ME, Pinto, A, Mancebo, MC, Rasmussen, SA, Eisen, JL. OCD with comorbid OCPD: a subtype of OCD? J Psychiatr Res. 2008; 42(4): 289–296.CrossRefGoogle ScholarPubMed
9.Phillips, KA, McElroy, SL. Personality disorders and traits in patients with body dysmorphic disorder. Compr Psychiatry. 2000; 41(4): 229–236.CrossRefGoogle ScholarPubMed
10.Diaferia, G, Bianchi, I, Bianchi, ML, Cavedini, P, Erzegovesi, S, Bellodi, L. Relationship between obsessive-compulsive personality disorder and obsessive-compulsive disorder. Compr Psychiatry. 1997; 38(1): 38–42.CrossRefGoogle ScholarPubMed
11.Gordon, OM, Salkovskis, PM, Oldfeild, VB, Carter, N. The association between obsessive compulsive disorder and obsessive compulsive personality disorder: prevalence and clinical presentation. Br J Clin Psychol. 2013; 52(3): 300–315.CrossRefGoogle ScholarPubMed
12.Albert, U, Maina, G, Forner, F, Bogetto, F. DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects. Compr Psychiatry. 2004; 45(5): 325–332.CrossRefGoogle ScholarPubMed
13.Starcevic, V, Berle, D, Brakoulias, V, et al. Obsessive–compulsive personality disorder co-occurring with obsessive-compulsive disorder: conceptual and clinical implications. Aust N Z J Psychiatry. 2013; 47(1): 65–73.CrossRefGoogle ScholarPubMed
14.Calvo, R, Lazaro, L, Castro-Fornieles, J, Font, E, Moreno, E, Toro, J. Obsessive-compulsive personality disorder traits and personality dimensions in parents of children with obsessive-compulsive disorder. Eur Psychiatry. 2009; 24(3): 201–206.CrossRefGoogle ScholarPubMed
15.Samuels, J, Nestadt, G, Bienvenu, OJ, et al. Personality disorders and normal personality dimensions in obsessive-compulsive disorder. Br J Psychiatry. 2000; 177(5): 457–462.CrossRefGoogle ScholarPubMed
16.Bienvenu, OJ, Samuels, JF, Wuyek, LA, Liang, KY, Wang, Y, Grados, MA. Is obsessive-compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective. Psychol Med. 2012; 42(1): 1–13.CrossRefGoogle ScholarPubMed
17.Eisen, JL, Coles, ME, Rasmussen, SA. Clarifying the convergence between obsessive compulsive personality disorder criteria and obsessive compulsive disorder. J Personal Disord. 2006; 20(3): 294–305.CrossRefGoogle ScholarPubMed
18.Pinto, A, Stienglass, JE, Greene, AL, Weber, EU, Simpson, HB. Capacity to delay reward differentiates obsessive-compulsive disorder and obsessive compulsive personality disorder. Biol Psychiatry. 2013; 75(8): 653–659.CrossRefGoogle ScholarPubMed
19.Fineberg, NA, Chamberlain, SR, Goudriaan, AE, et al. New developments in human neurocognition: clinical, genetic, and brain imaging correlates of impulsivity and compulsivity. CNS Spectr. 2014; 19(1): 69–89.CrossRefGoogle ScholarPubMed
20.Shin, M, Choi, H, Kim, H, Hwang, J, Kim, B, Cho, S. A study of neuropsychological deficit in children with obsessive-compulsive disorder. Eur Psychiatry. 2008; 23(7): 512–520.CrossRefGoogle ScholarPubMed
21.Chamberlain, SR, Fineberg, NA, Blackwell, AD, Robbins, TW, Sahakian, BJ. Motor inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania. Am J Psychiatry. 2006; 163(7): 1282–1284.CrossRefGoogle ScholarPubMed
22.Aron, AR, Fletcher, PC, Bullmore, ET, Sahakian, BJ, Robbins, TW. Stop-signal inhibition disrupted by damage to right inferior frontal gyrus in humans. Nat Neurosci. 2003; 6(2): 115–116.CrossRefGoogle ScholarPubMed
23.Cambridge Cognition Ltd. Cambridge Cognition. 2014. http://www.camcog.com.Google Scholar
24.García-Villamisar, D, Dattilo, J. Executive functioning in people with obsessive-compulsive personality traits: evidence of modest impairment. J Personal Disord. In press DOI: 10.1521/pedi_2013_27_101.Google Scholar
25.Chamberlain, SR, Fineberg, NA, Blackwell, AD, Clark, L, Robbin, TW, Sahakiana, BJ. A neuropsychological comparison of obsessive-compulsive disorder and trichotillomania. Neuropsychologia. 2007; 45(4): 654–662.CrossRefGoogle ScholarPubMed
26.Murphy, FC, Sahakian, BJ, Rubinsztein, JS, Michael, A, Rogers, RD, Robbins, TW. Emotional bias and inhibitory control processes in mania and depression. Psychol Med. 1999; 29(6): 1307–1321.CrossRefGoogle ScholarPubMed
27.Aigner, M, Sachs, G, Bruckmuller, E, et al. Cognitive and emotion recognition deficits in obsessive-compulsive disorder. Psychiatry Res. 2007; 149(1–3): 121–128.CrossRefGoogle ScholarPubMed
28.Corcoran, KM, Woody, SR, Tolin, DF. Recognition of facial expressions in obsessive-compulsive disorder. J Anxiety Disord. 2008; 22(1): 56–66.CrossRefGoogle ScholarPubMed
29.Daros, AR, Zakzanis, KK, Recto, NA. A quantitative analysis of facial emotion recognition in obsessive-compulsive disorder. Psychiatry Res. 2014; 215(3): 514–521.CrossRefGoogle ScholarPubMed
30.Sheehan, DV, Lecrubier, Y, Sheehan, KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998; 59(20): 22–33.Google ScholarPubMed
31.Nelson, HE, Willison, J. National Adult Reading Test (NART). Windsor, UK: Nfer-Nelson; 1991.Google Scholar
32.Young, AW, Perrett, D, Calder, A, Sprengelmeyer, R, Ekman, P. Facial Expressions of Emotion: Stimuli and Tests (FEEST). Suffolk, UK: Thurston, Thames Valley Test Company; 2002.Google Scholar
33.Jefferies, K, Laws, KR, Fineberg, NA. Superior face recognition in body dysmorphic disorder. Journal of Obsessive-Compulsive and Related Disorders. 2012; 1(3): 175–179.CrossRefGoogle Scholar
34.Feusner, JD, Moller, H, Altstein, K, et al. Inverted face processing in body dysmorphic disorder. J Psychiatr Res. 2010; 44(15): 1088–1094.CrossRefGoogle ScholarPubMed
35.Shallice, T. Specific impairments in planning. Philos Trans R Soc Lond B Biol Sci. 1982; 298(1089): 199–209.CrossRefGoogle ScholarPubMed
36.Nedeljkovic, M, Kyrios, M, Moulding, R, et al. Differences in neuropsychological performance between subtypes of obsessive-compulsive disorder. Aust N Z J Psychiatry. 2009; 43(3): 216–226.CrossRefGoogle ScholarPubMed
37.Lawrence, AJ, Luty, J, Bogdan, NA, Sahakian, BJ, Clark, L. Problem gamblers share deficits in impulsive decision-making with alcohol-dependent individuals. Addiction. 2009; 104(6): 1006–1015.CrossRefGoogle ScholarPubMed
38.Wilson, BA, Evans, JJ, Emslie, H, Alderman, N, Burgess, P. The development of an ecologically valid test for assessing patients with a dysexecutive syndrome. Neuropsychol Rehabil. 1998; 8(3): 213–228.CrossRefGoogle Scholar
39.Amann, B, Gomar, JJ, Ortiz-Gil, J, et al. Executive dysfunction and memory impairment in schizoaffective disorder: a comparison with bipolar disorder, schizophrenia and healthy controls. Psychol Med. 2012; 42(10): 2127–2135.CrossRefGoogle ScholarPubMed
40.Evans, JJ, Chua, SE, McKenna, PJ, Wilson, BA. Assessment of the dysexecutive syndrome in schizophrenia. Psychol Med. 1997; 27(3): 635–646.CrossRefGoogle Scholar
41.Ansell, EB, Pinto, A, Edelen, MO, Grilo, CM. Structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for obsessive-compulsive personality disorder in patients with binge eating disorder. Can J Psychiatry. 2008; 53(12): 863–867.CrossRefGoogle ScholarPubMed
42.Mataix-Cols, D, Frost, RO, Pertusa, A, et al. Hoarding disorder: a new diagnosis for DSM-V? Depress Anxiety. 2010; 27(6): 556–572.CrossRefGoogle ScholarPubMed
43.Roberts, ME, Tchanturia, K, Treasure, JL. Exploring the neurocognitive signature of poor set-shifting in anorexia and bulimia nervosa. J Psychiatr Res. 2010; 44(14): 964–970.CrossRefGoogle ScholarPubMed
44.Jefferies, K, Laws, K, Fineberg, NA. Cognitive and perceptual processing in body dysmorphic disorder. Eur Neuropsychopharmacol. 2010; 20(Suppl 3): S309–S310.CrossRefGoogle Scholar
45.Patel, DD, Laws, KR, Padhi, A, et al. The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis. Psychol Med. 2009; 40(6): 921–933.CrossRefGoogle ScholarPubMed
46.Whitton, AE, Henry, JD, Grisham, JR. Moral rigidity in obsessive-compulsive disorder: do abnormalities in inhibitory control, cognitive flexibility and disgust play a role? J Behav Ther Exp Psychiatry. 2014; 45(1): 152–159.CrossRefGoogle ScholarPubMed
47.Kashyap, H, Kumar, JK, Kandael, T, Reddy, YCJ. Neuropsychological functioning on obsessive- compulsive disorder: are executive functions the key deficit? Compr Psychiatry. 2013; 54(5): 533–540.CrossRefGoogle ScholarPubMed
48.Chamberlain, SR, Fineberg, NA, Menzies, LA, et al. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry. 2007; 164(2): 335–338.CrossRefGoogle ScholarPubMed
49.Tchanturia, K, Anderluh, MB, Morris, RG, et al. Cognitive flexibility in anorexia nervosa and bulimia nervosa. J Int Neuropsychol Soc. 2004; 10(4): 513–520.CrossRefGoogle ScholarPubMed
50.Vaghi, MMS, Hampshire, A, Fineberg, NA, et al. Neurocognitive endophenotype of obsessive-compulsive disorder. Paper presented at: Organization for Human Brain mapping; June 8–12, 2014; Hamburg, Germany.Google Scholar
51.Fineberg, NA, Robbins, TW, Bullmore, E, et al. Probing compulsive and impulsive behaviors, from animal models to endophenotypes: a narrative review. Neuropsychopharmacology. 2010; 35(3): 591–604.CrossRefGoogle ScholarPubMed
52.Dittrich, WH, Johansen, T, Fineberg, NA. Cognitive Assessment Instrument of Obsessions and Compulsions (CAIOC-13)—a new 13-item scale for evaluating functional impairment associated with OCD. Psychiatry Res. 2011; 187(1–2): 283–290.CrossRefGoogle ScholarPubMed