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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)
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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 

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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.

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