Internet Mental Health

OBSESSIVE-COMPULSIVE PERSONALITY DISORDER




Diagnostic Features of Obsessive-Compulsive Personality Disorder

SYMPTOM DEFINITION SELF-DESCRIPTION
EXCESSIVE CONSCIENTIOUSNESS (Excessive Self-Control)
Rigid Perfectionism Insisting on everything being flawless; holding self and others to unrealistically high standards "I spend too much time trying to do things perfectly."
Over-Working Being excessively dedicated to achieving success hence working to excess "I work so hard I don't have any time left for anything else."
Overcontrolling Being excessively dedicated to achieving success hence working to excess "I usually try to get people to do things my way."

Core Features of Personality Disorders:

The general requirements for the diagnosis of a personality disorder are:

  • a pervasive pattern of maladaptive traits and behaviours

  • beginning in early adult life

    • it usually has its first manifestations in childhood and is clearly evident in adolescence

    • it is not diagnosed before early adult life because these maladaptive traits are very common in childhood and adolescence, but most individuals age-out of these traits before early adulthood

  • leading to substantial personal distress and/or social dysfunction, and disruption to others

  • is of long duration, typically lasting at least several years

Severity Rating Scale For Personality Disorders:

Severity rating scale for personality disorders in the International Classification of Diseases (ICD)-11:

  • Mild Personality Disorder: There are notable problems in many interpersonal relationships and the performance of expected occupational and social roles, but some relationships are maintained and/or some roles carried out. Mild personality disorder is typically not associated with substantial harm to self or others .

  • Moderate Personality Disorder: There are marked problems in most interpersonal relationships and in the performance of expected occupational and social roles across a wide range of situations that are sufficiently extensive that most are compromised to some degree. Moderate personality disorder often is associated with a past history and future expectation of harm to self or others, but not to a degree that causes long-term damage or has endangered life .

  • Severe Personality Disorder: There are severe problems in interpersonal functioning affecting all areas of life. The individual's general social dysfunction is profound and the ability and/or willingness to perform expected occupational and social roles is absent or severely compromised. Severe personality disorder usually is associated with a past history and future expectation of severe harm to self or others that has caused long-term damage or has endangered life .

Onset:

Obsessive-Compulsive Personality Disorder occurs in between 2.1% to 7.9% of the U.S. population. Typical features of obsessive-compulsive personality disorder are difficulties in establishing and sustaining close relationships, associated with rigid perfectionism, inflexibility, and restricted emotional expression.

For this diagnosis to be given, the individual must be at least in early adulthood. This disorder is only diagnosed when these behaviors become persistent and very disabling or harmful to others.

Treatment:

There is insufficient (randomized controlled trial) evidence to prove the effectiveness of any psychological intervention or medication for adults with this disorder. Lacking such evidence, it would be prudent to only offer crisis intervention or short-term psychotherapy, rather than long-term psychotherapy.

Prognosis:

Obsessive-Compulsive Personality Disorder can persist for a lifetime. These individual's chronic preoccupation with rules, orderliness, and control seems to prevent many of the complications (e.g., drug abuse, reckless sex, financial irresponsibility) that are common to some other personality disorders.

Individuals with this disorder often become upset when control is lost. They then either emotionally withdraw from these situations, or become very angry. These individuals usually express affection in a highly controlled or stilted fashion and may be very uncomfortable in the presence of others who are emotionally expressive. They often have difficulty expressing tender feelings, and rarely pay compliments.

Occupationally, these individuals tend to be high achievers with an excessive devotion to work. However, inflexibility, perfectionism, preoccupation with detail, and inability to delegate work may seriously interfere with their ability to complete a given task. They experience occupational difficulties when confronted with new situations that demand flexibility and compromise.

SAPAS Personality Screening Test

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

Most of the time and in most situations:

      In general, do you have difficulty making and keeping friends?
      Would you normally describe yourself as a loner?
      In general, do you trust other people?
      Do you normally lose your temper easily?
      Are you normally an impulsive sort of person?
      Are you normally a worrier?
      In general, do you depend on others a lot?
      In general, are you a perfectionist?

7-Question Well-Being Screening Test (By P. W. Long MD, 2020

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

      Agreeableness: I was kind and honest.
      Conscientiousness: I was diligent and self-disciplined. (Instead had overconscientiousness: rigid perfectionism, overcontrolling, overworking, being excessively orderly).
      Openness/Intellect: I showed good problem-solving and curiosity.
      Sociality: I was gregarious, enthusiastic, and assertive.
      Emotional Stability: I was emotionally stable and calm.
      Physical Health: I was physically healthy.
      Role Functioning: I functioned well socially and at school/work.

How often in the past week did you do each of these 7 behaviors:


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Diagnose Obsessive-Compulsive Personality Disorder

Diagnose All Personality Disorders

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment

Obsessive-Compulsive Personality Disorder 301.4

This diagnosis is based on the following findings:

  • So preoccupied with details that loses sight of the goal (still present)

  • Shows perfectionism that interferes with task completion (still present)

  • Is excessively devoted to work to the exclusion of leisure activities and friendships (still present)

  • Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (still present)

  • Is unable to discard worn-out or worthless objects even when they had no sentimental value (still present)

  • Is reluctant to delegate tasks or to work with others unless they submit to exactly her way of doing things (still present)

  • Has a miserly spending style (hoarding money for future catastrophes) (still present)

  • Shows rigidity and stubbornness (still present)

Treatment Goals:

  • Goal: stay focused on goals, and don't get lost in detail.
    If this problem persists: She will continue to be preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity will be lost. She will pay extraordinary attention to detail and repeatedly check for possible mistakes. She will be oblivious to the fact that other people tend to become very annoyed at the delays and inconveniences that result from this behavior. She will poorly allocate her time, leaving her important tasks to the last moment.

  • Goal: finish tasks without excessive, time-wasting perfectionism.
    If this problem persists: She will continue to become so involved in making every detail of a project absolutely perfect that the project may never be finished. Deadlines will be missed, and aspects of her life that are not the current focus of activity may fall into disarray.

  • Goal: spend more time in social and recreational pursuits.
    If this problem persists: She will continue to be excessively devoted to work and productivity to the exclusion of leisure activities and friendships. There may be a great concentration on household chores (e.g., repeated excessive cleaning). Hobbies or recreational activities will be approached as serious tasks requiring careful organization and hard work to master. Her emphasis will be on perfect performance.

  • Goal: be more tolerant and flexible about matters of morality, ethics or values.
    If this problem persists: She will continue to be overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values. She will be rigidly deferential to authority and rules and may insist on quite literal compliance, with no rule bending for extenuating circumstances.

  • Goal: discard worthless possessions, and not be a "pack-rat".
    If this problem persists: She will continue to be unable to discard worn-out or worthless objects even when they had no sentimental value. Eventually others may complain about the amount of space taken up by her hoarding of her possessions.

  • Goal: delegate work more, and avoid overly controlling others.
    If this problem persists: She will continue to be reluctant to delegate tasks or to work with others. She will stubbornly and unreasonably insist that everything be done her way and that others conform to her way of doing things. She will give very detailed instructions about how things should be done (e.g., how to mow the lawn, or wash the dishes) and will be surprised and irritated if others suggest creative alternatives.

  • Goal: be less miserly, and stop hoarding money.
    If this problem persists: She will continue to maintain a standard of living far below what she can afford, believing that her spending must be tightly controlled to provide for future catastrophes.

  • Goal: be less rigid and stubborn.
    If this problem persists: She will continue to be so concerned about having things done the one "correct" way that she will have trouble going along with anyone else's ideas. She will plan ahead in meticulous detail and be unwilling to consider changes. Even when compromise would be the best course of action, she will stubbornly refuse to do so, arguing that it is "the principle of the thing".


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Diagnostic Features

"Anankastic [obsessive-compulsive] personality disorder is characterized by feelings of doubt, perfectionism, excessive conscientiousness, checking and preoccupation with details, stubbornness, caution, and rigidity. There may be insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive-compulsive disorder" (ICD10). It is "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" (DSM-5).

In terms of the "Big-6" Dimensions of Mental Health this disorder is characterized by excessive conscientiousness (rigid perfectionism, over-working, psychological rigidity). This is not diagnosed before early adulthood because these maladaptive traits are very common in childhood and adolescence, but most individuals age-out of these traits before early adulthood. This disorder is of long duration, typically lasting at least several years.

The diagnosis of Obsessive-Compulsive Personality Disorder requires four (or more) of the following:

  • Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

  • Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).

  • Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).

  • Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).

  • Is unable to discard worn-out or worthless objects even when they have no sentimental value.

  • Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

  • Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

  • Shows rigidity and stubbornness.

In Obsessive-Compulsive Personality Disorder there may be insistent and unwelcome thoughts or impulses, and in a minority of individuals these attain the severity of an Obsessive-Compulsive Disorder (hence these individuals would receive both diagnoses).

Obsessive-Compulsive Personality Disorder should not be diagnosed if its symptoms can be better explained as due to another mental disorder, Substance Use Disorder, or another medical condition.

Individuals with Obsessive-Compulsive Personality Disorder have excessive devotion to work, and poor work-life balance. Occupationally, they tend to be high achievers because of their excessive devotion to work. However their inflexibility, perfectionism, preoccupation with detail, and inability to delegate work may seriously interfere with their ability to complete a given task. They experience occupational difficulties when confronted with new situations that demand flexibility and compromise.

Individuals with Obsessive-Compulsive Personality Disorder are rigidly perfectionistic and insist on everything being flawless and perfect, including their own and others' performance. They become preoccupied with details, organization, and order. They may show excessive procrastination and perseveration (stubborn continuation of the same behavior despite repeated failures). They are inflexible and unwilling to take risks. Individuals with this disorder often are inflexible about matters of morality, ethics, or values. They may be miserly.

Individuals with Obsessive-Compulsive Personality Disorder have difficulty in establishing and sustaining close relationships. Their emotional expression is restricted. They have difficulty expressing tender feelings, and rarely pay compliments.

Like all personality disorders, Obsessive-Compulsive Personality Disorder is a deeply ingrained and enduring behavior pattern, manifesting as an inflexible response to a broad range of personal and social situations. This behavior represents an extreme or significant deviation from the way in which the average individual in a given culture relates to others. This behavior pattern tends to be stable.

Perfectionism In Young Adults

There's an alarming and increasing trend in the number of young people suffering from perfectionism and it's leading to soaring rates of depression and suicide. It appears this phenomenon is unique to millennials, who are under immense pressure from always being "sorted and ranked" — in exams, job performance assessments, or on social media, where they feel compelled to curate a perfect life.

They brood chronically about how they should behave, how they should look, or what they should own. As a result, they resort to perfectionism, doling out harsh self-criticism. Aside from mental health problems such as depression and anorexia nervosa, perfectionism can be a factor in suicide - the rate of which has spiked among millennials.

Course

Obsessive-Compulsive Personality Disorder usually begins by early adulthood, and has a chronic course.

Complications

In Obsessive-Compulsive Personality Disorder, the individual's chronic preoccupation with rules, orderliness, and control seems to prevent many of the complications (e.g., drug abuse, reckless sex, financial irresponsibility) that are common to some other personality disorders.

Individuals with this disorder often become upset when control is lost. They then either emotionally withdraw from these situations, or become very angry. These individuals usually express affection in a highly controlled or stilted fashion and may be very uncomfortable in the presence of others who are emotionally expressive. They often have difficulty expressing tender feelings, and rarely pay compliments.

Occupationally, these individuals tend to be high achievers with an excessive devotion to work. However, inflexibility, perfectionism, preoccupation with detail, and inability to delegate work may seriously interfere with their ability to complete a given task. They experience occupational difficulties when confronted with new situations that demand flexibility and compromise. Many of the features of Obsessive-Compulsive Personality Disorder overlap with "type A" personality characteristics (e.g., preoccupation with work, competitiveness, and time urgency), and these features are associated with an increased risk for heart attack.

Having obsessive-compulsive personality traits - being very conscientious and insisting on the rule of law - can be very advantageous during peacetime in a democracy. However, under a dictatorship, these same traits can get you killed. The first people Hitler murdered were those that conscientiously opposed his dictatorship.

It's one thing for armies to conscientiously oppose tyranny; however, it's often fatal for single individuals to conscientiously oppose a dictator and his police state (e.g., voicing opposition to Assad in Syria). This is an example of how the same personality trait may be very advantageous in one circumstance, and very dangerous in another circumstance.

Comorbidity

Personality disorders are an overlooked and underappreciated source of psychiatric morbidity. Comorbid personality disorders may, in fact, account for much of the morbidity attributed to axis I disorders in research and clinical practice. "High percentages of patients with Schizotypal (98.8%), Borderline (98.3%), Avoidant (96.2%), and Obsessive-Compulsive (87.6%) Personality Disorder and Major Depressive Disorder (92.8%) exhibited moderate (or worse) impairment or poor (or worse) functioning in at least one area."
Some other disorders frequently occur with this disorder:

    Non-Personality Disorders

            Mood Disorders:
      • Persistent Depressive Disorder (Dysthymia)
      • Possible comorbidity with Bipolar Disorder, Major Depressive Disoder
            Anxiety Disorders:
      • Generalized Anxiety Disorder, Social Anxiety Disorder (Social Phobia), Specific Phobias
            Obsessive-Compulsive and Related Disorders:
      • 47% of individuals with Obsessive-Compulsive Disorder have Obsessive-Compulsive Personality Disorder
            Eating Disorders

    Personality Disorders

      No comorbid personality disorders.

Associated Laboratory Findings

No laboratory test has been found to be diagnostic of this disorder.

Prevalence

The prevalence of Obsessive-Compulsive Personality Disorder ranges from 2.1% to 7.9% in the general population. It is twice as common in males as females.

Controlled Clinical Trials Of Therapy

Click here for a list of all the controlled clinical trials of therapy for this disorder.

Psychotherapy

Obsessive-Compulsive Personality Disorder is a very common disorder; yet there are no randomized controlled trials on psychotherapy for this disorder. Lacking such evidence, it would be prudent to only offer crisis intervention or short-term psychotherapy, rather than long-term psychotherapy.

Pharmacotherapy

There are currently no medications approved by the FDA to treat this disorder. Vitamins and dietary supplements are ineffective for all Personality Disorders.

Trustworthy Research (PubMed.gov)


A Dangerous Cult: Videos


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Videos


Stories

Rating Scales

Core Feature Of Obsessive-Compulsive Personality Disorder

The core feature of Obsessive-Compulsive Personality Disorder is fear of failure. Individuals with this disorder desperately attempt to avoid failure by being perfectionistic, over-workng, being inflexibile and avoiding risk taking. Unfortunately all these coping strategies backfire, and only increase the risk of failure.

Lack Of Social Skills In Personality Disorders

There are social skills that are essential for healthy social functioning. Individuals with obsessive-compulsive personality disorder lack the essential social skills of moderation, work-life balance, and flexibility. Obsessive-compulsive personality disorder is not statistically related to any other personality disorder.

Social Skills That Are Lacking In Obsessive-Compulsive Personality Disorder

SOCIAL SKILL OBSESSIVE-COMPULSIVE PERSONALITY HEALTHY PERSONALITY
Moderation Perfectionism Setting realistic goals; accepting "good enough" rather than demanding perfection
Work-life balance Life is "all work and no play" Maintaining a proper balance between work and the rest of life
Flexibility Inflexibility and risk avoidance Willingness to try new things; ability to tolerate normal disorder; taking reasonable risks

How Was Order vs. Chaos Seen 2,800 Years Ago

At the start of Greek civilization (9th century BCE), the ancient Greeks believed that a titanic struggle between two gods, order (Chronos) vs. disorder (Chaos) controlled their lives. The meaning of our word "chaos" dates back to these ancient times. The god Chronos was the god of Time and Order (hence our word "chronology"). The ancient Greeks saw that their crops and their cities took time to grow. They believed that, before the beginning of Time (Chronos), all that existed was unformed disorder (Chaos). However, with the beginning of Time (Chronos) there became order and the universe formed. The ancient Greeks believed that nothing lasted for ever, because eventually Time (Chronos) would destroy it. These ancient Greeks believed that those individuals that allied with Chronos by making long-term plans, and living an ordered life, would be rewarded. Whereas, they believed that those individuals that allied with Chaos by being impulsive, and living a disordered life, would be punished. This battle between individuals living an ordered, law-abiding life vs. those living a chaotic, law-breaking life continues today - 2,800 years after the ancient Greeks first conceptualized this struggle.

A Good Life

How does one live a good life?

One approach to answering this question is to study the behavior of individuals who live troubled lives. Could the opposite of their maladaptive behavior define how to live a good life?

Consider the troubled lives of people with obsessive-compulsive personality disorder. Individuals with this disorder are inflexible and perfectionistic.

Could the opposite of the maladaptive behaviors seen in obsessive-compulsive personality disorder be a clue to how to live a good life? All religions stress the importance of being conscientious. Unfortunately, in obsessive-compulsive personality disorder, there is excessive conscientiousness.


Obsessive-Compulsive Personality Disorder The Opposite Of Obsessive-Compulsive Personality Disorder
Excessive Conscientiousness: Normal Conscientiousness:
Shows rigidity and stubbornness Flexible, not overly rigid and stubborn
Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values Not overly inflexible about morality, ethics or values
So preoccupied with details that loses sight of the goal Not overly preoccupied with details, rules, etc.
Shows perfectionism that interferes with task completion Not overly perfectionistic
Is excessively devoted to work to the exclusion of leisure activities and friendships Good work-life balance
Is unable to discard worn-out or worthless objects even when they had no sentimental value Able to discard worn-out or worthless objects
Is reluctant to delegate tasks or to work with others unless they submit to exactly her way of doing things Able to delegate tasks and responsibilities
Has a miserly spending style (hoarding money for future catastrophes) Generous

Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder

Research has shown that genetic, environmental, and prenatal factors all play important roles in the development of personality disorder. Research has also shown that low parental affection and harsh parenting increase the risk of a child later developing a personality disorder.

"Low affection" was defined as: low parental affection, low parental time spent with the child, poor parental communication with the child, poor home maintenance, low educational aspirations for the child, poor parental supervision, low paternal assistance to the child's mother, and poor paternal role fulfillment. "Harsh parenting" was defined as: harsh punishment, inconsistent maternal enforcement of rules, frequent loud arguments between the parents, difficulty controlling anger toward the child, possessiveness, use of guilt to control the child, and verbal abuse.


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(USE SLIDER ON RIGHT SIDE OF THE ABOVE PAGE TO SEE FULL CHECKLIST)



This disorder is characterized by pathological personality traits in the following domains:

  • Overconscientiousness , characterized by:

    • Rigid Perfectionism:
      Insisting on everything being flawless; holding self and others to unrealistically high standards.
      Question: "Do you spend too much time trying to do things perfectly?"

      • "Preoccupation with details, rules, lists, order, organization or schedule." (ICD-10) "Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost" (DSM-5)

      • "Perfectionism that interferes with task completion." (ICD-10) "Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)." (DSM-5)

      • "Excessive conscientiousness and scrupulousness." (ICD-10) "Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)." (DSM-5)

      • "Feelings of excessive doubt and caution." (ICD-10)

      • "Is unable to discard worn-out or worthless objects even when they have no sentimental value." (DSM-5)

      • "Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes." (DSM-5)

    • Over-Working:
      Being excessively dedicated to achieving success hence working to excess.
      Question: "Do you work so hard that you don't have any time left for anything else?"

      • "Undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships." (ICD-10) "Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)." (DSM-5)

    • Overcontrolling:
      Being rigid, stubborn, and over-controlling of others; reluctant to delegate tasks or control.
      Question: "Do you usually try to get people to do things your way?"

      • "Excessive pedantry and adherence to social conventions." (ICD-10)

      • "Rigidity and stubbornness." (ICD-10 and DSM-5)

      • "Unreasonable insistence that others submit to exactly his or her way of doing things, or unreasonable reluctance to allow others to do things." (ICD-10) "Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things." (DSM-5)


(Note: Recovery = symptomatic remission + full-time gainful employment + weekly contact with friends)


Anankastic [Obsessive-Compulsive] Personality Disorder F60.5 - ICD10 Description, World Health Organization

Anankastic [obsessive-compulsive] personality disorder is characterized by feelings of doubt, perfectionism, excessive conscientiousness, checking and preoccupation with details, stubbornness, caution, and rigidity. There may be insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive-compulsive disorder.

ICD-10 International Personality Disorder Examination Screening Questions

  • I'm not fussy about little details (False).

  • I'm a very cautious person.

  • I spend too much time trying to do things perfectly.

  • People think I'm too strict about rules and regulations.

  • I work so hard I don't have time for anything else.

  • People think I'm too stiff or formal.

  • It's hard for me to get used to a new way of doing things.

  • I usually try to get people to do things my way.

ICD-10 Diagnostic Criteria (For Research)

A. The general criteria of personality disorder must be met:

  • Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range (or 'norm').

  • The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e. not being limited to one specific 'triggering' stimulus or situation).

  • There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior.

  • There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.

  • The deviation cannot be explained as a manifestation or consequence of other adult mental disorders.

  • Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation.

B. At least four of the following must be present:

  • Feelings of excessive doubt and caution.
      (E.g., "I'm a very cautious person.")

  • Preoccupation with details, rules, lists, order, organization or schedule.
      (E.g., "I'm fussy about little details.")

  • Perfectionism that interferes with task completion.
      (E.g., "I spend too much time trying to do things perfectly.")

  • Excessive conscientiousness and scrupulousness.
      (E.g., "People think I'm too strict about rules and regulations.")

  • Undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships.
      (E.g., "I work so hard I don't have any time left for anything else.")

  • Excessive pedantry and adherence to social conventions.
      (E.g., "People think I am too stiff or formal.")

  • Rigidity and stubbornness.
      (E.g., "It's hard for me to get used to a new way of doing things.")

  • Unreasonable insistence that others submit to exactly his or her way of doing things, or unreasonable reluctance to allow others to do things.
      (E.g., "I usually try to get people to do things my way.")

Obsessive-Compulsive Personality Disorder - Diagnostic Criteria, American Psychiatric Association

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, as indicated by 4 (or more) of the following:

  • Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

  • Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).

  • Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).

  • Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).

  • Is unable to discard worn-out or worthless objects even when they have no sentimental value.

  • Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

  • Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

  • Shows rigidity and stubbornness.

  • This enduring pattern of inner experience and behavior must deviate markedly from the expectations of the individual's culture.

  • This enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

  • This enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • Empirically Derived Taxonomy for Personality Diagnosis: Obsessive-Compulsive Personality Disorder

    (This section uses an alternative classification system to that of the American Psychiatric Association)

    These individuals:

    • Become absorbed in details (often to the point of missing what is important).

    • Self-critical, expecting themselves to be "perfect", and to be equally critical of others, whether overtly or covertly.

    • Are excessively devoted to work and productivity to the detriment of leisure and relationships.

    • See themselves as logical and rational, uninfluenced by emotion.

    • Prefer to operate as if emotions were irrelevant or inconsequential.

    • Think in abstract and intellectualized terms.

    • Are controlling, oppositional, and self-righteous or moralistic.

    • Adhere rigidly to daily routines, becoming anxious or uncomfortable when they are altered, and to be overly concerned with rules, procedures, order, organization, and/or schedules.

    • Are prone to being stingy and withholding (e.g., of time, money, affection).

    • Are inhibited and constricted, and have difficulty acknowledging or expressing wishes, impulses, or anger.

    • Rationality and regimentation generally mask underlying feelings of anxiety or anger.

    • See themselves as emotionally strong, untroubled, and in control, despite evidence of underlying insecurity, anxiety, or distress.

    • Deny or disavow their need for nurturance or comfort, often regarding such needs as weakness.

    • Tend to be conflicted about anger and aggression.

    • Are often conflicted about authority, struggling with contradictory impulses to submit versus defy.

    • May be preoccupied with concerns about dirt, cleanliness, or contamination.

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    Treatment

    Setting Goals In Therapy

      Questions To Ask When Setting Goals

      In The Past Week:
      • WHO: was your problem?

      • EVENT: what did he/she do?

      • RESPONSE: how did you respond to that event?

      • OUTCOME: did your response help?

      • TRIGGER: what did you do that could have triggered this problem?

      • GOAL: what life skill(s) do you have to work on? (from checklist)

      Example Of Setting Goals In Interviewing A Person With Obsessive-Compulsive Personality Disorder

      In The Past Week:
      • WHO: was your problem?
        "My wife."

      • EVENT: what did he/she do?
        "My wife complained that I am spending too much time at work, and not enough time with her and our children."

      • RESPONSE: how did you respond to that event?
        "I told her that I have a big project at work, and that it is taking much more time to complete than I thought."

      • OUTCOME: did your response help?
        "No. My wife says that I've used this same excuse for as long as we've been married."

      • TRIGGER: what did you do that could have triggered this problem?
        "I want to make sure that I don't screw up on this project; so I'm rechecking everything I'm doing. But I'm procrastinating too much on finishing this project. I'm becoming paralyzed, and I now fear I'll never finish this project on time."

      • GOAL: what life skill(s) do you have to work on? (from checklist)
        "I want to work on: (1) Moderation ("Setting realistic goals; accepting "good enough" rather than demanding perfection"), and (2) Work-Life Balance ("Maintaining a proper balance between work and the rest of life")."


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    Self-Help Resources

    Monitoring Your Progress

    NOTE: When each of the following presentations finish; you must exit by manually closing its window in order to return to this webpage.

    The Healthy Social Behavior Scale lists social behaviors that research has found to be associated with healthy social relationships. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    The Mental Health Scale lists behaviors and symptoms that research has found to be associated with mental health (or disorder). You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    The Life Satisfaction Scale lists the survey questions often used to measure overall satisfaction with life. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    Life Satisfaction Scale (5-Minute Video)

    The "Big 6" Dimensions of Mental Health

    Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders.

    This website uses these 5 major dimensions of human behavior (i.e., Agreeableness, Conscientiousness, Openness/Intellect, Extraversion/Sociability, and Emotional Stability) to describe all mental disorders. This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.

    The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].



    Desiderata (5-Minute Video)



    The following "Morning Meditation" allows you to plan your day using these "Big 6" dimensions of mental health.



    The following "Evening Meditation" allows you to review your progress on these "Big 6" dimensions of mental health.




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      "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

      Lord Kelvin (1824 – 1907)


    • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

    • Economist in grim battle against deceptive scholarship

    • List of Predatory Journals and Publishers

    • The power of asking "what if?"

    • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

    • Criteria For High Quality Research Studies

    • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

      • Randomized Controlled Trial:
        Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

      • Representative Sample:
        Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

      • Single Blind Trial:
        Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

      • Double Blind Trial (Better Than Single Blind Trial):
        Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

      • Baseline Comparability:
        Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

      • Confounding Factors:
        Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

      • Intervention Integrity:
        Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

      • Statistical analysis:
        Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

        Ask: Are the results both statistically significant and clinically significant? Many medical research findings are statistically significant (with a p-value <0.05), but they are not clinically significant because the difference between the experimental and control groups is too small to be clinically relevant.

        For example, the effect of a new drug may be found to be 2% better than placebo. Statistically (if the sample size was large enough) this 2% difference could be statistically significant (with a p-value <0.05). However, clinicians would say that this 2% difference is not clinically significant (i.e., that it was too small to really make any difference).

        Statistically, the best way to test for clinical significance is to test for effect size (i.e., the size of the difference between two groups rather than confounding this with statistical probability).

        When the outcome of interest is a dichotomous variable, the commonly used measures of effect size include the odds ratio (OR), the relative risk (RR), and the risk difference (RD).

        When the outcome is a continuous variable, then the effect size is commonly represented as either the mean difference (MD) or the standardised mean difference (SMD) .

        The MD is the difference in the means of the treatment group and the control group, while the SMD is the MD divided by the standard deviation (SD), derived from either or both of the groups. Depending on how this SD is calculated, the SMD has several versions such, as Cohen's d, Glass's Δ, and Hedges' g.

          Clinical Significance: With Standard Mean Difference, the general rule of thumb is that a score of 0 to 0.25 indicates small to no effect, 0.25-0.50 a mild benefit, 0.5-1 a moderate to large benefit, and above 1.0 a huge benefit. It is a convention that a SMD of 0.5 or larger is a standard threshold for clinically meaningful benefit.

        The statistical summary should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention).

        In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

          Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

          Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

          Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

        Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

      • Completeness of follow-up data:
        Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

      • Handling of missing data:
        Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

      • Replication of Findings:
        Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

      • Fraud:
        Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size ( n ), mean ( M ) and standard deviation ( SD ) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

        • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean ( M ) is defined as "the sum ( Sum ) of the values of each observation divided by the total number ( n ) of observations". So: M = Sum / n . Thus: ( Sum ) = ( M ) multiplied by ( n ). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate ( M ) multiplied by ( n ). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean ( M ) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value , and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

        • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible.

        • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

        • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

        • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

        • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

        • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

        The most common type of scientific fraud is when a research study's data contradicts the study's own conclusions.

    • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

    • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

    • Not All Scientific Studies Are Created Equal - video

    • The efficacy of psychological, educational, and behavioral treatment

    • Estimating the reproducibility of psychological science

    • Psychologists grapple with validity of research

    • Industry sponsorship and research outcome (Review) - Cochrane Library

    • 'We've been deceived': Many clinical trial results are never published - (text and video)

    • Junk science misleading doctors and researchers

    • Junk science under spotlight after controversial firm buys Canadian journals

    • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

    • When Evidence Says No, But Doctors Say Yes


    • Cochrane Reviews (the best evidence-based, standardized reviews available)

    Research Topics

    Obsessive-Compulsive Personality Disorder - Core Clinical Journals

    Obsessive-Compulsive Personality - All Journals

    Obsessive-Compulsive Personality - Review Articles - Core Clinical Journals

    Obsessive-Compulsive Personality - Review Articles - All Journals

    Obsessive-Compulsive Personality Disorder - Treatment - Core Clinical Journals

    Obsessive-Compulsive Personality Disorder - Treatment - All Journals

    Recommended Free Full Text Articles


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    Normal Distribution Of Human Attributes

    Regression to the Mean (Or Why Scientific Experiments Require A Control Group)

    The "Big 6" Dimensions of Mental Health

    Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Five Factor Model of Personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

    This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.)

    The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].

    Which "Big 6" Dimensions of Mental Health are Impaired in Obsessive-Compulsive Personality Disorder?

    THE POSITIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THE NEGATIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THIS DISORDER
    Agreeableness
    Being kind and honest.
    Antagonism
    Being unkind or dishonest.
    Conscientiousness
    Being diligent and self-disciplined.
    Disinhibition
    Being distractible, impulsive, or undisciplined.
          Excessive Conscientiousness
    Openness/Intellect
    Showing good creativity, problem-solving, and learning ability
    Impaired Intellect
    Showing decreased creativity, problem-solving, or learning ability.
    Extraversion
    Being gregarious, assertive and enthusiastic.
    Detachment
    Being detached, unassertive, and unenthusiastic.
    Emotional Stability
    Being emotionally stable and calm.
    Emotional Distress
    Being emotionally unstable/distressed.
    Physical Health
    Being physically fit and healthy.
    Physical Symptoms
    Being physically unfit or ill.






    The Following Will Only Discuss The Dimensions of Mental Illness That Are Abnormal In This Disorder

    The problems that are characteristic of this disorder are highlighted with this pink background color.


    CONSCIENTIOUSNESS VS. DISINHIBITION

    CONSCIENTIOUSNESS (Self-Control)
    Description: Conscientiousness is synonymous with being industrious and orderly. The Conscientiousness dimension measures the behaviors that are central to the concept of SELF-CONTROL - organizing and controlling one's behavior in order to achieve one's goals. This involves traits like paying attention, controlling impulses, and delaying gratification. Individuals with high Conscientious work hard to achieve goals, pursue accuracy and perfection, show prudent, careful decision making, and are orderly with things and time. High Conscientiousness is associated with better: longevity, health, school and job performance. (This dimension appears to measure the behaviors that differentiate industriousness from distractibility [or order from chaos]).
    Descriptors: Cautious, self-disciplined, industrious, efficient, organized.
    • From Between facets and domains: 10 aspects of the Big Five
      • Industriousness:
        • Do a thorough job
        • Do things efficiently
        • Not lazy
        • Carry out my plans
        • Finish what I start
        • Get things done quickly
        • Always know what I am doing
      • Orderliness:
        • Like order
        • Keep things tidy
        • Follow a schedule
        • Want everything to be “just right”
        • See that rules are observed
        • Want every detail taken care of
    • From International Personality Item Pool:
      • Avoid mistakes
      • Follow the rules
      • Get chores done right away
      • Work hard
      • Complete tasks successfully
      • Like order
    Chimpanzees: The Conscientious-Disinhibited dimension of human behavior is also evident in chimpanzees. Chimpanzees can plan for the future and control their impulses (video). Goal-directed behavior requires good impulse control, otherwise it becomes distracted and disorganized.
    Evolution: The brains of sentient species evolved to allow the pursuit of non-immediate goals, keeping behavior on track by orienting attention away from distractions and toward goal-relevant stimuli.
    Language Characteristics: Many positive emotion words (e.g. happy, good), few emotional distress words (e.g. hate, bad), more perspective, careful to check that information is conveyed correctly, straight to the point, formal, few negations, few swear words, few references to friends, few disfluencies or filler words, many insight words, not impulsive.
    Research: Higher scores on Conscientiousness predict greater success in school and at work. *MRI research found that Conscientiousness was associated with increased volume in the lateral prefrontal cortex, a region involved in planning and the voluntary control of behavior.
    Video Example: Here is an example of a very conscientious person - President Obama discussing the Iranian nuclear treaty.
    "I do a thorough job. I want everything to be 'just right'. I want every detail taken care of."
    "I am careful."
    "I am a reliable hard-worker."
    "I am organized. I follow a schedule and always know what I am doing."
    "I like order. I keep things tidy."
    "I see that rules are observed."
    "I do things efficiently. I get things done quickly."
    "I carry out my plans and finish what I start."
    "I am not easily distracted."
    Overconscientiousness
    ICD-11 Description: The core feature of the Overconscientiousness (or Anankastia) trait domain is a narrow focus on one’s rigid standard of perfection and of right and wrong, and on controlling one’s own and others’ behaviour and controlling situations to ensure conformity to these standards. Common manifestations of Overconscientiousness include: perfectionism (e.g., concern with social rules, obligations, and norms of right and wrong, scrupulous attention to detail, rigid, systematic, day-to-day routines, hyper-scheduling and planfulness, emphasis on organization, orderliness, and neatness); and emotional and behavioral constraint (e.g., rigid control over emotional expression, stubbornness and inflexibility, risk-avoidance, perseveration, and deliberativeness).
    Rigid Perfectionism
    "Even though it drives other people crazy, I insist on absolute perfection in everything I do."
    "I simply won't put up with things being out of their proper places."
    "People complain about my need to have everything all arranged."
    "People tell me that I focus too much on minor details."
    "I have a strict way of doing things."
    "I postpone decisions."
    DISINHIBITION (Impaired Self-Control)
    Description: Disinhibition is synonymous with being distractible, impulsive and disorganized. Individuals with high Disinhibition avoid difficult tasks or challenging goals, don't mind incompleteness or inaccurracy, act without thinking of the consequences, have disorganized surroundings and schedules.
    ICD-11 Description: The core feature of the Disinhibition trait domain is the tendency to act rashly based on immediate external or internal stimuli (i.e., sensations, emotions, thoughts), without consideration of potential negative consequences. Common manifestations of Disinhibition include: impulsivity; distractibility; irresponsibility; recklessness; and lack of planning.
    Descriptors: Impulsive, uncontrolled, distractible, inefficient, disorganized, irresponsible.
    • From Between facets and domains: 10 aspects of the Big Five
      • Distractibility:
        • Waste my time
        • Find it difficult to get down to work
        • Mess things up
        • Don’t put my mind on the task at hand
        • Postpone decisions
        • Am easily distracted
      • Disorderliness:
        • Leave my belongings around
        • Am not bothered by messy people
        • Am not bothered by disorder
        • Dislike routine
    • From International Personality Item Pool:
      • Rush into things
      • Break rules
      • Waste my time
      • Do just enough to get by
      • Misjudge situations
      • Leave a mess
    Language Characteristics: Few positive emotion words, many emotional distress words, less perspective, less careful, more vague, informal, many negations, many swear words, many references to friends (e.g. pal, buddy), many disfluencies or filler words, few insight words, impulsive.Few positive emotion words, many emotional distress words, less perspective, less careful, more vague, informal, many negations, many swear words, many references to friends (e.g. pal, buddy), many disfluencies or filler words, few insight words, impulsive.
    Screening Questions:
    • "People would describe me as reckless."
    • "I feel like I act totally on impulse."
    • "Even though I know better, I can’t stop making rash decisions."
    • "Others see me as irresponsible."
    • "I’m not good at planning ahead."
    ("Conscientiousness vs. Disinhibition" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five) [More Information]
    *MRI Research:
    Testing predictions from personality neuroscience. Brain structure and the big five.





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    The "Five Factor Model of Personality" as Shown In Dogs

    All animals have personalities - that is, consistent individual differences in behavior. Within virtually any population, some individuals are consistently more active, more aggressive, or are more willing to engage in risk-taking behavior. Thus the same "Big 5 Factors" of personality found in humans can be found in dogs.



    AGREEABLENESS VS. ANTAGONISM
    Agreeableness ("Friend")
    Dog is friendly towards unfamiliar people.
    Dog is friendly towards other dogs.
    When off leash, dog comes immediately when called.
    Dog willingly shares toys with other dogs.
    Dog leaves food or objects alone when told to do so.
    Antagonism ("Foe")
    Dog is dominant over other dogs.
    Dog is assertive with other dogs (e.g., if in a home with other dogs, when greeting).
    Dog behaves aggressively towards unfamiliar people.
    Dog shows aggression when nervous or fearful.
    Dog aggressively guards coveted items (e.g., stolen item, treats, food bowl).
    Dog is quick to sneak out through open doors, gates.

    CONSCIENTIOUSNESS VS. DISINHIBITION
    Conscientiousness ("Self-Controlled")
    Dog works at tasks (e.g., getting treats out of a dispenser, shredding toys) until entirely finished.
    Dog works hard all day herding or pulling a sleigh (if a "working dog" on the farm or in the snow). *
    Dog is curious.
    Disinhibition ("Disinhibited")
    Dog is boisterous.
    Dog seeks constant activity.
    Dog is very excitable around other dogs.

    OPEN-MINDEDNESS / INTELLECT VS. CLOSED-MINDEDNESS / IMPAIRED INTELLECT
    Intellect
    Dog is able to focus on a task in a distracting situation (e.g., loud or busy places, around other dogs).
    Impaired Intellect
    Dog is slow to respond to corrections.
    Dog ignores commands.
    Dog is slow to learn new tricks or tasks.

    EXTRAVERSION VS. DETACHMENT
    Sociality ("Approach")
    Dog is attention seeking (e.g., nuzzling, pawing or jumping up on family members looking for attention and physical contact).*
    Dog seeks companionship from people.
    Dog is affectionate.
    Detachment ("Avoidance")
    Dog is aloof.
    Dog gets bored in play quickly.
    Dog is lethargic.

    EMOTIONAL STABILITY VS. EMOTIONAL DISTRESS
    Emotional Stability ("Safety")
    Dog tends to be calm.
    Dog is relaxed when greeting people.
    Dog is confident.
    Dog adapts easily to new situations and environments.
    Emotional Distress ("Danger")
    Dog is anxious.
    Dog is shy.
    Dog behaves fearfully towards unfamiliar people.
    Dog exhibits fearful behaviors when restrained.
    Dog avoids other dogs.
    Dog behaves fearfully towards other dogs.
    Dog behaves submissively (e.g., rolls over, avoids eye contact, licks lips) when greeting other dogs.
    Modified from Jones, A. C. (2009). Development and validation of a dog personality questionnaire. Ph.D. Thesis. University of Texas, Austin.

    * New items added by Phillip W. Long MD

    The "Five Factor Model of Personality" In A Social Species

    The behaviors of the "Five Factor Model of Personality" serve adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociality" ], (4) decide whether to proceed in a self-controlled or disinhibited manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness to Experience" ].

    Spider Personalities

    All animals have personalities (defined as consistent behavioral differences among individuals). Animals can consistently differ on: (1) Antagonism (e.g., aggression), (2) Disinhibition (e.g., risk taking), (3) Intellect (e.g., inventiveness), (4) Extraversion (e.g., assertiveness), and (5) Emotional Stability (e.g., calmness).

    Some social spiders live in colonies of up to several hundred individuals, and exhibit cooperative behaviours such as prey capture and maternal care. Researchers have found that spider personalities differ in aggressiveness:
    • Aggressive spiders are more likely to attack their mirror image than are shy spiders who are more likely to run away.
    • In a spider colony, individual spiders differ in degree of boldness (aggression) vs. shyness (nonaggression). [Aggressive spiders show shorter latencies to attack prey and to resume movement after a disturbance.] Hunting prey for these social spiders is a collective effort. The presence of a bold spider causes the shy spiders to become bolder which increases the effectiveness of their collective hunting effort. A positive feedback loop is established whereby hunting success increases spider boldness which increases future collective hunting success. However, when researchers removed these bold "leader" spiders, the collective hunting by the remaining spiders became less successful. The bold "leader" spiders thus were shown to have a disproportionately large impact on the group, and so were named "keystone individuals". Because of their special personality characteristic (boldness) the "leader" spiders performed a vital function (making the shy spiders bolder) which fascilitated collective social action.

      This research made the very important finding that the spiders modified each other's personalities. The bold spiders became bolder because of their hunting success. However their hunting success was entirely dependent upon gaining the collective support of the shy spiders. Likewise, the shy spiders owed their hunting success to being made bolder by association with the bold spider. Thus for more successful collective action, the bold "leader" spider needed to have followers, and the shy "follower" spiders needed to have a "leader". To make their collective social action more successful, the different spider personalities had to bring out the "best" in each other.



    The "Five Factor Model of Personality" and Personality Disorders

    The following diagram shows the relationship between the "Five Factor Model of Personality" and personality disorders. This diagram is based on the research of Sam Gosling, Jason Rentfrow, and Bill Swann, Gerard Saucier, Colin G. DeYoung, and Douglas Samuel and Thomas Widiger.


    Enlarge Image


    3D Models of How the Personality Disorders Are Correlated



    The DSM-IV personality disorders in the National Comorbidity Survey Replication study determined how personality disorders statistically correlated with each other. The above 3D model was created (by P.W. Long MD) from this correlational data.

      Note: Due to their low prevalence in this study, Histrionic and Narcissistic Personality Disorder were not included. However, these 2 missing personality disorders were inserted into the 3D model (by PWL) where other research suggested they should occur.


    This statistical model shows that all of the personality disorders are highly correlated - they are overlapping entities that blend into each other with no clear boundaries. This 3D model groups personality disorders into two highly interrelated large clusters (named "greed" and "fear" by PWL).

    The fact that these personality disorders are so highly interrelated suggests that it is common for individuals to have multiple personality disorders.



    Section III of the DSM-5 presents an alternative model for personality disorders. Based on research findings, this model drops four personality disorders: Schizoid, Paranoid, Dependent, and Histrionic.

    The above 3D model shows the statistical correlations between personality disorders in this alternative DSM-5 model.

      Note: Borderline Personality Disorder plays a central role in this model. It is correlated to all of the other major personality disorders (except Schizotypal Personality Disorder). It could be argued that Borderline Personality Disorder may not be a true personality disorder. Instead, it may more represent chaotic instability - an advanced stage in which a previous stable personality disorder becomes unstable and goes from order into chaos. This would explain why Borderline Personality Disorder is usually diagnosed in combination with another personality disorder.

      Thus, it is argued, instead of diagnosing someone as having both "Antisocial and Borderline Personality Disorders"; it would be more correct to diagnose "Antisocial Personality Disorder with Emotionally Unstable Traits".

      Chaos theory states that balanced systems under stress can be pushed into instability. Specifically, as stress on a stable system is increased, a "tipping point" is reached wherein the system quickly goes from stability to instability. The following animated graphs illustrate this mathematical principle. The vertical (y) axis represents the stress level. As the stress level increases, a tipping point is reached whereafter the system becomes more unstable. (These animations recycle.)

      Logistic map animation.gif
      By Snaily CC BY-SA 3.0, The "tipping point" between stability and instability



      According to chaos theory, these animations could represent what happens when a personality disorder is under increasing stress. Initially, the personality disorder remains stable; then under increasing stress a tipping point is reached wherein the previously stable personality disorder becomes chaotic. Any further stress makes the personality disorder even more unstable.

      Thus the emotional instability, chaotic social functioning, and self-harming behavior of Borderline Personality Disorder could represent a chaotic, unstable state of a previously stable personality disorder.


    Primate Evolution

    There appears to be three different ways in which primates have evolved socially:

    • The chimpanzees have evolved to be socially antagonistic, competitive, callous, and manipulative. Chimpanzees are the only primates (apart from humans) that wage organized war. Thus chimpanzee social behavior most closely mirrors the antagonistic behavior of the antisocial-paranoid-narcissistic-histrionic-borderline cluster of personality disorders.

    • In contrast, the bonobos have evolved to be socially anxious, peaceful, cooperative, and loving. Thus bonobo social behavior most closely mirrors the emotional distress (anxious) behavior of the avoidant-dependent cluster of personality disorders.

    • Another separate evolutionary path was followed by the orangutans. They evolved to become solitary hermits. Thus orangutan social behavior most closely mirrors the detached behavior of the schizoid-schizotypal cluster of personality disorders.


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