Can Elements of OCPD Help Women Be Effective? · OCPD is a personality (disorder) with a...
Transcript of Can Elements of OCPD Help Women Be Effective? · OCPD is a personality (disorder) with a...
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Date Presented: November 1, 2014 1
A WOMAN’S JOURNEY
Can Elements of OCPD Help
Women Be Effective?
Presented by: Gerald Nestadt MD
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Disclosures
• None
October 27, 2014 2
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Why ask this question?
…it seems that effective women have
these features
Is this true?
… recognize the features; but not sure we
like the features/cost
What are the costs?
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Obsessive-Compulsive
Personality Disorder
OCPD is a personality (disorder) with a
constellation of specific traits
Different from a “state”; i.e. not a change from
ones’ usual pattern of functioning.
It is not an illness/disease;
There is NO “broken part”
It is NOT OCD
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Personality Traits
…enduring patterns of
perceiving, relating to and
thinking about the environment
and oneself, and are exhibited in
a wide range of important social
and personal contexts.
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Obsessive-Compulsive
Personality (Disorder) Features
Preoccupation with details, rules, lists, order, or schedules
Perfectionism that interferes with task completion
Excessive devotion to work and productivity
Overconscientious, scrupulous and inflexible
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OCPD
Inability to discard worn or worthless objects
Reluctance to delegate tasks
Miserly spending style
Rigidity and stubbornness
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Percent (%) Prevalence of
Compulsive Personality Traits
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Five-factor Solution for DSM
Personality Attributes
Factors
Compulsive Aloof Neurotic
Avoidant
Impulsive
Callous
Egocentric Prevalence
Obsessive-Compulsive
Excessive work devotion 0.51 0.14 0.07 0.01 0.16 16.35
Perfectionism 0.69 -0.02 0.10 - 0.09 0.17 26.37
Preoccupied with details 0.67 0.06 0.21 -0.08 0.11 19.64
Hoarding behaviors 0.29 0.11 0.23 0.09 -0.06 27.20
Overconscientiousness 0.69 0.12 0.01 - 0.13 0.07 18.41
Miserliness 0.54 0.15 0.05 - 0.02 0.05 8.10
Reluctant to delegate 0.79 0.01 0.09 0.06 0.14 29.26
Rigidity 0.68 0.19 0.04 0.27 0.09 43.27
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Prevalence (%) of DSM-III compulsive personality
traits and disorder weighted to the general
population
Compulsive
score 3+
Compulsive
score 6+
DSM-III
disorder
Total 20.0 (2.0) 3.3 (0.8) 1.7 (0.6)
SexMale 26.0 (3.5)* 5.7 (2.0) 3.0 (1.5)
Female 15.2 (2.1) 1.4 (0.6) 0.6 (0.4)
Education< 12 grade 16.6 (2.5) 2.0 (0.8) 0.9 (0.6)*
13 + grade 23.9 (3.2) 4.9 (1.6) 4.5 (2.2)
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Prevalence (%) of DSM-III compulsive personality traits
and disorder weighted to the general population
Compulsive
score 3+
Compulsive
score 6+
DSM-III
disorder
Marital Status
Married 29.4 (3.8) 4.7 (1.7) 3.1 (1.4)
Widowed 16.1 (4.1) 0.9 (0.5) 0.2 (0.2)
Sep./Div. 13.1 (3.2) 3.9 (1.9) 1.8 (1.5)
Never married 9.2 (2.6) 2.0 (1.4) --
EmploymentEmployed 25.8 (3.6) 4.8 (1.7) 3.3 (1.4)*
Unemployed 15.2 (2.5) 2.1 (0.9) 0.5 (0.5)
Income< $10,000 15.8 (2.2) 1.4 (0.7) 0.4 (0.4)*
> $10,000 28.8 (4.3) 7.1 (2.3) 4.1 (1.8)
Birth OrderEldest sibling 24.9 (2.3) 4.5 (1.0) 3.1 (1.6)
Not eldest Sibling 16.5 (3.7) 2.8 (1.8) 1.3 (0.8)
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Dimension Perspective
(Personality)
Assumptions:
– People differ from one another in their
psychological attributes.
– Such attributes can be construed as (affective)
dimensions of variations. (graded/quantified)
– People who deviate to an extreme along such
dimensions may be vulnerable to emotional
distress in particular circumstances.
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Potentials Provocations Responses
(Personality) (Life Circumstances) (Neurotic Symptoms)
Emotive triad.
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Generalized Anxiety Disorder and Alcohol Use
Disorders by Compulsive and Antisocial Personality
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Probability of Obsessions and Compulsions
by Compulsive Personality Score
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GAF score in 1996-1999
by personality traits in 1981.
55
60
65
70
75
80
OCPD BPD Avoidant
0
1 or 2
>2
**
*
GAF s
core
* Significant at p<0.05
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…it seems that effective women
have these features
Is this true? YES
More likely :
Successful in producing a desired or intended result
Getting things done
Social, occupational, and family successes
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But it depends……
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… recognize the features; but not
sure we like the features/cost
What are the costs?
Increased possibility of distress,
anxiety, and depression
Family, social, and occupational costs
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OCD ≠ OCPD
22
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OCD
Obsessions:
Unbidden thoughts (images) that intrude and
are difficult to expel, despite their unwanted
nature.
Compulsions:
Actions (behavioral/mental) that the person
feels compelled to do, despite the recognition
that they are unwarranted.
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Epidemiology
Prevalence:
Common disorder, ~2% in population; ~5-6 million Americans.
Disability:
Considered among the ten most disabling disorders by the WHO.
Cost to society:
$8.4 billion in social & economic costs;
6% of total mental health bill ($148 billion).
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Management of OCPD
• Education and guidance
• Treat symptomatically
• Pharmacology: selective-serotonin
reuptake inhibitors
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Knowledge = Empowerment
Recognize your own style; its yours
Listen… or even ask
Listen to yourself: is it worth it
What’s making me anxious? Angry? Demoralized?
Is it in my power to change this?
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Conclusions
Effective women have some compulsive
features
Be aware of taking care of yourself
It’s fine to have a few foibles or idiosyncrasies