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Continuity between DSM‐5 Section II and Section III personality traits for obsessive–compulsive personality disorder

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Clinical Psychology & Psychotherapy

Published online on

Abstract

Objective Obsessive–compulsive personality disorder (OCPD) is formally operationalized in Section II of the DSM‐5 by a heterogeneous collection of 8 categorical criteria. Section III contains an alternative model operationalizing personality disorders via dimensional personality traits and associated impairment. The extent to which the personality traits used to define OCPD in Section III correspond with the Section II operationalization of the disorder is contested. The current study aims to contribute to the evidence base necessary to solidify the optimal trait profile for this disorder via a more fine‐tuned examination of OCPD. Method The research questions were examined using a clinical sample of 142 Danish adults who completed the Structured Clinical Interview for DSM‐IV Axis II Disorders and the Personality Inventory for DSM‐5 to index both the Sections II and III (personality traits) operationalizations of OCPD, respectively. Results Bivariate correlations supported Rigid Perfectionism and Perseveration as traits relevant to OCPD; however, hierarchical regression analyses indicated that of the 4 traits used in the Section III operationalization of OCPD, only Rigid Perfectionism uniquely predicted OCPD (p < .05). In addition to Rigid Perfectionism, the conceptually relevant traits of Submissiveness, Suspiciousness, and (low) Impulsivity were also found to uniquely predict OCPD and its specific symptoms in a regression model. Conclusions These findings indicate that the traits proposed in Section III are only partially aligned with the traditional, Section II conceptualization of OCPD, and may be augmented by incorporating Submissiveness, Suspiciousness, and (low) Impulsivity. In light of the current findings and existing literature, a modified constellation of traits to operationalize OCPD is likely justified. Key Practitioner Message Rigid Perfectionism, Perseveration, and Restricted Affectivity emerged as Section III OCPD traits that were substantially associated with the Section II categorical criteria of OCPD. Rigid Perfectionism is strongly associated, and Perseveration is moderately associated with Section II OCPD. Rigid Perfectionism should be considered the core personality trait underpinning OCPD. The trait facets of Submissiveness, Suspiciousness, and Impulsivity also predicted individual Section II OCPD criteria. OCPD may be best conceptualized as a disorder characterized by Rigid Perfectionism and Perseveration, with other traits influencing how the disorder manifests.