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The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder

Published online by Cambridge University Press:  13 October 2015

Olivia M. Gordon ,
Paul M. Salkovskis  and
Victoria Bream
Olivia M. Gordon*
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Paul M. Salkovskis
Affiliation:
University of Bath, UK
Victoria Bream
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, and South London and Maudsley NHS Trust, UK
*
Reprint requests to Olivia Gordon, Centre for Anxiety Disorders and Trauma, 99 Denmark Hill, London SE5 8AZ, UK. E-mail: [email protected]
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Abstract

Background: It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. Aims: The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. Method: 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. Results: At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. Conclusion: The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.

Keywords

Obsessive compulsive disorderobsessive compulsive personality disorderAxis IIcognitive behaviour therapy
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 44 , Issue 4 , July 2016 , pp. 444 - 459
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Abramowitz, J. S. (1998). Does cognitive-behavioral therapy cure obsessive-compulsive disorder? A meta-analytic evaluation of clinical significance. Behavior Therapy, 29, 339–355.CrossRefGoogle Scholar
Albert, U., Maina, G., Forner, F. and Bogetto, F. (2004). DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects. Comprehensive Psychiatry, 45, 325–332.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Baer, L., Jenike, M. A., Ricciardi, J. N., Holland, A. D., Seymour, R. J. and Minichiello, W. E. (1992). Standardised assessment of personality disorders in obsessive-compulsive disorders. Archives of General Psychiatry, 47, 826–830.Google Scholar
Beck, A. T., Freeman, A., Davis, D. and Associates (2004). Cognitive Therapy of Personality Disorders. New York: Guilford Press.Google Scholar
Beck, A. T. and Steer, R. A. (1993). Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, A. T., Steer, R. A. and Brown, G. K. (2005). Manual for the Beck Depression Inventory II. San Antonio, TX: Psychological Corporation.Google Scholar
Cavedini, P., Erzegovesi, S., Ronchi, P. and Bellodi, L. (1997). Predictive value of obsessive-compulsive personality disorder in antiobsessional pharmacological treatment. European Neuropsychopharmacology, 7, 45–49.CrossRefGoogle ScholarPubMed
Challacombe, F., Oldfield, V. B. and Salkovskis, P. M. (2011). Break Free From OCD: overcoming obsessive compulsive disorder with CBT. London: Vermilion.Google Scholar
Dreessen, L. and Arntz, A. (1998). The impact of personality disorders on treatment outcome of anxiety disorders: best evidence synthesis. Behaviour Research and Therapy, 36, 483–504.Google Scholar
Dreessen, L., Arntz, A., Luttels, C. and Sallaerts, S. (1994). Personality disorders do not influence the results of cognitive behaviour therapies for anxiety disorders. Comprehensive Psychiatry, 35, 265–274.Google Scholar
Dreessen, L., Hoekstra, R. and Arntz, A. (1997). Personality disorders do not influence the results of cognitive and behavioural therapy for obsessive compulsive disorder. Journal of Anxiety Disorders, 11, 503–521.Google Scholar
Foa, E. (1979). Failures in treating obsessive compulsives. Behaviour Research and Therapy, 17, 169–176.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (1996). Stuctured Clinical Interview for DSM-IV Axis I Disorders, Clinical Version (SCID – CV). Washington, DC: American Psychiatric Press.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B. W. and Benjamin, L. (1997). Structured Clinical Interview for DSM-IV Personality Disorders (SCID II). Washington, DC: American Psychiatric Press.Google Scholar
Foa, E. B., Kozak, M. J., Salkovskis, P. M., Coles, M. E. and Amir, N. (1998). The validation of a new obsessive-compulsive disorder scale: the Obsessive-Compulsive Inventory. Psychological Assessment, 10, 206–214.Google Scholar
Gordon, O., Salkovskis, P., Oldfield, V. B. and Carter, N. (2013). The association between obsessive compulsive disorder and obsessive compulsive personality disorder: prevalence and clinical presentation. British Journal of Clinical Psychology, 52, 300–315. doi:10.1111/bjc.12016 Google Scholar
Guidano, V. F. and Liotti, G. (1983). Cognitive Processes and Emotional Disorders. New York: Guilford Press.Google Scholar
McGlashan, T., Grilo, C. M., Sanislow, C. A., Ralevski, E., Morey, L. C., Gunderson, J. G., et al. (2005). Two- year prevalence and stability of individual DSM-IV criteria for schizotypal, borderline, avoidant and obsessive-compulsive personality disorders: toward a hybrid model of axis II disorders. American Journal of Psychiatry, 162, 883–889.Google Scholar
Mennin, D. S. and Heimberg, R. G. (2000). The impact of comorbid mood and personality disorders in the cognitive-behavioural treatment of panic disorder. Clinical Psychology Review, 20, 339–357.CrossRefGoogle Scholar
Pinto, A., Liebowitz, M. R., Foa, E. B. and Simpson, H. B (2011). Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder. Behaviour Research and Therapy, 49, 453–458.Google Scholar
Rachman, S. (1983). Obstacles to the successful treatment of obsessions. In Foa, E. and Emmelkamp, P. M. G. (Eds.), Failures in Behaviour Therapy. New York: John Wiley and Sons.Google Scholar
Reich, J. (2003). The effect of axis II disorder on the outcome of treatment of anxiety and unipolar depressive disorders: a review. Journal of Personality Disorders, 17, 387–405.Google Scholar
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: a cognitive account. Behavioural Psychotherapy, 19, 6–19.Google Scholar
Salkovskis, P. M. (1996). Cognitive-behavioural approaches to the understanding of obsessional problems. In Rapee, R., Current Controversies in the Anxiety Disorders. New York: Guilford.Google Scholar
Salkovskis, P. M. and Forrester, E. (2002). Responsibility . In Frost, R. O. and Steketee, G., Cognitive Approaches to Obsessions and Compulsions: theory assessment and treatment (pp.45–61). Oxford: Pergamon.Google Scholar
Salkovskis, P. M., Forrester, E. Richard, H. C. and Morrison, N. (1998). The devil is in the detail: conceptualising and treating obsessional problems. In Tarrier, N., Wells, A. and Haddock, G. (Eds.), Treating Complex Cases: the cognitive behavioural approach. Chichester: John Wiley.Google Scholar
Salkovskis, P. M., Wroe, A., Gledhill, A., Morrison, N., Forrester, E., Richards, H. C., et al. (2000). Responsibility attitudes and interpretations are characteristic of obsessive-compulsive disorder. Behaviour Research and Therapy, 38, 347–372.Google Scholar
Steketee, G., Chambless, D. L. and Tran, G. Q. (2001). Effects of Axis I and II comorbidity on behaviour therapy outcome for obsessive-compulsive and agoraphobia. Comprehensive Psychiatry, 42, 76–86.Google Scholar
van den Hout, M., Brouwers, C. and Oomen, J. (2006). Clinically diagnosed axis II co-morbidity and the short term outcome of CBT for axis I disorders. Clinical Psychology and Psychotherapy, 13, 56–63.Google Scholar
Watson, J. P. and Marks, I. M. (1971). Relevant and irrelevant fear in flooding: a cross-over study of phobic patients. Behaviour Therapy, 2, 275–295.Google Scholar
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