Can Elements of OCPD Help Women Be Effective?

Transcription

1 A WOMAN S JOURNEY Can Elements of OCPD Help Women Be Effective? Presented by: Gerald Nestadt MD Date Presented: November 1,

2 Disclosures None October 27,

3 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?

4 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

5 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.

6 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

7 OCPD Inability to discard worn or worthless objects Reluctance to delegate tasks Miserly spending style Rigidity and stubbornness

8 Percent (%) Prevalence of Compulsive Personality Traits

9 Five-factor Solution for DSM Personality Attributes Obsessive-Compulsive Factors Compulsive Aloof Neurotic Avoidant Impulsive Callous Egocentric Prevalence Excessive work devotion Perfectionism Preoccupied with details Hoarding behaviors Overconscientiousness Miserliness Reluctant to delegate Rigidity

10 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) Sex Education Male 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) < 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)

11 Prevalence (%) of DSM-III compulsive personality traits and disorder weighted to the general population Marital Status Employment Income Birth Order Compulsive score 3+ Compulsive score 6+ DSM-III disorder 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 (3.2) 3.9 (1.9) 1.8 (1.5) Never married 9.2 (2.6) 2.0 (1.4) -- Employed 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) < $10, (2.2) 1.4 (0.7) 0.4 (0.4)* > $10, (4.3) 7.1 (2.3) 4.1 (1.8) Eldest 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)

12 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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14 Potentials Provocations Responses (Personality) (Life Circumstances) (Neurotic Symptoms) Emotive triad.

15 Generalized Anxiety Disorder and Alcohol Use Disorders by Compulsive and Antisocial Personality

16 Probability of Obsessions and Compulsions by Compulsive Personality Score

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18 GAF score GAF score in by personality traits in * * * 0 1 or 2 > OCPD BPD Avoidant * Significant at p<0.05

19 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

20 But it depends

21 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

22 OCD OCPD 22

23 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.

24 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).

25 Management of OCPD Education and guidance Treat symptomatically Pharmacology: selective-serotonin reuptake inhibitors

26 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?

27 Conclusions Effective women have some compulsive features Be aware of taking care of yourself It s fine to have a few foibles or idiosyncrasies