Clinical and neurocognitive correlates of obsessive-compulsive personality disorder symptoms: A transdiagnostic study in individuals with compulsive behaviors

This is the authors' abstract. We don't add key points for this paper.

Background: Obsessive-Compulsive Personality Disorder (OCPD) is characterized by a lifelong pattern of excessive attention to detail, rigidity and perfectionism. Although OCPD was historically linked to Obsessive-Compulsive and Related Disorders (OCRDs), this connection lacks consistent evidence. Compulsive behaviors, core to OCRDs, are repetitive actions aimed at reducing distress. To elucidate mechanistic links between OCPD and compulsive behaviors, this study examined relationships between OCPD traits, OCRD symptom domains, and cognitive functioning. Methods: In a transdiagnostic sample of 229 adults with reported compulsive behaviors (CBs) enrolled in a larger clinical trial, we assessed maladaptive OCPD traits using the Pathological Obsessive Compulsive Personality Scale (POPS) and examined their associations with a range of OCRD self-report scales, including measures of hair pulling and skin picking. We evaluated cognitive performance using two NIH toolbox tests and a "two-step" reinforcement learning task. Results: OCPD symptom scores correlated positively with OCD symptom severity on the OCI-R (r = 0.42, p < .001) and YBOCS (r = 0.38, p < .001). Higher OCPD scores were also associated with having a larger number of discrete OCRD symptom domains (r = 0.39, p < .001), and with higher scores across the majority of OCRD scales examined. OCPD scores, unlike OCD scores, showed no significant association with Flanker test or two-step task performance. Discussion: Severity of pathological OCPD traits was related to overall higher severity of OCD symptoms, and linked to several individual domains of OCRDs. Neurocognitive indices showed modest relationships with OCRD symptom severity but not with OCPD. These findings contribute to our understanding of how these phenotypes may co-occur, and help guide future research.