TY - JOUR
T1 - Attachment insecurity and obsessive-compulsive personality disorder among inpatients with serious mental illness
AU - Wiltgen, Anika
AU - Adler, Herman
AU - Smith, Ryan
AU - Rufino, Katrina
AU - Frazier, Christopher
AU - Shepard, Christopher
AU - Booker, Kirk
AU - Simmons, Diedra
AU - Richardson, Leah
AU - Allen, Jon G.
AU - Fowler, James Chris
N1 - Funding Information:
Research is supported by The Menninger Foundation . The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or manuscript. Thus, the authors were independent from study sponsors in the context of the research.
Publisher Copyright:
© 2014 Elsevier B.V. All rights reserved.
PY - 2015/3/15
Y1 - 2015/3/15
N2 - Background Obsessive-compulsive personality disorder (OCPD) is characterized by traits such as extreme rigidity, perfectionism, and controlling behavior, all of which have a negative impact on interpersonal functioning. Attachment theory provides a useful framework to elucidate the interpersonal dysfunction characteristic of OCPD; yet, there is a dearth of attachment research on OCPD in the context of severe mental illness.Methods Attachment security and personality disorders were assessed in adult inpatients with severe mental illness. Propensity Score Matching (PSM) was used to match OCPD and control subjects on age, gender, number of psychiatric disorders, and number of criteria endorsed for borderline personality disorder.Results Consistent with hypotheses, the OCPD group (n=61) showed greater attachment avoidance than controls (n=61), and the avoidance was manifested in a predominance of the most insecure attachment style, fearful attachment. Correlations between attachment anxiety/avoidance with specific OCPD diagnostic criteria revealed that attachment avoidance was correlated with four of eight OCPD criteria across the full sample. Within the subset of OCPD patients, attachment avoidance was significantly correlated with OCPD criterion 3 (is excessively devoted to work and productivity to the exclusion of leisure activities and friendships).Limitations The use of self-report measure of attachment and the high burden of illness in the SMI population may not generalize to interview based assessment or outpatients, respectively.Conclusions Findings attest to the severity of impairment in interpersonal functioning and attachment avoidance, in particular, is characteristic of OCPD patients. These results suggest that viable treatment targets include interpersonal functioning along with more classical features of OCPD such as perfectionism and obsessiveness in task performance.
AB - Background Obsessive-compulsive personality disorder (OCPD) is characterized by traits such as extreme rigidity, perfectionism, and controlling behavior, all of which have a negative impact on interpersonal functioning. Attachment theory provides a useful framework to elucidate the interpersonal dysfunction characteristic of OCPD; yet, there is a dearth of attachment research on OCPD in the context of severe mental illness.Methods Attachment security and personality disorders were assessed in adult inpatients with severe mental illness. Propensity Score Matching (PSM) was used to match OCPD and control subjects on age, gender, number of psychiatric disorders, and number of criteria endorsed for borderline personality disorder.Results Consistent with hypotheses, the OCPD group (n=61) showed greater attachment avoidance than controls (n=61), and the avoidance was manifested in a predominance of the most insecure attachment style, fearful attachment. Correlations between attachment anxiety/avoidance with specific OCPD diagnostic criteria revealed that attachment avoidance was correlated with four of eight OCPD criteria across the full sample. Within the subset of OCPD patients, attachment avoidance was significantly correlated with OCPD criterion 3 (is excessively devoted to work and productivity to the exclusion of leisure activities and friendships).Limitations The use of self-report measure of attachment and the high burden of illness in the SMI population may not generalize to interview based assessment or outpatients, respectively.Conclusions Findings attest to the severity of impairment in interpersonal functioning and attachment avoidance, in particular, is characteristic of OCPD patients. These results suggest that viable treatment targets include interpersonal functioning along with more classical features of OCPD such as perfectionism and obsessiveness in task performance.
KW - Attachment insecurity
KW - Fearful attachment style
KW - OCPD
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U2 - 10.1016/j.jad.2014.12.011
DO - 10.1016/j.jad.2014.12.011
M3 - Article
C2 - 25553401
AN - SCOPUS:84920174422
SN - 0165-0327
VL - 174
SP - 411
EP - 415
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -