Unrelenting Little Perfectionists: Obsessive Compulsive Personality Disorder in Children

Obsessive Compulsive Personality Disorder in Children

Many people have heard of obsessive compulsive disorder (OCD), but have you heard of obsessive compulsive personality disorder (OCPD)? Although these two disorders may sound similar, they are quite different. First of all, OCD is an anxiety disorder, and OCPD is a personality disorder associated with severe disturbances in a child’s behavior. While children with OCD present a narrow range of thoughts and behavior, children with OCPD are meticulous and compulsive about everything in their lives. Children with OCPD have preoccupations with orderliness and perfectionism, and must maintain mental and interpersonal control. These children have great difficulties with efficiency, flexibility, and openness. A child with OCPD, for example, must clean his room daily, arrange his toys in a specific way, follow the same nightly ritual, and obey rules precisely.

Unlike a child with OCD who becomes distressed by his thoughts and actions, a child with OCPD feels comfortable with his behavior. A child with OCPD may not be disturbed by his rigidly and stubbornness. OCPD in children, however, is a disorder that can significantly disrupt daily life. A child with OCPD can be so preoccupied with minute details and have an overwhelming concern with perfectionism that completing activities or homework assignments becomes impossible. Finishing a short worksheet, making simple decisions, or even enjoying leisure activities, can be really difficult for a child with OCPD.

Affecting more men than women, OCPD generally develops in early childhood or in early adulthood. OCPD can be found in 1% of the population. Some signs and symptoms of OCPD in children include:

• having a preoccupation with rules, lists, order, organization, details, and schedules;
• being very rigid and inflexible in their beliefs;
• showing perfectionism so much so that it interferes with completing a task;
• focusing excessively on being productive with their time, at the expense of leisure activities and friendships;
• being overly conscientious;
• having inflexible morality, ethics, or values, and;
• hoarding worn-out or worthless items.

Some children with OCPD have an obsession for cleanliness. Those who do not have this tendency may be good at planning to maintain cleanliness, but may not follow through with cleaning due to other priorities. A child’s need to receive a good grade or to complete a school project, for instance, may cause him to have a quite messy and disorganized room.

Treatment for OCPD can be complex and lengthy. While medication by itself is not used to treat OCPD, fluoxetine, an antidepressant, can relieve some symptoms. Anti-anxiety medication may decrease fear, too, and medication for Attention Deficit Disorder can improve concentration and task completion, leading to increased self-esteem. Cognitive-behavioral therapy can help children develop a greater tolerance of the gray areas of the world, instead of the black and white lines of rigidly held beliefs. Intervention may also deal with hoarding and include social skills training and role-playing to help facilitate friendships.

References

Pediatric Obsessive Compulsive Disorder Research. (2006). Facts about ocd. Retrieved August 5, 2010, from intramural.nimh.nih.gov/pocd/pocd-faqs.htm