Personality Disorders 617
When considering the diagnosis of dependent personality disorder, cliniciansneed to keep in mind that cultures have different norms about appropriate de-
pendent behaviors; moreover, these norms may vary for men and women and for
people of different ages. For instance, some Asian cultures may promote more def-
erence or passivity than is the norm in North America, and some Latino cultures
promotemarianismo (the opposite of machismo), where women are expected to
be submissive to and dependent on men. These behaviors, normal within those cul-
tures, should be distinguished from symptoms of dependent personality disorder
(Paniagua, 2001).
Obsessive-Compulsive Personality Disorder
Obsessive-compulsive personality disorder is characterized by preoccupations with
perfectionism, orderliness, and self-control as well as low levels of fl exibility and
effi ciency (American Psychiatric Association, 2000). It is the personality disorder
associated with the least disability (Skodol, Gunderson, et al., 2002) and the highest
obtained educational level (Torgersen, Kringlen, & Cramer, 2001). Rachel Reiland
describes her father as having some elements of obsessive-compulsive personal-
ity disorder: He was strict, “coveted control,” and became enraged when events
weren’t to his liking. Reiland herself had some elements of this disorder: “Once
upon a time perfectionism was my noble aspiration. My perfectionism extended be-
yond academics or career. I also aspired to be the perfect mother, lover, and friend,
always appropriate in all my emotional expressions” (2004, p. 361).
What Is Obsessive-Compulsive Personality Disorder?
People with obsessive-compulsive personality disorder can get so bogged down in
details that they leave the most important elements to the last minute (see Table
13.25 for the complete diagnostic criteria). For instance, when preparing a presenta-
tion, people with this disorder might spend hours creating a single PowerPoint slide,
trying to get it perfect, and end up running out of time for organizing their talk.
They can’t see the forest for the trees. For people with obsessive-compulsive person-
ality disorder, decision making is a painful, long process; thus, once they’ve made a
decision, they’re not likely to change their minds—which can end up making them
appear rigid and infl exible. And, like Reiland’s fa-
ther, when they are unable to control a situation,
they may become angry, irritable, or upset.
Some (but not all) people who are worka-holics may have obsessive-compulsive personal-
ity disorder—they may feel uncomfortable on
vacations unless they take work along with them.
Alternatively, others with obsessive-compulsive per-
sonality disorder may spend inordinate amounts of
time on hobbies or household chores, striving for
perfection and adhering to rules inflexibly. They
may hold others to these same unrealistically strin-
gent standards.
The relationships of people with obsessive-compulsive personality disorder are normally for-
mal and serious; they are preoccupied with logic
and intellect, are overly conscientious, and are
intolerant of emotional or “illogical” behavior in
others. Typically, people with obsessive-compulsive
personality disorder feel uncomfortable with oth-
ers who express emotions easily and openly. People
with this disorder are not likely to express tender
feelings or pay compliments. Other people often
feel frustrated by their rigidity. In turn, people with
Table 13.25 • DSM-IV-TR Diagnostic Criteria for
Obsessive-Compulsive Personality DisorderA pervasive pattern of preoccupation with orderliness, perfectionism, and mental and
interpersonal control, at the expense of fl exibility, openness, and effi ciency, beginning
by early adulthood and present in a variety of contexts, as indicated by four (or more)
of the following:
(1) is preoccupied with details, rules, lists, order, organization, or schedules to the
extent that the major point of the activity is lost
(2) shows perfectionism that interferes with task completion (e.g., is unable to complete
a project because his or her own overly strict standards are not met)
(3) is excessively devoted to work and productivity to the exclusion of leisure activities
and friendships (not accounted for by obvious economic necessity)
(4) is overconscientious, scrupulous, and infl exible about matters of morality, ethics,
or values (not accounted for by cultural or religious identifi cation)
(5) is unable to discard worn-out or worthless objects even when they have no senti-
mental value
(6) is reluctant to delegate tasks or to work with others unless they submit to exactly his
or her way of doing things
(7) adopts a miserly spending style toward both self and others; money is viewed as
something to be hoarded for future catastrophes
(8) shows rigidity and stubbornness
Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders,
Text Revision, Fourth Edition, (Copyright 2000) American Psychiatric Association.Obsessive-compulsive personality disorder
A personality disorder characterized
by preoccupations with perfectionism,
orderliness, and self-control as well as low
levels of fl exibility and effi ciency.