Epidemiological, Factor-Analytic, and Cognitive Factors in the Position of Obsessive-Compulsive Personality Disorder among the Cluster C Personality Disorders Commentary on Cluster C Anxious-Fearful Personality Pathology and Avoidance

This commentary presents some reflections on the peculiar position obsessive-compulsive personality disorder (OCPD) has among Cluster C PDs. Based on epidemiological, factor-analytic, and cognitive considerations, it is argued that OCPD deviates from avoidant and dependent PD. First, epidemiological research shows that in the general population OCPD is not associated with markers of poor functioning and unfortunate living circumstances. On the contrary, positive associations between OCPD and such markers are found. Moreover, disproportionally few people with OCPD seek mental health care. Second, based on a second-order factor analysis on a large data set that confirms the cluster structure in PDs, it is argued that OCPD has a deviant position, relatively weakly loading on the cluster-C factor. Third, research on cognitive processes and structures in PDs indicates that OCPD deviates from avoidant and dependent PD in several ways, including sharing an interpretation style with nonpatients, and in not reporting vulnerable cognitive-emotional states. Dysfunctional cognitive characteristics might be pushed out of awareness by powerful overcompensatory strategies that are more characteristic for Cluster B than for Cluster C. Alternatively, OCPD is characterized more by deviant cognitive processes than by specific content of schemas. OCPD’s dysfunctional core should be clarified.