Phenomenology of Obsessive Compulsive Personality Disorder

描述(由申请人提供)：拟议的以患者为导向的导师研究职业发展奖(K23)是一个五年计划，将使候选人能够发展他的职业生涯，作为一名临床研究人员，在强迫症(OCPD)领域具有规划的研究路线。该申请整合了正式课程、在知名研究人员的辅助指导下以及独立研究计划，这将使应聘者能够：(1)发展强迫症现象学和人格障碍评估方面的专业知识；(2)精通对执行功能的神经心理学评估；(3)增加其临床试验方法/研究伦理的知识，以便能够研究强迫症的新疗法；以及(4)增强其手稿和拨款撰写技能，以便建立一个独立资助的强迫症研究计划。除了有指导的培训活动外，候选人还提出了三个研究项目，每个项目都旨在通过填补我们对OCPD理解的具体空白来推进OCPD的研究。在项目1中，候选人将系统地研究强迫症的现象学，特别是其核心维度，心理社会功能(从患者和家庭的角度)，以及与强迫症(OCD)的有争议的关系。候选人将为这种疾病开发急需的临床工具，包括一份表征强迫症特征和症状行为的核对表，以及一次评估严重性的半结构化面试，这两项都将促进进一步的研究。项目2将是第一个关于强迫症(与对照)假想的执行缺陷，即认知缺乏灵活性和对细节的过度关注的全面研究，使用集转移、反应抑制、决策和计划的神经认知测试。为了阐明强迫症和强迫症的趋同，将对强迫症患者和非强迫症患者进行临床和神经认知测试。项目3将测试一种新的干预措施-认知补救疗法，在神经性厌食症和强迫症方面证明是成功的，是否会导致OCPD严重程度的改善，以及执行和心理社会功能的改善。与公共卫生相关：强迫症是一种受损但知之甚少的人格障碍。尽管它是社区和临床样本中最常见的被诊断为人格障碍的疾病之一，但在过去的20年里，OCPD几乎没有得到经验上的关注，目前还没有针对这种疾病的循证治疗。这项拟议的研究有望具有重大的临床和公共卫生意义，因为它将在现象学、评估和神经认知方面提供必要的基础，以开发新的治疗方法。此外，神经认知数据将为理解潜在的潜在机制提供第一步，开放试验将在这一患者组中提供新干预措施的第一次测试。

DESCRIPTION (provided by applicant): The proposed Mentored Patient-Oriented Research Career Development Award (K23) is a five-year plan that will enable the candidate to develop his career as a clinical researcher with a programmatic line of research in the area of obsessive compulsive personality disorder (OCPD). The application integrates formal coursework, complementary mentorship under established researchers, and an independent research program that will enable the candidate to: (1) develop expertise in the phenomenology of OCPD and personality disorder assessment; (2) become proficient in the neuropsychological assessment of executive functioning; (3) increase his knowledge of clinical trial methodology/research ethics so that he can examine novel therapeutics for OCPD; and (4) enhance his manuscript- and grant-writing skills in order to establish an independently-funded OCPD research program. In addition to mentored training activities, the candidate also proposes three research projects, each designed to advance the study of OCPD by filling specific gaps in our understanding of the disorder. In Project 1, the candidate will systematically examine the phenomenology of OCPD, particularly its core dimensions, psychosocial functioning (from both the patient and family perspective), and the controversial relationship with obsessive compulsive disorder (OCD). The candidate will develop much needed clinical instruments for the disorder, including a checklist of OCPD traits and symptomatic behaviors for characterization and a semi-structured interview to assess severity, both of which will facilitate further research. Project 2 will be the first comprehensive study of hypothesized executive deficits in OCPD (versus controls), namely cognitive inflexibility and overattention to details, using neurocognitive tests of set-shifting, response inhibition, decision making, and planning. To clarify the convergence of OCPD and OCD, the clinical and neurocognitive measures will be administered to OCPD subjects with and without comorbid OCD. Project 3 will test whether a novel intervention, cognitive remediation therapy, with demonstrated success in anorexia nervosa and OCD, leads to improvement in OCPD severity, as well as executive and psychosocial functioning. Public Health Relevance: OCPD is an impairing yet poorly understood personality disorder. Even though it is one of the most frequently diagnosed personality disorders across community and clinical samples, OCPD has received little empirical attention in the last two decades and there are currently no evidence-based treatments for the disorder. The proposed research is expected to have substantial clinical and public health significance because it will provide the necessary groundwork in phenomenology, assessment, and neurocognition to develop new treatments. In addition, the neurocognitive data will offer a first step in understanding potential underlying mechanisms, and the open trial will provide the first test of a novel intervention in this patient group.