Phenomenology of Obsessive Compulsive Personality Disorder

描述（由申请人提供）：拟议的指导以患者为导向的研究职业发展奖（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个临床研究人员在强迫性人格障碍（OCPD）的研究领域的程序线。该应用程序集成了正式的课程，在既定的研究人员的补充指导，和一个独立的研究计划，将使候选人：（1）发展在OCPD和人格障碍评估的现象学的专业知识;（2）成为执行功能的神经心理学评估精通;（3）增加临床试验方法学/研究伦理学的知识，以便研究OCPD的新疗法;和（4）提高他的手稿和赠款写作技巧，以建立一个独立资助的OCPD研究计划。除了指导培训活动，候选人还提出了三个研究项目，每个项目旨在通过填补我们对这种疾病的理解中的具体空白来推进OCPD的研究。在项目1中，候选人将系统地研究OCPD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）的争议关系。候选人将为这种疾病开发急需的临床工具，包括OCPD特征和症状行为的清单，用于表征和半结构化访谈，以评估严重程度，这两者都将促进进一步的研究。项目2将是第一个全面研究假设的执行缺陷OCPD（与对照组），即认知能力和过度关注细节，使用神经认知测试的集转移，反应抑制，决策和规划。为了阐明OCPD和OCD的一致性，将对患有和不患有共病OCD的OCPD受试者进行临床和神经认知测量。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取得了成功，是否会导致OCPD严重程度以及执行和心理社会功能的改善。公共卫生相关性：OCPD是一种损害性但知之甚少的人格障碍。尽管它是社区和临床样本中最常诊断的人格障碍之一，但在过去的二十年里，OCPD几乎没有受到经验主义的关注，目前还没有针对这种障碍的循证治疗方法。这项拟议中的研究预计将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迈出第一步，开放试验将为该患者群体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.