Phenomenology of Obsessive Compulsive Personality Disorder

点击翻译按钮获取中文摘要

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.