Descriptive Psychopathology: The Signs and Symptoms of ...

306 Section 3: Examination domainspedophilia, voyeurism [“Peeping Tom”], and frotteurism [rubbing against anon-consenting person]) or elicits substantial distress in the person or the partner(e.g. because of fetishism, transvestic fetishism [cross-dressing], voyeurism, compulsivemasturbation, dependence on pornography, and bestiality). 102 The subjectiveexperiences of such patients before, during and after the sexual compulsivebehavior are similar to those with more classic OCD, and also include distress atthe loss of control. The use of illicit drugs and alcohol at the time of the behavioris common. 103Obsessive–compulsive personalityThe place for obsessive–compulsive personality in classification is uncertain.The association with OCD is modest, while the linkage to other Axis II conditionsis weak. Overall, the evidence indicates it can be considered a mild form of OCDand part of the OCD spectrum. Obsessive–compulsive personality traits arereported to commonly precede OCD and OCD spectrum conditions, and thesetraits are also common in the relatives of patients with OCD and OCD spectrumconditions. 104Much of the uncertain findings stems from the delineation of obsessive–compulsive personality by psychoanalytic rather than by empirically deriveddescriptors and the application of descriptors categorically rather than as traitdimensions. 105 “Anal character type” and the ICD anankastic personality disorderare terms reflecting the theoretical pedigree of obsessive–compulsive personality.Common descriptors of DSM and ICD (anankastic) obsessive–compulsive personalityare: preoccupation with details (rules, lists, order, and schedules), excessiveconscientiousness, rigidity and stubbornness, and being overly controlling.NOTES1 Henry Maudsley (1874) cited by M.J. Clark in Scull (1981), page 271.2 Yaryura-Tobias and Neziroglu (1997).3 Tynes et al. (1990).4 Bartz and Hollander (2006).5 Dannon et al. (2006).6 Dannon et al. (2004a,b).7 Hollander et al. (2005); Lochner et al. (2005a).8 They also propose a “depersonalization disorder” which does not fit the data.9 Compulsive shopping and Internet usage are also being considered as variants of thiscluster.10 Autism is also being considered for this category.