Altered responses to social closeness and rule violations in obsessive-compulsive personality disorder

This study evaluated whether Obsessive-Compulsive Personality Disorder (OCPD) is associated with impairments across multiple domains of psychosocial functioning, and whether such impairments vary as a function of treatment-seeking status, specific psychopathological features, and social-cognitive response patterns. Global, social-occupational, relational and empathic functioning, perceived quality of life, rigidity and perfectionism were compared among 39 outpatients with OCPD, 36 non-clinical OCPD individuals (NC-OCPD) and 80 healthy controls (HC). Participants then completed two virtual ball-toss paradigms: Cyberball , assessing distress following excessive social closeness (overinclusion) relative to fair inclusion and exclusion, and Cybershape , assessing distress in response to rule-violation scenarios relative to fair play. OCPD showed greater psychosocial impairment and worse quality of life compared to the other groups, as well as lower perspective taking and higher personal distress than HC. Both OCPD and NC-OCPD reported higher rigidity and perfectionism than HC, but OCPD also had higher rigidity than NC-OCPD. Rigidity had stronger correlations with functional impairment than perfectionism and correlated with decreased perspective taking. Following Cyberball , both OCPD and NC-OCPD showed higher negative emotions than HC after the overinclusion condition, but only OCPD reacted more negatively than HC to standard social inclusion, and this difference was associated with increased personal distress. Following Cybershape , OCPD reported that even the fair-play condition violated their expectations. Conversely, NC-OCPD reported greater distress in response to rule violations than HC throughout the task. Treatment-seeking OCPD individuals show greater psychosocial impairment and rigidity than both NC-OCPD and HC, along with heightened sensitivity to both excessive and normal interpersonal closeness and a tendency to perceive even normative social contexts as violating their expectations. Conversely, NC-OCPD individuals maintain levels of functioning comparable to HC but remain distressed by excessive interpersonal closeness and by situations requiring adherence to explicit behavioral rules. Overall, these findings indicate that the severity of OCPD pathology modulates functional outcomes, with rigidity playing a central role in psychosocial impairment, and point to specific social-cognitive patterns associated with psychosocial difficulties in OCPD.