Obsessive-compulsive personality disorder, sometimes called anankastic personality disorder, involves rigid rules, very high personal standards, and a strong need for things to be done exactly right, even when this causes problems in daily life. It has long been linked to perfectionism, but few studies have looked closely at how the two conditions relate to one another.
A study by Redden et al. examined 74 university students with elevated perfectionism. Each completed a diagnostic assessment and a range of self-report measures, then was randomly assigned to either an exposure-based treatment for perfectionism or a waitlist. Thirty-four participants, or 45.95%, met DSM-IV diagnostic criteria for OCPD.
Compared with those without OCPD, participants with OCPD showed higher levels of both general and specific perfectionism, including personal standards, and reported more social anxiety. They were also more likely to have a current anxiety disorder. Despite these differences, people with and without OCPD responded to treatment in a similar way: the exposure-based approach appeared to benefit both groups.
These findings suggest that perfectionism can exist alongside a personality disorder that adds to anxiety and social difficulty, without necessarily changing how well treatment works. If perfectionism or anxiety is making things harder for you, a psychologist can help you understand what is going on and talk through options that might be of use.
What OCPD actually is
Obsessive-Compulsive Personality Disorder (OCPD) — also called anankastic personality disorder in some diagnostic systems — is a personality disorder marked by a pervasive pattern of preoccupation with order, rules, perfectionism, and control, often at the expense of flexibility and efficiency. It's distinct from Obsessive-Compulsive Disorder (OCD): OCD involves intrusive thoughts and compulsive rituals that the person usually recognises as distressing and unwanted, whereas OCPD traits (like rigid standards or an intense need for things to be 'correct') often feel justified or even valuable to the person, which is part of why they can be harder to shift.
What the study did
Redden et al. recruited 74 university students who all had elevated perfectionism. Each completed a diagnostic assessment (to check for OCPD and other conditions) plus self-report questionnaires measuring perfectionism, anxiety, and related traits. Participants were then randomly assigned to either an exposure-based treatment for perfectionism or a waitlist control group. Random assignment to a treatment versus a waitlist is a standard design in clinical psychology (a type of randomised controlled trial) because it lets researchers see whether improvements are due to the treatment itself rather than time passing or other factors. Exposure-based treatment works by having someone gradually and repeatedly face the situations or feelings they usually avoid — in this case, likely things like making deliberate small mistakes or leaving a task 'imperfect' — so that the anxiety attached to imperfection weakens over time. Of the 74 participants, 34 (45.95%) met DSM-IV diagnostic criteria for full OCPD.
What it found
Compared with participants who didn't meet OCPD criteria, those who did showed higher levels of both general and specific domains of perfectionism, including higher personal standards. They also reported higher social anxiety and had higher rates of a current anxiety disorder diagnosis. Despite these differences, when it came to treatment, the two groups improved by a comparable amount — having OCPD didn't reduce how much someone benefited from the exposure-based treatment for perfectionism.
Why it matters
This tells us that within a group of people who all struggle with strong perfectionism, there's a meaningful subgroup — those with OCPD — who tend to carry a heavier load: stricter internal standards, more social anxiety, and more current anxiety disorders. That's clinically useful, because it suggests perfectionism isn't one uniform experience. At the same time, the finding that treatment worked equally well regardless of OCPD status is encouraging, since personality disorders are often assumed to be more entrenched and harder to treat than single symptoms or traits.
Its limits
The sample was university students rather than a broader clinical population, so it's not yet clear whether these patterns and treatment outcomes would look the same in older adults or in people seeking help outside a university setting. OCPD was diagnosed using DSM-IV criteria, an earlier version of the diagnostic manual. The study also compared subgroups within one perfectionism sample rather than against people without perfectionism at all, so it can't tell us about OCPD's role outside this specific context.
If perfectionism or rigid personal standards are making life feel heavier than it should, this research is a reminder that effective psychological support exists — and it's worth reaching out to a psychologist to explore it.