Do Obsessive Compulsive Disorder (OCD) and Asperger's disorder (AS) co-exist?

Apr 14, 2010 | Author: Bio Behavioral Institute

Asperger’s disorder (AS) and Obsessive Compulsive Disorder (OCD) are both neurological disorders characterized by obsessive and repetitive behaviors, however many significant differences are observed.  AS, one of five pervasive developmental disorders, involves impairments in language, communication and social skills. Often, individuals diagnosed with AS also participate in obsessive and repetitive behaviors, upset easily if routines are not followed strictly, or complex rituals are interrupted. Obsessive compulsive disorder (OCD) stems from anxiety and is characterized by recurring, obsessive thoughts, or compulsive actions. Obsessive thoughts repeatedly enter the mind and compulsions or rituals are behaviors which are repeated over and over again to prevent fear and discomfort.  Unlike AS individuals, those with OCD, may be effected socially due to their need to perform their rituals, however the significant impact on communication, social reciprocity, and interpersonal relationships, is not observed to the same degree.  A person can be diagnosed with both Asperger Syndrome and OCD. In fact, it is common for a person with AS or autism to also have an additional neurological or behavioral disorder. One way to recognize the difference between the obsessive and stimming behavior of Aspergers versus OCD behavior is to figure out whether the behavior is driven by anxiety.  Szatmari et al (1989) studied a group of 24 children. He discovered that 8% of the children with Asperger syndrome and 10% of the children with high-functioning autism were diagnosed with OCD.  Some examples of specific similarities and differences noted are listed below:

 

Some Similarities:

  • Both exhibit “stereotyped” or repetitive behaviors.  Examples of these behaviors include: following rigid routines, inflexibility, self-stimulatory behaviors, etc..
  • Often display “obsessive” behaviors or interests in specific things
  • Focus on unusual objects or activities for extended periods of time.
  • Increased anxiety when a routine or ritual is interrupted.  This interruption may make other daily activities difficult to participate in.
  • Participation in this routine or ritual aids in regulation of behavior.

 

Some Differences:

OCD

Asperger’s Disorder (AS)

  • Focus of thoughts and behaviors: are often contamination (excessive hand washing), violent/sexual, checking (locks, switches, etc.), hoarding, counting, etc...
  • Bothered by thoughts and behaviors: They would like to stop their bad thought from occurring and realize that their behaviors are odd.  In addition, they are usually unhappy about their inability to control these symptoms. 
  • Social: They frequently feel ashamed of the rituals and are concerned with how others will view them.
  • Motivation: Behaviors and rituals are highly driven by the need to reduce anxiety or the fear that something bad will happen if the behavior is not completed.
  • Interrupted rituals: Often cause anxiety due to a fear of what will happen if the ritual is not completed.
  • Obsessions are bad: They interfere with the person’s functioning.  When severe, they can interfere socially, occupationally, academically, etc...
  • Diagnosed: Usually in late adolescence, early adulthood
  • Treatment: A combination of anti-depressants, most commonly Selective Serotonin Reuptake Inhibitors (SSRI’s) and Cognitive Behavior Therapy (CBT), is the recommended treatment for OCD.
  • Focus of thoughts and behaviors: are often on repeating things (spinning objects, rocking back and forth), due to an “obsessive need for sameness,” and memorizing details of a specific interest (highways on maps).
  • Not bothered by thoughts and behaviors: They do not want or try to stop having the thoughts. Unlike a compulsive disorder, they are not invasive or annoying. The individual may really enjoy their interest or obsession and therefore, not have the desire to resist it.
  • Social: They have social interaction difficulties, don’t seem to be bothered by what others think of their behavior
  • Motivation: Repetitive behaviors can reduce anxiety, but their purpose is not to reduce anxiety.
  • Interrupted rituals: Frustration may be the result of disappointment at not being able to complete a pleasurable activity.
  • Obsessions are not bad: Obsessions may be used by both the individual and those working with the person to help them to learn new ideas, learn a trade or skill. (Ex: an obsession with computers may allow for a career in technology).
  • Diagnosed: Early childhood
  • Treatment: CBT may be effective for treating AS individual’s, however, it will only be effective if the person wants to stop their obsessions.  Medication may also aid in reducing anxiety and therefore allowing them to better tolerate the frustration of not being able to carry out the behavior.