Relationship-related obsessive-compulsive symptoms may occur in various types of relationships including people’s relationship with their parents, children, mentors, or even their God. In the below we refer to ROCD within the context of romantic relationships.
There are two main presentations of obsessive-compulsive symptoms focusing on intimate relationships:Relationship-Centered Obsessive-Compulsive Symptom (ROCD Type I) including obsessive doubts, preoccupation, checking, and reassurance seeking behaviors on three relational dimensions; feelings towards one’s partner (e.g., “I continuously reassess whether I really love my partner“; ), one’s perception of partner’s feelings (e.g., “I continuously doubt my partner’s love for me“( and one’s appraisal of the “rightness” of the relationship (e.g., “I check and recheck whether my relationship feels right“). Partner-Focused Obsessive-Compulsive Symptom (ROCD Type II) include preoccupation, checking, and reassurance seeking behaviors relating to one’s partner’s perceived flaws in six domains; physical appearance, sociability, morality, emotional stability, intelligence and competence.
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Research summary
Relationship-centered obsessive-compulsive symptoms (ROCD Type I)
Previous research has indicated that, compared with the general population, OCD patients often report disturbances in relationship functioning, including lower likelihood of marrying and increased marital distress (Emmelkamp, de Haan, & Hoogduin, 1990; Rasmussen & Eisen, 1992; Riggs, Hiss, & Foa, 1992). Recently, Doron et al. (2012) proposed that OC phenomena affect intimate relationships more directly when the main focus of the symptoms is the relationship itself. Doron et al. (2012) conducted two independent studies using community cohorts to assess relationship-centered OC phenomena and its links with related constructs. In the first study, Doron et al. (2012) examined the factorial structure of a newly constructed self-report measure – the Relationship Obsessive-Compulsive Inventory (ROCI; see Measures page). This 12-item measure taps the severity of obsessive (e.g., preoccupation and doubts) and compulsive (e.g., checking and reassurance seeking) behaviors on three relational dimensions: one’s feelings towards a relationship partner (e.g., “I continuously reassess whether I really love my partner”), the partner’s feelings towards oneself (e.g., “I continuously doubt my partner’s love for me”), and the “rightness” of the relationship (“I check and recheck whether my relationship feels right”).
In a second study, Doron et al., (2012) replicated the factor structure of the ROCI and assessed the link between relationship-centered OC phenomena, OCD symptoms and cognitions, negative affect, low self-esteem, and relationship variables such as relationship ambivalence and attachment insecurity. Findings showed the expected positive associations between ROCI scores and these theoretically related measures. Moreover, the ROCI significantly predicted relationship dissatisfaction and depression over and above common OCD symptoms, relationship ambivalence, and other mental health and relationship insecurity measures.
Doron et al. (2012) proposed several mechanisms that may make relationship-centered OC symptoms particularly disabling. For instance, they suggested that symptoms such as repeated doubting about one’s feelings towards a partner or the “rightness” of a relationship may destabilize the relational bond (e.g., “I can’t trust her/him to stay with me”), increase fears of abandonment, promote relationship distress, and challenge mutual trust. In addition, continuous preoccupation with a partner’s love may increase clinging and dependent behaviors resulting in maladaptive relationship dynamics (e.g., hierarchical relationships). Thus, relationship-centered OC symptoms can compromise satisfactory intimate relationships that are an important resource for individuals’ resilience and wellbeing.
Also see manuscripts page.
Partner-focused obsessive-compulsive symptoms (ROCD Type II)
Relationship-centered OC symptoms may be particularly detrimental to relationship quality. Yet, obsessive compulsive symptoms can affect relationships in additional ways. As intimate relationships progress, more attention is paid to one’s partner’s real or imagined faults (Hatfield & Sprecher, 1986; Sprecher & Metts, 1999). In fact, accepting that one’s partner is less-than-perfect may be one of the most challenging aspects in the development of a long-term stable relationship (Murray & Holmes, 1993). It seems that forming a more balanced and realistic assessment of one’s relationship partner, including their perceived flaws and deficits, is a necessary element in long-term relational involvements (Thompson & Holmes, 1996). For some individuals, however, preoccupation with the perceived deficits of their partner becomes increasingly time consuming, distressing, and a significant cause of dyadic distress (e.g., Josephson & Hollander, 1997).
Doron et al., (2012) attempted to extend previous findings on the links between OCD and close relationships by exploring an additional facet of relationship-related OC phenomena – partner-focused obsessive-compulsive symptoms. With this aim in mind, They constructed the Partner-Related Obsessive-Compulsive Inventory (PROCSI), a 24-item scale assessing the severity of OC symptoms relating to one’s partner’s perceived flaws in six domains: physical appearance, sociability, morality, emotional stability, intelligence and competence. The PROCSI was found to be internally consistent, had good test-retest reliability, and showed theoretically-coherent significant but moderate associations with existing measures of OCD symptoms and related cognitions, negative affect, low self-esteem, and relationship variables. Moreover, the PROCSI significantly predicted relationship dissatisfaction and depression, over and above relationship-centered OC symptoms and other mental health and relationship insecurity measures. Thus, findings indicated that the PROCSI has good validity and reliability and that it captures a distinct theoretical construct that has unique predictive value (see Measures page).
As hypothesized, moderate to high correlations were found between partner-focused OC symptoms and relationship-centered OC symptoms. These two relationship-related OC phenomena seem to be associated. Moreover, longitudinal analyses revealed a reciprocal association between the PROCSI and the ROCI, showing that both partner-focused OC symptoms at Time 1 predicted subsequent changes in relationship-centered OC symptoms, and relationship-centered OC symptoms at Time 1 predicted subsequent changes in partner-focused OC symptoms. Obsessing about partners’ faults may heighten uncertainty, doubts, and preoccupation regarding the relationship itself and one’s feelings towards his or her partner. These heightened relationship-centered obsessions and compulsions may, in turn, further increase one’s vigilance towards his or her partner’s perceived flaws.
Doron et al., findings also suggested that partner-focused OC symptoms may involve processes that are specific to this type of relationship-related OC phenomena. Specifically, the only additional significant unique predictor of the PROCSI (but not the ROCI) was a measure of dysmorphic body concerns. Hyper-attention to one’s own perceived flaws in appearance and catastrophic misinterpretation of such flaws may reflect a general predisposition to detect perceived deficits and overestimate their consequences, not only in the self, but also in relationship partners. Indeed, this proposal is consistent with Josephson and Hollander’s (1997) case discussions of BDD by proxy.
Also see manuscripts page.