In psychology, relationship obsessive–compulsive disorder (ROCD) is a form of obsessive–compulsive disorder focusing on close intimate relationships. Such obsessions can become extremely distressing and debilitating, having negative impacts on relationships functioning. Obsessive–compulsive disorder comprises thoughts, images or urges that are unwanted, distressing, interfere with a person's life and that are commonly experienced as contradicting a person's beliefs and values. In the fifth and most recent version of the Diagnostic and Statistical Manual (DSM-5) the criteria for obsessive-compulsive disorder is characterized as of obsessions, compulsions, or both. Obsessions are unwanted chronic distressing thoughts, sometimes called intrusive thoughts. Such intrusive thoughts are frequently followed by compulsive behaviors aimed at "neutralizing" the feared consequence of the intrusions and temporarily relieve the anxiety caused by the obsessions. Attempts to suppress or "neutralize" obsessions increase rather than decrease the frequency and distress caused by the obsessions. While not specifically defined in the DSM-5, subtypes of OCD exist surrounding different obsessive themes. Common obsessive themes include fear of contamination or of losing control; aggressive thoughts; or a desire for symmetry. People with obsessive-compulsive disorder may also have obsessive themes surrounding religious or sexual taboos. Some people may also experience obsessions relating to close interpersonal relationships, either current or past, a subtype referred to as relationship obsessive-compulsive disorder (ROCD). Relationship OCD often refers to a person's obsessions regarding a romantic relationship or romantic partner but is not limited to this; symptoms can manifest in different non-romantic contexts such as parent-child relationships. As with other OCD themes, ROCD preoccupations are unwanted, intrusive, chronic and disabling. General OCD, absent of specific relationship-related obsessions, can also affect a person's interpersonal relationships, especially intimate romantic relationships. Women with OCD have been shown to have decreased sexual function and satisfaction compared to women with generalized anxiety disorder. OCD symptoms have been shown to affect sexual functioning in both men and women. OCD symptoms have even been shown to have a moderate negative correlation with different forms of intimacy, though the relationship between the two is complicated. Obsessive washing themes has been shown to be positively correlated with fear of contamination during sex and also sexual desire. Additionally, certain compulsive behaviors such as washing and neutralizing have been shown to be positively correlated with various relationship factors. Even when symptoms do not necessarily follow relationship themes, OCD still affects a person's ability to form and maintain relationships.
Signs and symptoms Relationship OCD symptoms, especially in romantic relationships, generally present as relationship-centered or partner-focused symptoms. Though these presentations are different they are not mutually exclusive as they tend to co-occur and even compound each other.
Relationship-centered symptoms Relationship-centered symptoms refer to thoughts that revolve around the "rightness" of the relationship, including doubts about one's own feelings or the sincerity of one's partner's feelings. People may continuously doubt whether they love their partner, whether their relationship is the "right" relationship, or whether their partner really loves them. Often, patients know these doubts are irrational and will seek reassurance either from themselves or their partner. This can cause distress whether the person chooses to remain in the relationship or leave it.
Partner-focused symptoms Partner-focused symptoms refer to obsessions regarding a partner's perceived flaws. These perceived deficits can be related to many factors including appearance, sociability, intelligence or morality. Partner-focused symptoms can also manifest in parent child relationships, where the parent obsesses over the child's perceived flaws. Both types of symptoms can manifest as intrusive thoughts, images, and/or urges related to the relationship. There is often a great deal of distress associated with these symptoms, as they tend to contradict one's personal values and the subjective experience of the relationship. The individual views these symptoms as unacceptable and unwanted, invoking feelings of guilt and shame. People suffering with ROCD often perform compulsions to deal with the significant distress. Compulsions may include constant reassurance seeking, being hyperaware of one's feelings, comparing their partners to other potential partners, and trying to visualize being happy with their partner. Recent research suggests that partner-focused symptoms in a parent-child context can cause significant parental stress, and depression. Additionally, it can promote anxiety, depression, and OCD symptoms in the child.
Causes Like other forms of OCD, psychological and biological factors are believed to play a role in the development and maintenance of ROCD. In addition to the maladaptive ways of thinking and behaving identified as important in OCD, models of ROCD suggest that over-reliance on intimate relationships or the perceived value of the partner for a person's feelings of self-worth and fear of abandonment (also see attachment theory) may increase vulnerability and maintain ROCD symptoms.
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