Asperger Syndrome and OCD

by Adrienne Warber

Asperger Syndrome and OCD are two different neurological disorders with some similarities. There is some confusion over the definition of the two disorders, especially since a person can have both Asperger's syndrome and Obsessive Compulsive Disorder (OCD).

Asperger syndrome and OCD are both neurological disorders characterized by obsessive and repetitive behaviors.

Asperger's Syndrome

Asperger's Syndrome is one of five pervasive developmental disorders, along with Autism, that involve impairments in language, communication and social skills. A person with Aspergers may participate in obsessive and repetitive behaviors and gets upset if strict routines or complex rituals are interrupted.

Examples of obsessive behavior in AS are spinning objects, rocking back and forth or memorizing every detail of the US highway system map. Aspergers is often diagnosed in early childhood.

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) is a neurological disorder that stems from anxiety. A person has obsessive thoughts and compulsions to participate in obsessive and repetitive behavior that can involve complex and unusual rituals. If he cannot participate in a ritual, he experiences great fear and discomfort.

Examples of OCD behaviors are excessive hand washing, repetitively checking locks, irrationally hoarding objects and counting rituals. The behavior generally centers on a specific anxiety. The behavior can get in the way of daily living, if untreated. OCD is generally diagnosed in late adolescence or adulthood.

Aspergers and OCD share the following similarities:

• Obsessive behaviors or obsessive interests
• Repetitive behaviors
• Self-stimulating behaviors or "stimming," such as hand flapping, twirling or head banging (However, some experts argue that similar behavior in OCD is not really stimming but instead a part of an OCD ritual.)
• Unusual rituals
• Strict routines
• Focus on unusual object or activity for hours, which can seem like an obsession
• Anxiety when a ritual or routine is interrupted and may make the rest of the day's activities difficult for him to participate in.
• Participating in the ritual or routine helps regulate behavior to some degree.

Differences Between Aspergers and OCD

There is a major difference in what compels a person with Aspergers or Autism to participate in obsessive behavior or repetitive rituals and the motivation of a person with OCD.

Anxiety is not the driving force behind repetitive behaviors, but it can alleviate feelings of anxiety. Just as someone may bite his nails when he is anxious, a person with AS may engage in repetitive behaviors.

He does not seem to care what others think of his behavior or feel bad or about any compulsions. When he gets upset over an interrupted ritual or routine, his frustration may stem from being deprived of a pleasurable activity, not a necessarily a fear of what will happen.

Obsessions in Aspergers and Autism are not always viewed as undesired behavior. Parents and therapists may even create learning situations that utilize an obsession with a favorite topic to help a child with AS learn new things.

For example, a child who is obsessed with trains may respond better to any new activity or idea that includes his favorite subject. A person with Aspergers who is obsessed with computer code may turn his obsession into a computer career.

A person with OCD is generally driven to the obsessive behavior by anxiety and a fear that something bad will happen if he does not complete the repetitive ritual. He often feels ashamed of the compulsive behavior and worries what others think about it.

Can a Person Have Both Aspergers and OCD?

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 whether the behavior is driven by great anxiety.

Generally, doctors can diagnosis both conditions, if present, during the initial autism screening.

However, if anyone suspects a loved one with Aspergers has developed OCD and remain undiagnosed, seek diagnosis and treatment immediately. Call the loved one's doctor or a local autism support organization for assistance and doctor recommendations.

Conclusion

Aspergers and OCD share many similarities but have significant differences. It is important for anyone suspecting Aspergers or OCD to seek a diagnosis. Left untreated, the two conditions can make social interaction difficult. Many modern medical options can treat both conditions and lessen any undesired symptoms. The right treatment plan can help an affected individual to live a fulfilling and productive life.

For more information on Asperger's syndrome and obsessive compulsive disorder, visit the Online Aspergers Information and Support (OASIS) website for Aspergers information and the Obsessive Compulsive Disorder Foundation (OCF) website for details on OCD. .

Tales From the Mang: The Asperger's Test

Over the last 18 months, my psychologist, Dr, R., has floated recurring hints that I might have Asperger's syndrome. Aspeger's or "high functioning autism" is yet another psychological spectrum disorder.

From the Wikipedia, "Asperger syndrome (AS), also known as Asperger's syndrome or Asperger disorder, is an autism spectrum disorder (ASD) that is characterized by significant difficulties in social interaction, alongside restricted and repetitive patterns of behavior and interests.

It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. Although not required for diagnosis, physical clumsiness and atypical use of language are frequently reported.

The syndrome is named after the Austrian pediatrician Hans Asperger who, in 1944, studied and described children in his practice who lacked nonverbal communication skills, demonstrated limited empathy with their peers, and were physically clumsy. The modern conception of Asperger syndrome came into existence in 1981, and went through a period of popularization, becoming standardized as a diagnosis in the early 1990s. Many questions remain about aspects of the disorder. For example, there is doubt about whether it is distinct from high-functioning autism (HFA); partly because of this, its prevalence is not firmly established. It has been proposed that the diagnosis of Asperger's be eliminated, to be replaced by a diagnosis of autism spectrum disorder on a severity scale."

Continuing the Wikiquote, "Many children with AS are initially misdiagnosed with attention-deficit hyperactivity disorder (ADHD). Diagnosing adults is more challenging, as standard diagnostic criteria are designed for children and the expression of AS changes with age; adult diagnosis requires painstaking clinical examination and thorough medical history gained from both the individual and other people who know the person, focusing on childhood behavior. Conditions that must be considered in a differential diagnosis include other ASDs, the schizophrenia spectrum, ADHD, obsessive compulsive disorder, major depressive disorder, semantic pragmatic disorder, nonverbal learning disorder, Tourette syndrome, stereotypic movement disorder, and bipolar disorder."

Now, in my heart, I don't really believe I'm an Aspie, but I've long suspected my older brother, Alfred, could be. How else could he beat me at chess nine billion times? Why else would he floss his teeth in public? But then again, he could simply be an bridge engineer, like he claims to be. So, I agree to take Dr. R.'s assessment test, just to see what's what, and OK, to also have a test on hand to spring on my brother, the next time he comes to town.

Pretty soon, I find I'm answering yes to an awful lot of the tells. I have super-hearing, I hate loud noises, I wear the same style clothes week after week, almost like a uniform. I have an awesome visual memory, and so on. I wasn't expecting this. Uh-oh. To quote Homer Simpson, "D'oh!"

I still don't believe it though, because I'm far too aware of "social cues." When I worked retail in the eighties with four or five managers, I got to where I could smell even the faintest whiff of their latest top-secret management coups a mile away. I was like one of those canaries in the coal mines. Sadly, whenever one of the supreme leaders attained dominance, the others would immediately form a new coalition to overthrow her regime. On, and on, and on the leadership paradigm shifts rock and rolled. Those yentas were a real bad-news gang of retail warlords. It's was all during the lost Cabbage Patch Doll and Tickle Me Elmo decade. Thank God, I finally got out when I switched jobs to become the company courrier.

A must-read, hilarious memoir by an actual Aspie is Look Me in the Eye by John Elder Robison.


 A New York Times Bestseller

“As sweet and funny and sad and true and heartfelt a memoir as one could find.”—from the foreword by Augusten Burroughs

"Ever since he was young, John Robison longed to connect with other people, but by the time he was a teenager, his odd habits—an inclination to blurt out non sequiturs, avoid eye contact, dismantle radios, and dig five-foot holes (and stick his younger brother, Augusten Burroughs, in them)—had earned him the label “social deviant.” It was not until he was forty that he was diagnosed with a form of autism called Asperger’s syndrome. That understanding transformed the way he saw himself—and the world. A born storyteller, Robison has written a moving, darkly funny memoir about a life that has taken him from developing exploding guitars for KISS to building a family of his own. It’s a strange, sly, indelible account—sometimes alien yet always deeply human."

As we go over the test results, Dr. R. waffles a bit in his interpretation, "You might not have Asperger's -- you might just be 'talented.'"

Talented? Are you kidding me?, I think, "Is that a sho' nuff' mental disorder, now? It used to be a point of pride when I went to Roger's Park Elementary School."

When my brother blew into to town this April for an Engineering Conference, I got my chance to pepper him with the Aspie questions. Unperturbed, half-way through the grilling, he interrupts the endless "on a scale of 0-5..."  probes to serve up this joke, "What's the difference between an introverted and an extroverted engineer? An introverted engineer looks at his shoes; an extroverted one looks at your shoes."

Damn -- that's good.