Obsessive Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is a condition in which an individual experiences intrusive thoughts, images, or impulses which create a high degree of emotional distress. Although these emotions primarily involve anxious arousal; guilt and disgust may also be experienced. For example, a woman with OCD, may experience an obsession which involves the thought or image of killing her child by stabbing him or her. This intrusive thought causes her to feel anxious, disgusted with herself, as well as guilt-ridden. This emotional distress is triggered by not only the intrusive thought, but primarily because this thought is ego-dystonic (i.e., not a true representation of her true personality). As a result of this emotional distress, the person feels a need to perform some type of ritual (either overt or covert in nature). The ritual serves two functions: (1) to reduce the intensity of the anxiety, disgust, etc. and (2) to prevent or lessen the likelihood of acting on the thought/image. This is referred to as “thought-action fusion” (TAF).

The majority of individuals with OCD experience both obsessions and compulsions. Although individuals with OCD are aware that their rituals are senseless (unless they lack insight), they have great difficulty not engaging in their ritualistic behaviors, for the reasons mentioned above. The majority of people with OCD have both obsessions and compulsions, but a minority (about 20 percent) have obsessions alone or compulsions alone (about 10 percent).

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The DSM-5 criteria for Obsessive-Compulsive Disorder are:

The presence of obsessions, compulsions, or both. Obsessions are defined by (1) and (2) as follows:

1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and cause marked anxiety and distress

2. The person attempts to suppress or ignore such thoughts, impulses, or images or to neutralize them with some other thought or action

Compulsions are defined by (1) and (2) as follows:

1. Behaviors (i.e. hand washing, ordering, checking) or mental acts (eg, praying, counting, repeating words silently) in response to an obsession or according to rules that must be applied rigidly

2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a way that could realistically neutralize or prevent whatever they are meant to address, or they are clearly excessive.

Signs and symptoms

Common obsessions include the following:

  • Contamination

  • Safety

  • Doubting one’s memory or perception

  • Scrupulosity (need to do the right thing, fear of committing a transgression, often religious)

  • Need for order or symmetry

  • Unwanted, intrusive sexual/aggressive thoughts

Common compulsions include the following:

  • Cleaning/washing

  • Checking (eg, locks, stove, iron, safety of children)

  • Counting/repeating actions a certain number of times or until it “feels right”

  • Arranging objects

  • Touching/tapping objects

  • Hoarding

  • Confessing/seeking reassurance

  • List making

Do you think that you or someone you know are suffering from Obsessive Compulsive Disorder?

If so, Complete the following anonymous quiz: Free Obsessive Compulsive Disorder test

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