Common Obsessions and Compulsions to Assist in the Diagnosis of OCD
Merlo & Storch (2006), identified in The Journal of Family Practice, common obsessions and compulsions related to OCD. Common obsessions include those of contamination, aggression, sexual, hoarding, magical thinking, health related, mortality and religion amongst many other miscellaneous topics of concern. Contamination obsessions are often evidenced by distress caused by dirt, germs, disease, illnesses etcetera. Aggressive obsessions may include the harming of oneself or others due to acting on impulses behaviorally or through thoughts. Frightening and violent mental images are examples of compulsions marked by aggression. Sexual obsessions include forbidden thoughts, images, impulses, desires and sexual acts toward others. Obsessional hoarding or saving is characterized by distress due to losing things or throwing away objects that may hold some significance or value. Magical thinking encompasses obsessive thoughts or beliefs holding great significance such as lucky or unlucky numbers, colors and names. Health or body obsessions may be related to fear of contracting an illness, physical appearance, and physical abnormalities that may be real or imagined. Obsessions related to mortality and religion are often associated with dying and not going to heaven, offending God, being sinful, and right vs. wrong. The final miscellaneous obsessions include memorization, music, numbers or the avoidance of the use of specific words (Merlo & Storch, 2006). These obsessive concerns are commonly present when diagnosing OCD and are used in the Yale-Brown Obsessive-Compulsive Scale, as are the following compulsive rituals.
Common compulsions in the diagnosis of OCD include washing and cleaning, checking, repeating, counting, ordering or arranging, hoarding and saving, superstitions, reassurance seeking as well as miscellaneous compulsive rituals (Merlo & Storch, 2006). Merlo & Storch (2006) compiled the following descriptions as derived from the Yale-Brown Obsessive-Compulsive Scale. Washing and cleaning compulsions include excessive cleansing and avoidance of contamination. Checking is often characterized by rituals to ensure safety such as inspection of locks and alarms. Checking also includes intense scrutiny to avoid mistakes. Repeating includes rewriting, rereading, recopying and repetitious actions. Counting can be related to specific objects that a subject counts such as stairs, tiles and chewing or mental counting until reaching a magic number. Ordering or arranging includes lining objects in a specific manner, sometimes including patterns or even groups that create symmetry in appearance. Hoarding and saving includes keeping unimportant and unnecessary objects, sometimes including trash. Superstitious compulsions are completed to prevent bad things from happening such as the avoidance of stepping on cracks or repetitive touching or tapping. Reassurance seeking compulsions can include repeatedly asking the same questions or forcing family members to operate in certain ways while avoiding specific things or activities.