Conditions on the OCD Spectrum

Page content

A number of psychiatric conditions have been identified as being part of the OCD spectrum. The common factor of all of these is the presence of repetitive thoughts or behaviors. The sufferer commonly has obsessive thoughts and these are played out by compulsive, repetitive behavior. The person feels powerless to stop the cycle and their condition may isolate them socially. Some of the more common disorders on the spectrum are looked at in detail below.

Body Dysmorphic Disorder

This condition is considered the one most similar to OCD. A person is convinced that their physical appearance is lacking in some way and that they appear ugly, deformed or defective. If there is a genuine problem with some part of their body, it is usually minor and unnoticeable to most people. In other cases, the supposed fault does not exist at all. In spite of this, the sufferer becomes obsessed with their physical appearance and may go to extreme lengths to try and disguise the supposed defect. The perceived problems may be related to one of the following:

  • Scars or skin discoloration
  • Moles and freckles
  • Pimples and skin conditions
  • Too much or too little hair
  • Size and shape of genitals and breasts
  • Size of muscles
  • Shape, size and symmetry of face or other body parts

In an effort to fix their physical appearance, a person with body dysmorphic disorder often employs one or more of the following methods:

  • Repetitive scrutiny of the supposed defect
  • Repetitive grooming or application of makeup in attempt to disguise the problem
  • Clothing may be chosen or arranged so as to hide a perceived deformity
  • Avoidance of mirrors and photographs of themselves
  • An excessive amount of medical procedures and visits to doctors and dermatologists to try and repair the fault

Hair Pulling

Hair pulling or trichotillomania is the practice of pulling out one’s own hair. This behavior is repetitive and compulsive and although the person may be embarrassed by the resulting bald spots, they feel powerless to stop the cycle. The most common sites for hair pulling are the scalp and face but some people also pull hair from their pubic regions, arms, chest and legs. They may use their fingers but sometimes tweezers are preferred. Social isolation is common as sufferers don’t want people to know they have a problem. When they do have to interact with others, they may wear clothing or accessories that hide the results of the hair pulling. These may include long-sleeved shirts, hats, caps and false eyelashes.

A person normally engages in hair pulling while alone. It may be done as a conscious behavior but is often something the sufferer does while reading, watching television or driving. As such it becomes a bad habit as well as a compulsive repetitive behavior.


Hoarding is a problem that many people are aware of. However, not everyone realizes that it may be related to OCD and the spectrum of conditions that sometimes accompany it. Hoarding is defined as the collection and accumulation of apparently worthless items. In a serious case, the clutter may take over the person’s home and living space and cause problems with their health. Obsessive hoarders collect items for a number because they are unable to make decisions over whether something is of value or not and they fear that if they throw something away, they will need it later.

Many hoarders collect the same type of things and these include the following:

  • Newspapers, magazines and junk mail
  • Old receipts, shopping lists and bills
  • Plastic bags, margarine containers and milk cartons
  • Screws, nuts, bolts, wire and other hardware-related items
  • Old washing machines, car tires, pianos and electrical appliances

A hoarder is usually attached to their collection of junk even though they may acknowledge that it is worthless and are embarrassed by the extent of it. Any suggestion of cleaning up the mess is often met with great resistance and the person may become extremely distressed if someone throws away any of their stuff. This can place pressure on family members living with a hoarder and eventually the clutter may cover the floor, chairs, tables and every surface in their home.

As seen from the above examples, the OCD spectrum includes a variety of different conditions. The link to OCD is the repetitive and obsessive nature of a person’s thoughts and actions. Identifying and understanding a disorder is often the first step towards finding help and effective treatment to overcome it.


The Austin Center for the Treatment of Obsessive-Compulsive Disorder:

OCD Spectrum Clinic:

Lori Riddle-Walker MFT:

Wiley Online Library: