Criteria for diagnosis of OCD (DSM-5)
To be diagnosed with OCD, a person must meet the following criteria:
1. Presence of obsessions, compulsions, or both
2. Obsessions or compulsions are time-consuming (> 1 hour per day) or cause significant distress or impairment in one's daily functioning
3. Symptoms are not better accounted for by the physiological effects of a substance, medical condition, or other mental illness
What are obsessions and compulsions?
Obsessions are recurrent, persistent, intrusive, and unwanted thoughts, images, or urges that cause anxiety or distress.
Compulsions are repetitive behaviours or mental acts performed according to a rigid set of rules. They are clearly excessive or not connected realistically to the problem they are intended to address.
How OCD impacts life - the process
For example, an individual with OCD may become obsessed with the worry that they will unintentionally cause a fire in their home due to carelessness. The fear becomes so overwhelming that it drives them to perform compulsions (e.g. checking all the outlets in their home before leaving the house), to reduce the perceived risk that a fire will occur. Doing so drastically diminishes the anxiety associated with the obsession.
Characteristics of OCD obsessions
Obsessions in OCD are distressing, time-consuming, and fear-driven. Below are some characteristics:
1. Internal experiences occur repeatedly, are unwanted, and feel as though they are outside of the individual’s control
2. They cause a great deal of discomfort, such as anxiety, disgust, fear, and may be overwhelming
3. The persistence of these ideas interferes with the person's ability to attend to other things of importance to them
Common types of obsession
1. | Obsessions related to contamination (e.g. dirt, germs, bodily fluids) |
2. | Harm obsessions - fear of unintentionally causing harm through carelessness |
3. | Unwanted sexual thoughts |
4. | Religiosity/ scrupulosity - obsessive thoughts, worries, concerns about moral judgement and behaviours |
5. | Fear of losing control |
Common types of obsession
6. | Perfectionism - concern with evenness, exactness, symmetry, adhering to rigid routine or expectation, an overall need for something to feel “just right” |
7. | Preoccupied with worries that they have a disease or might get one |
8. | Superstitious beliefs - belief that certain numbers, colors, words, or phrases are lucky or unlucky, and may go to great lengths to avoid them or use compensatory compulsive behaviours to quell the anxiety |