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Introduction to Obsessive-Compulsive Spectrum Disorders

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C. E. Zupanick, Psy.D.

Lonely treeimage by karol m (lic)Obsessive-compulsive spectrum disorders are a group of similar psychiatric disorders. These disorders are characterized by repetitive thoughts, distressing emotions, and compulsive behaviors. The specific types of thoughts, emotions, and behaviors vary according to each disorder. These disorders are:

1. obsessive-compulsive disorder (OCD);
2. body dysmorphic disorder (BDD);
3. hoarding disorder;
4. hair-pulling disorder (trichotillomania); and,
5. skin-picking disorder (excoriation).

Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted. Common obsessional themes include concerns about contamination; harm happening to oneself or others; intrusive sexual thoughts; religious preoccupation and rituals; repeated and excessive doubts about safety and security; the need for symmetry and order; and perfectionism. Because obsessions are unwanted, they create anxiety and distress when they occur. To reduce this discomfort people perform compulsions.

Compulsions are behaviors or mental acts that a person feels "driven" to perform in response to an obsession. Common compulsions include excessive hand washing; re-ordering objects in a specific way; checking on safety and security (a door lock, an electric appliance); counting (aloud or silently); and the ritualistic repetition of prayers in one's mind. Obsessive-compulsive spectrum disorders share many similar features. However, there are also important differences. The following example illustrates the importance of these differences.