Obsessive-compulsive disorder

A disorder involving obsessions, compulsions or both with clinically significant distress, time cost or impairment. Compulsions may be overt or mental. Unwanted thoughts alone are insufficient to establish the disorder; their appraisal and associated responses matter.

Changes by relatives or carers that facilitate avoidance or rituals, such as supplying repeated reassurance or completing checks. Addressing accommodation collaboratively can support treatment without blaming the family for the origin of the disorder.

An excessive appraisal of personal responsibility for causing or preventing harm. It can make ordinary uncertainty feel unacceptable and motivate repeated checking or neutralization.^[ref]

A repetitive behavior or mental act performed according to rules or in response to an obsession, commonly to reduce distress or prevent a feared outcome. Covert neutralization can serve the same maintaining function as a visible ritual.

A covert mental act intended to cancel a threat, remove a thought's significance or prevent a feared outcome. Mental neutralization can preserve a compulsion cycle even when visible rituals have decreased.

A recurrent intrusive thought, image or urge experienced as unwanted, often associated with distress and attempts to suppress or neutralize it. An intrusive thought's content is not by itself a measure of intention or a substitute for assessment.