It is likely for someone with Obsessive-Compulsive Disorder (OCD) to be preoccupied with cleanliness, order, hygiene, and safety. However, there is a thin line between having OCD and just being tidy and neat, cautious, and clean. Where do professionals draw the line and when is such behaviour a problem? Diagnosing OCD is a difficult task, performed by professionals such as therapists, psychiatrists and general practitioners.
These professionals need to focus on many different aspects before a diagnosis can be made. While diagnosing OCD, a professional needs to be aware of the cultural background of the person, because superstitious behaviour and rituals are more common among certain cultures compared to others.
Rituals and superstitious behaviour are also very common among (professional) sportsmen. However, sportsmen and/or people from cultures rich in rituals and superstitious behaviour, are most likely not suffering from OCD. Someone needs to suffer from the OCD symptoms listed below to be able to get diagnosed with OCD. When someone is suffering from OCD symptoms, it’s important for that person to get the right treatment. Diagnosing OCD is important because a proper diagnosis can help people find the right treatment for their issues. At the same time, a professional can rule out other mental disorders as a possible explanation for someone’s issues. This page focuses on the OCD criteria and explains some of the symptoms in more detail.
At Barends Psychology Practice obsessive-compulsive disorder treatment is offered (also online). Go to contact us to schedule a first, free of charge, first session.(Depending on your health insurance, treatment may be reimbursed).
Diagnosing OCD – the criteria according to the DSM
Someone can experience obsessions, compulsions or both. The criteria for each of them are listed below:
Someone meets the criteria for obsessions if the following 4 components are present:
Thoughts are reoccurring and persistent, with impulses and images being experienced as intrusive and causing great anxiety. Such as thoughts of catching a disease or illness, losing your job, or accidents that are causing great anxiety.
These thoughts are not just excessive worries about real life problems. If you made a couple of horrible mistakes at work, chances of getting fired increase. If you have a malign brain tumor chances of dying increase as well. For you these may be real life problems. However, for people with OCD, there is no indication for them to worry about such things at all.
The sufferer tries to suppress, ignore or neutralize the unwanted thoughts by forcing other thoughts or actions. For instance thinking about preventing a horrible accident from happening by looking left and right 25 times in a row before crossing a street.
And that the sufferer recognizes that these thoughts are produced by their own mind, and not caused by a true threat. Someone with OCD must be aware of the fact that their thoughts are unrealistic and that their neutralizing behaviour is out of proportion to the threat.
Examples for obsessive thoughts include unwanted thoughts of harming loved ones, fears of having not turned off appliances, fears of being unclean or contaminated, and intrusive sexual or violent thoughts that the person doesn’t want.
Someone meets the criteria for compulsions if the following 2 components are present:
Mental acts or repetitive behaviours that someone feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. Examples of mental acts are praying, repeating words (silently), and counting. Examples of repetitive behaviours are checking, hand washing, and ordering.
The aim of these behaviours or mental acts ais to reduce or prevent distress or to prevent some dreaded event or situation from happening. NOTE: these behaviours or mental acts are not connected in a realistic way to prevent or neutralize an event/feeling or are clearly excessive. Hand washing helps you to get rid of bacteria and dirt, so it helps you reducing distress. However, washing your hands 10 times in a row is excessive and redundant. Hopping 3 times on your left foot before hopping 3 times on your right does not prevent a dreaded event from happening.
Recent research has found that OCD sufferers tend to have obsessions and compulsions that have been categorized into 5 main groups:
Obsessions about being responsible for causing or not preventing harm; compulsive checking and need for reassurance.
Obsessions with symmetry; compulsive order and counting rituals.
Obsessions with contamination; compulsive washing and cleaning rituals.
Repulsive obsessions about violence, sex and religion.
Obsessions with collecting or keeping items; compulsive collecting behaviours.
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Other OCD criteria:
Criteria B: The person has recognized that the obsessions and/or compulsions as states above are excessive or unreasonable. Criteria C: The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships. Criteria D: If another Axis I disorder (all mental disorders except personality disorders and mental retardation) is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorders; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).
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Criteria E: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.