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Obsessions and Compulsions Checklist

PART A

Have you been bothered by unpleasant thoughts or images that repeatedly enter your mind such as:

1. concerns with contamination (dirt, germs, chemicals, radiation) or acquiring a serious illness such as AIDS?
Yes No

2. over concern with keeping objects (clothing, groceries, tools) in perfect order or arranged exactly?
Yes No

3. images of death or other horrible events?
Yes No

4. personally unacceptable religious or sexual thoughts?
Yes No


Have you worried a lot about terrible things such as:

5. fire, burglary, or flooding the house?
Yes No

6. accidentally hitting a pedestrian with your car or letting it roll down the hill?
Yes No

7. spreading an illness (giving someone AIDS)?
Yes No

8. losing something valuable?
Yes No

9. harm coming to a loved one because you weren't careful enough?
Yes No


Have you worried about acting on an unwanted and senseless urge or impulse, such as:

10. Physically harming a loved one, pushing a stranger in front of a bus, steering your car into oncoming traffic; inappropriate sexual contact; or poisoning dinner guests?
Yes No


Have you felt driven to perform certain acts over and over again, such as:

11. Excessive or ritualized washing, cleaning, or grooming?
Yes No

12. checking light switches, water faucets, the stove, door locks, or emergency brake?
Yes No

13. counting; arranging; evening-up behaviors (making sure socks are at same height)?
Yes No

14. collecting useless objects or inspecting the garbage before it is thrown out?
Yes No

15. repeating routine actions (in/out of chair, going through doorway, re-lighting cigarette) a certain number of times or until it feels just right?
Yes No

16. need to touch objects or people?
Yes No

17. unnecessary rereading or rewriting; reopening envelopes before they are mailed?
Yes No

18. examining your body for signs of illness?
Yes No

19. avoiding colors ("red" means blood), numbers ("l 3" is unlucky), or names (those that start with "D" signify death) that are associated with dreaded events or unpleasant thoughts?
Yes No

20. needing to "confess" or repeatedly asking for reassurance that you said or did something correctly?
Yes No

So . . . is your score 2 or greater? If yes, complete part B below:


PART B - The following questions refer to the repeated thoughts, images, urges, or behaviors identified in Part A. Consider your experience during the past 30 days when selecting an answer.

1. On average, how much time is occupied by these thoughts or behaviors each day?
None
Mild (less than 1 hour)
Moderate (1 to 3 hours)
Severe (3 to 8 hours)
Extreme (debilitating)

2. How Much distress do they cause you?
None
Mild
Moderate
Severe
Extreme (debilitating)

3. How hard is it for you to control them?
Complete Control
Much Control
Moderate Control
Little Control
No Control

4. How much do they cause you to avoid doing anything, going any place, or being with anyone?
No Avoidance
Occasional Avoidance
Moderate Avoidance
Frequent and Extensive Avoidance
Extreme Avoidance (house bound)

5. How much do they interfere with school, work or your social or family life?
None
Slight Interference
Definitely Interferes with Functioning
Much Interference
Extreme (disabling)

Scoring: If you answered YES to 2 or more of questions in Part A and scored 5 or more on Part B, you may wish to contact your physician, the Center for Psychological Services (775-3407), or a patient advocacy group (such as, the Obsessive Compulsive Foundation, Inc.) to obtain more information on OCD and its treatment. Remember, a high score on this questionnaire does not necessarily mean you have OCD--only an evaluation by an experienced clinician can make this determination.

© Wayne K. Goodman, M.D., 1994, University of Florida College of Medicine

You do not have to deal with this alone. Seek assistance!
Call the Counseling and Wellness Services at 775-3407.

Counseling & Wellness Services
053 Student Union
937-775-3407
Hours:  Monday through Friday 8:30 am - 5:00 pm