Have you been bothered by unpleasant
thoughts or images that repeatedly enter your mind such
1. concerns with contamination
(dirt, germs, chemicals, radiation) or acquiring a serious
illness such as AIDS?
2. over concern with keeping objects
(clothing, groceries, tools) in perfect order or arranged
3. images of death or other horrible
4. personally unacceptable religious
or sexual thoughts?
Have you worried a lot about
terrible things such as:
5. fire, burglary, or flooding
6. accidentally hitting a pedestrian
with your car or letting it roll down the hill?
7. spreading an illness (giving
8. losing something valuable?
9. harm coming to a loved one
because you weren't careful enough?
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?
Have you felt driven to perform
certain acts over and over again, such as:
11. Excessive or ritualized washing,
cleaning, or grooming?
12. checking light switches, water
faucets, the stove, door locks, or emergency brake?
13. counting; arranging; evening-up
behaviors (making sure socks are at same height)?
14. collecting useless objects
or inspecting the garbage before it is thrown out?
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?
16. need to touch objects or people?
17. unnecessary rereading or rewriting;
reopening envelopes before they are mailed?
18. examining your body for signs
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?
20. needing to "confess" or repeatedly
asking for reassurance that you said or did something correctly?
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?
Mild (less than 1 hour)
Moderate (1 to 3 hours)
Severe (3 to 8 hours)
2. How Much distress do
they cause you?
3. How hard is it for you to control them?
4. How much do they cause you
to avoid doing anything, going any place, or
being with anyone?
Frequent and Extensive Avoidance
Extreme Avoidance (house bound)
5. How much do they interfere with
school, work or your social or family life?
Definitely Interferes with Functioning
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.