Intrusive thoughts, images, or urges
Unwanted thoughts that show up even when you do not want them.
Repetitive behaviors or mental rituals
Checking, washing, repeating, counting, reviewing, neutralizing.
Reassurance and certainty seeking
Asking, searching, confessing, repeating the question.
Avoidance and safety behaviors
Steering around triggers, extra steps, shrinking the map.
Time cost and interference
Hours, lateness, work, relationships, distress about the cost.
Insight and belief strength
How real the fear feels in the moment. Higher scores mean the fear felt more necessary or more literal.
Rule-out and overlap flags
These yes/no items are not added to the severity score. They help you notice other possible explanations.