What is the difference between obsessions and compulsions in OCD?

• A. Obsessions are intrusive thoughts; compulsions are repetitive behaviors performed to reduce distress
• B. Obsessions are physical acts; compulsions are memories
• C. They are the same
• D. Compulsions are dangerous acts

Answer: (A)

Obsessions are intrusive, distressing thoughts, images, or urges that appear against a person’s will and trigger anxiety. Compulsions are repetitive behaviors or mental acts that the person feels driven to perform in response to those obsessions, with the goal of reducing distress or preventing a feared event, even though the actions may not be realistically connected to the outcome. This distinction is why the statement describing obsessions as intrusive thoughts and compulsions as repetitive behaviors to reduce distress is the best fit. For example, worry about contamination (obsession) often leads to excessive washing or ritualized checking (compulsions). The other characterizations mix up what obsessions and compulsions are (they are not physical acts or memories, they are not the same thing, and compulsions are not inherently dangerous, though they can be distressing and impairing).