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Common Obsessions — Symptoms of Pediatric OCD

UPMC Content 2

Obsessions — or repeating, unwanted thoughts — are a symptom of obsessive compulsive disorder (OCD).

Children and adolescents with OCD may have these common obsessions:

Contamination Worries

  • Dirt, germs, bodily fluids, or illnesses
  • Taking on personality traits of others
  • Animals or insects causing illness
  • Household cleaners, solvents, or environmental wastes leading to sickness or injury

Fear of “Bad Things” Happening, Aggressive Thoughts

  • Not being able to control impulses
  • Harming a loved one
  • Environmental disasters
  • Excessive doubt about possessing a stolen item
  • Violent images of harm coming to self or others

Need for Symmetry, Precision (“Just Right” OCD)

  • Not tolerating items out of place
  • Not tolerating the texture of clothing or food
  • Overwhelming feeling that something must be fixed or finished
  • Extreme discomfort when something feels uneven
  • Difficulty making transitions

Urge to Tell, Confess, Ask, Know With Certainty

  • Need to confess every detail about the day
  • Uncertainty about understanding directions perfectly
  • Not tolerating responses that are vague, such as “I don't know” or “maybe” 

Saving, Hoarding

  • Overwhelming need to acquire objects, even if not needed
  • Need to collect or carry items in pockets of no value (e.g., lint, pieces of paper from the floor)

Moral Dilemma and Religious Preoccupations (Scrupulosity)

  • Extreme fear of telling a lie or having an “impure” thought
  • Excessive concern about being right or wrong, or morally acceptable or offensive
  • Excessive worry about offending religious figures or objects
  • Rigid preoccupation with rules
  • Distressing images or thoughts about what happens after death
  • Preoccupation with making the “right” decision

Sexual and “Forbidden” Thoughts

  • Worry that he or she has sexually assaulted a stranger
  • Worry about behaving in a sexually inappropriate way toward a loved one
  • Doubts about sexual orientation

Magical Thinking

  • Associating certain numbers, colors, words, or personal behaviors with other people's actions or the outcomes of events

Make an Appointment With the Pediatric OCD Program

To a schedule an evaluation of your child's symptoms to see if they meet the criteria for an OCD diagnosis, or to discuss OCD treatment options, call 412-235-5354.