While those without primarily obsessional OCD might instinctively respond to bizarre, intrusive thoughts or impulses as insignificant and part of a normal variance in the human mind, someone with Pure-O will respond with profound alarm followed by an intense attempt to neutralize the thought or avoid having the thought again. They will understand that these fears are unlikely or even impossible but the anxiety felt will make the obsession seem real and meaningful. An example of this difference could be that someone with traditional OCD is overly concerned or worried about security or cleanliness, whereas someone with Pure-O may be terrified that they have undergone a radical change in their sexuality (e.g., might be or might have changed into a pedophile), that they might be a murderer, or that they might cause any form of harm to a loved one or an innocent person or to themselves, or that they will go insane. Pure-O fears usually focus on self-devastating scenarios that they feel would ruin their life or the lives of those around them. The fears associated with primarily obsessional OCD tend to be far more personal and terrifying for the affected individual than the fears of someone with traditional OCD. The nature and type of primarily obsessional OCD vary greatly, but the central theme for all affected is the emergence of a disturbing, intrusive thought or question, an unwanted/inappropriate mental image, or a frightening impulse that causes the person extreme anxiety because it is antithetical to closely held religious beliefs, morals, or societal norms. to yourself or others." The thoughts "quite likely, are of an aggressive or sexual nature." ![]() ![]() Primarily obsessional OCD has been called "one of the most distressing and challenging forms of OCD." People with this form of OCD have "distressing and unwanted thoughts pop into head frequently," and the thoughts "typically center on a fear that you may do something totally uncharacteristic of yourself, something. The distinction between the presence of subclinical symptoms and a clinical disorder requires assessment of a number of factors, including the individual's level of distress and impairment in functioning." Presentation Īccording to the DSM-5, "The obsessive-compulsive and related disorders differ from developmentally normative preoccupations and rituals by being excessive or persisting beyond developmentally appropriate periods. Primarily obsessional OCD takes the form of intrusive thoughts often of a distressing, sexual, or violent nature (e.g., fear of acting on impulses). While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD (checking, counting, hand-washing, etc.). ![]() Primarily obsessional obsessive–compulsive disorder, also known as purely obsessional obsessive–compulsive disorder ( Pure O), is a lesser-known form or manifestation of OCD. Lesser-known form of OCD involving mostly mental compulsions that are difficult to observe
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