(DSM-V, 2013) Preoccupations and rituals that are performed excessively or persistently beyond appropriate periods. An obsession is a persistent or recurrent thought, urge, or image that is intrusive and unwanted. A compulsion is a repetitive behavior or mental act that one is driven to perform responding to a rigid rule or obsession. 

Obsessive Compulsive Disorder (OCD)

(DSM-V, 2013) Obsessions and compulsions must be present. Examples of obsessive behavior consist of thoughts (e.g., of contamination), images (e.g., of a violent or horrific scene), or urges (e.g., to stab someone). An obsession is not a voluntary experience nor is it pleasurable; it is unwanted and intrusive cause stress or anxiety. An individual will try to ignore an obsessive behavior by avoiding triggers, suppress it with thought suppression techniques, or neutralize it by performing another action like a compulsion. A compulsion is a ritual or repetitive behavior or mental act one will perform in response to an obsession following a set of specific rigid rules. An example of OCD is the obsession with becoming contaminated causing washing rituals. 

Body Dysmorphic Disorder

(DSM-V, 2013) An individual whom is absorbed in one or more self-perceived flaw or defect in their physical appearance that will think looks ugly, unattractive, abnormal, or deformed. The preoccupations will last anywhere from 3-8 hours of the day, challenging to control or resist, and are un-wanted or intrusive. The perceived flaw is not perceived by others and can range from mild sense of looking “unattractive” or “not right” to looking “hideous” or “like a monster.” The flaws can be perceived on any part of the body; skin (e.g., acne, scars, lines, wrinkles, paleness), hair (e.g., “thinning” hair or “excessive” body or facial hair), nose (e.g., size or shape), asymmetry of the body, or other parts of the body (e.g., eyes, teeth, weight, stomach, breasts, legs, face size or shape, lips, chin, eyebrows, genitals). 

Hoarding Disorder

(DSM-V, 2013) A persistent difficulty parting with possessions by means of selling, throwing away, recycling or giving away regardless of value. It is typically a long standing concern as opposed to a short term issue of clutter. These items are perceived to have a high value in their usefulness, beauty, or sentimentality. Some typical items that individuals will hold on to are newspapers, magazines, old clothing, bags, books, mail, paperwork, and just about any item can be held on to including expensive items that can get mixed in with the less valuable items.

Trichotillomania (Hair Pulling Disorder)

(DSM-V, 2013) The recurrent pulling out of one’s hair. The hair pulling can transpire in any area of the body but most often occurs from the scalp, eyebrows, and eyelids. Less common areas of occurrence are from axillary, facial, pubic, and peri-rectal regions. Over time locations of hair pulling may vary and can occur in brief moments throughout the day or for hours over a span of months to years. Some cases lead to hair loss that the individual may try and conceal.

Excoriation (Skin Picking) Disorder

(DSM-V, 2013) The recurrent picking at one’s skin. The most common areas of picking occur on the face, arms, and hands but can occur on any area of the body. The individual may pick at healthy skin, minor irregularities, lesions like pimples or calluses, or at scabs. Most commonly use their fingertips but some may use tools such as tweezers, pins, or another type of an object. In addition to the behavior of picking there may also be actions of rubbing, squeezing, lancing, or biting. Episodes can last up to several hours of a day and for a span of time from months to years. Some cases may develop lesions so severe that they will try and conceal them from others view.


Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Arlington, VA, American Psychiatric Association, 2013.