Harm OCD: 1 questionnaire and rating scale
Harm OCD shows up as an intrusive fear of committing a violent or unacceptable act against one's will, with no desire to do so and no acting out. Related questionnaires quantify these obsessions and the associated distress, and support screening and monitoring.
OTCI
Obsessive Thoughts and Compulsions Inventory
This exploratory questionnaire describes obsessions and compulsions by their main themes (contamination and washing, responsibility and checking, unacceptable thoughts, symmetry and order), along with mental rituals, reassurance seeking, and the impact on daily life. It helps name the aggressive, sexual, or religious thoughts that patients rarely bring up on their own and identify the role family members have taken on. Useful when obsessive-compulsive disorder (OCD) is being considered, the profile guides the choice of initial targets for exposure and response prevention.
Frequently asked questions
Does harm OCD mean the person will act on their thoughts?
No. These are ego-dystonic intrusive thoughts, dreaded by the person themselves. They belong to the obsessional register, not to an aggressive intent.
What type of scale should I use?
Instruments from the obsessive-compulsive spectrum are most often used, as they explore obsessions and the associated distress. Each questionnaire listed here shows its description and administration time.
Should I reassure the patient?
Repeated reassurance brings short-term relief but maintains the disorder. Quantifying symptoms with a scale helps tell the obsession apart from an intention and guides treatment.
Harm OCD in clinical practice
Harm OCD, also called impulse phobia, refers to an obsessive fear of losing control and committing an aggressive or transgressive act (hurting a loved one, jumping from a height). These thoughts are ego-dystonic and experienced as intrusive and distressing.
Far from signaling an intent to act, it belongs to the obsessional register: the person fears precisely what they condemn. It is often linked to the OCD spectrum and assessed with similar instruments.
- Harm OCD is not a distinct DSM-5 category; it resembles the obsessions of obsessive-compulsive disorder.
- The risk of acting on these thoughts is considered very low: the distress stems from the conflict between the thought and the person's values.
- Reassurance seeking and avoidance maintain the disorder; identifying them guides treatment.