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.
- Number of questions
- 24 questions
- Estimated duration
- 6 minutes
- Language
- English
- Original name
- Obsessive Thoughts and Compulsions Inventory
- Target audience
- Adults
- Exploratory questionnaire
- Exploratory questionnaire
Preview of the 24 questions
Scoring & interpretation
Scoring
| Symmetry and order | 10 / 16 |
A need for things to be exact, lined up, or done "just right," with arranging, repeating, and counting.
Areas to explore: what has to be exact, the discomfort felt until it is done, how much is magical thinking ("otherwise something bad will happen") and how much is simple discomfort.
See also: DOCS.
| Contamination and washing | 9 / 16 |
Fear of being dirtied or contaminated or of spreading an illness, with washing, cleaning, and avoidance of contact.
Areas to explore: what the person fears (illness, dirt, disgust, a feeling of being soiled), the washing and how long it lasts, the objects and places avoided, the condition of the skin.
See also: DOCS, OCI-R.
| Responsibility, doubt, and checking | 9 / 16 |
Fear of causing harm through carelessness, doubt about one's own actions, checking, and the need to redo things.
Areas to explore: the disasters feared, the sense of responsibility, what the person checks and how many times, what allows them to stop.
See also: DOCS, OBQ-44.
| Impact | 9 / 16 |
Time lost, avoidance, exhaustion, and the place rituals take in the lives of the people around the person.
Areas to explore: the time taken up each day, activities given up, how family members take part or adapt (family accommodation), what led the person to seek help.
See also: Y-BOCS.
| Unacceptable thoughts | 6 / 16 |
Aggressive, sexual, or religious thoughts, images, or impulses, experienced as shocking and contrary to one's values.
Areas to explore: the content of the thoughts when it can be put into words, what the person believes the thoughts reveal about them, what they do to protect themselves (avoiding knives, certain people, or certain places).
See also: DOCS, OII.
| Neutralizing and reassurance | 6 / 16 |
Mental rituals, actions, or prayers to push away a thought or prevent danger, and repeated requests for confirmation.
Areas to explore: mental rituals, which are often invisible, questions put to loved ones or searches online, the effect of reassurance and how long it lasts.
See also: TCQ.
No validated clinical or psychometric cutoffs have been established for this test yet. The results should therefore be considered exploratory indicators, meant to support the clinical interview, not diagnostic findings.
Scoring
Each statement is scored from 0 (never) to 4 (very often) based on its frequency over the past month. Each domain combines 4 statements spread throughout the questionnaire, giving a score from 0 to 16.
Reading the profile
There is no total score. Domains are ranked from most to least elevated, each with a description of what it covers and points to explore in the interview. The four thematic domains (contamination, responsibility, unacceptable thoughts, symmetry) correspond to the main dimensions of obsessive-compulsive symptoms, which often occur together; "Neutralizing and reassurance" and "Impact" describe what keeps the symptoms going and what they cost, including for family members. Unacceptable thoughts without visible rituals often come with mental neutralizing or reassurance seeking, which should be included in response prevention just like observable rituals.
Clinical cautions
The aggressive or sexual thoughts explored here are intrusions that the person experiences as contrary to their values: on their own, they do not signal a risk of acting on them, and an alarmed reaction reinforces shame and secrecy. Thoughts experienced with desire or without distress call for a different evaluation. The questionnaire explores neither hoarding nor body-focused repetitive behaviors (hair pulling, skin picking), which should be looked for in the interview.
Limitations
This exploratory questionnaire has not undergone psychometric validation and has no cutoffs. It supports the clinical interview and does not provide a diagnosis.
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