OBSESSIVE CONCERNS CHECKLIST1 PAGE 1

Name: Date :

Age: Sex:

For some people certain thoughts may seem to occur against their will and they cannot get rid of them. Only
endorse items which apply to you due to: (1) their having been performed excessively, (2) their undesirability, (3)
your attempts to resist, and (4) their having interfered with your functioning in some way.
Rate the thoughts listed below from 1 to 5, according to the degree of disturbance during the past week:

1 – This thought does not trouble me at all

2 – This thought rarely troubles me (once a week or less)
3 – This thought often troubles me (several times weekly)
4 – This thought troubles me very often (daily)
5 – This thought troubles me continually (all waking hours)

I. AGGRESSIVE OBSESSIONS

Î Ï Ð Ñ Ò 1. Actively harming others intentionally

Î Ï Ð Ñ Ò 2. Harming yourself intentionally
Î Ï Ð Ñ Ò 3. Going crazy and harming others
Î Ï Ð Ñ Ò 4. Violent or repulsive images, thoughts or words
Î Ï Ð Ñ Ò 5. Blurting out obscenities or insults
Î Ï Ð Ñ Ò 6. Making embarrassing or obscene gestures
Î Ï Ð Ñ Ò 7. Writing obscenities
Î Ï Ð Ñ Ò 8. Acting out in antisocial ways in public
Î Ï Ð Ñ Ò 9. Having insulted or offended others
Î Ï Ð Ñ Ò 10. Acting on impulses to rob, steal from, take advantage of, or cheat others
Î Ï Ð Ñ Ò 11. Rejecting, divorcing, or being unfaithful to a loved one
Î Ï Ð Ñ Ò 12. Deliberately hoping that others will have accidents, become ill or die
Î Ï Ð Ñ Ò 13. Other:

II. SEXUAL OBSESSIONS

Î Ï Ð Ñ Ò 1. Forbidden or perverse thoughts, images or impulses

Î Ï Ð Ñ Ò 2. Sex with children
Î Ï Ð Ñ Ò 3. Sex with animals
Î Ï Ð Ñ Ò 4. Incest

1
From Freedom From Obsessive Compulsive Disorder: A Personalized Recovery Program for Living with
Uncertainty by Jonathan Grayson. Berkely/Penguin Press. NY. 2014. Adapted and Modified from Obsessive-
Compulsive Disorders: A Complete Guide to Getting Well And Staying Well by Fred Penzel.
OBSESSIVE CONCERNS CHECKLIST PAGE 2

Î Ï Ð Ñ Ò 5. Being homosexual or acting homosexually

Î Ï Ð Ñ Ò 6. Doubt about your sexual identity
Î Ï Ð Ñ Ò 7. Sex with religious figures or celebrities
Î Ï Ð Ñ Ò 8. Acting sexually toward others
Î Ï Ð Ñ Ò 9. Doubt about possibly having acted sexually toward others
Î Ï Ð Ñ Ò 10. Doubt about possibly having been acted upon sexually by others
Î Ï Ð Ñ Ò 11. Other:

III. CONTAMINATION OBSESSIONS

Î Ï Ð Ñ Ò 1. Bodily waste or secretions, e.g. feces, urine, saliva, perspiration, blood, semen
Î Ï Ð Ñ Ò 2. Dirt or grime
Î Ï Ð Ñ Ò 3. Germs, or viruses
Î Ï Ð Ñ Ò 4. Environmental contaminants (asbestos, lead, radiation, toxic wastes, etc.)
Î Ï Ð Ñ Ò 5. Household chemicals (cleansers, solvents, drain openers, insecticides)
Î Ï Ð Ñ Ò 6. Auto exhaust or other poisonous gases
Î Ï Ð Ñ Ò 7. Garbage, refuse, or their containers
Î Ï Ð Ñ Ò 8. Grease or greasy items
Î Ï Ð Ñ Ò 9. Sticky substances
Î Ï Ð Ñ Ò 10. Medication, or the effects of having ingested medication in the past
Î Ï Ð Ñ Ò 11. Your food or drink having been adulterated or tampered with by others
Î Ï Ð Ñ Ò 12. Broken glass
Î Ï Ð Ñ Ò 13. Poisonous plants
Î Ï Ð Ñ Ò 14. Contact with live animals
Î Ï Ð Ñ Ò 15. Contact with dead animals Contact with insects
Î Ï Ð Ñ Ò 16. Contact with other people
Î Ï Ð Ñ Ò 17. Contact with unclean or shabby looking people
Î Ï Ð Ñ Ò 18. Contracting an unspecified illness
Î Ï Ð Ñ Ò 19. Contracting a specific illness:
Î Ï Ð Ñ Ò 20. Spreading illness to, or contaminating others
Î Ï Ð Ñ Ò 21. Hospitals, doctor's offices and health care workers
Î Ï Ð Ñ Ò 22. Leaving or spreading an essence or trace of yourself behind on objects or others
Î Ï Ð Ñ Ò 23. Being contaminated by thoughts of harm happening to yourself or others
Î Ï Ð Ñ Ò 24. A specific person, or place felt to be contaminated in some nonspecific way
Î Ï Ð Ñ Ò 25. Being contaminated by certain words:
Î Ï Ð Ñ Ò 26. Being contaminated by the names of certain illnesses
Î Ï Ð Ñ Ò 27. Being contaminated by seeing an ill or disabled person
Î Ï Ð Ñ Ò 28. Being contaminated by the memory of a person who has died
OBSESSIVE CONCERNS CHECKLIST PAGE 3

Î Ï Ð Ñ Ò 29. Being contaminated by certain numbers or their multiples

Î Ï Ð Ñ Ò 30. Being contaminated by certain colors
Î Ï Ð Ñ Ò 31. Your belongings being contaminated by having been present or used when something
unpleasant was occurring
Î Ï Ð Ñ Ò 32. Being contaminated by evil or the devil
Î Ï Ð Ñ Ò 33. Other:

IV. RELIGIOUS OBSESSIONS

Î Ï Ð Ñ Ò 1. Being deliberately sinful or blasphemous

Î Ï Ð Ñ Ò 2. Doubtful thoughts as to whether you acted sinfully or blasphemously in the past
Î Ï Ð Ñ Ò 3. Fears of having acted sinfully or unethically
Î Ï Ð Ñ Ò 4. Doubting your faith or beliefs
Î Ï Ð Ñ Ò 5. Unacceptable thoughts about religious figures, religion, or deities
Î Ï Ð Ñ Ò 6. Thoughts of being possessed
Î Ï Ð Ñ Ò 7. Thoughts of having to be perfectly religious
Î Ï Ð Ñ Ò 8. Other:

V. OBSESSIONS OF HARM, DANGER, LOSS, OR EMBARRASSMENT

Î Ï Ð Ñ Ò 1. Having an accident, illness or being injured

Î Ï Ð Ñ Ò 2. An accident, illness or injury happening to someone else
Î Ï Ð Ñ Ò 3. Accidentally losing control and harming others
Î Ï Ð Ñ Ò 4. Accidentally losing control and harming self
Î Ï Ð Ñ Ò 5. Causing harm to others through your own negligence or carelessness
Î Ï Ð Ñ Ò 6. Causing harm to others through my thoughts
Î Ï Ð Ñ Ò 7. Causing harm to self through your own negligence or carelessness
Î Ï Ð Ñ Ò 8. Causing harm to self through my thoughts
Î Ï Ð Ñ Ò 9. Never being able to be happy, or never being able to get what you want in life
Î Ï Ð Ñ Ò 10. Doubt about whether you somehow harmed or injured others in the past
Î Ï Ð Ñ Ò 11. Being deliberately harmed by others
Î Ï Ð Ñ Ò 12. Being rejected by a loved one
Î Ï Ð Ñ Ò 13. Being cheated or taken advantage of by others
Î Ï Ð Ñ Ò 14. Having somehow cheated or taken advantage of others
Î Ï Ð Ñ Ò 15. Having insulted or offended others
Î Ï Ð Ñ Ò 16. Objects in the environment having been moved or changed in unexplainable ways
Î Ï Ð Ñ Ò 17. Damage or theft of property
Î Ï Ð Ñ Ò 18. Losing or misplacing property
OBSESSIVE CONCERNS CHECKLIST PAGE 4

Î Ï Ð Ñ Ò 19. Forgetting information (memories, facts, appointments, etc.)

Î Ï Ð Ñ Ò 20. Being trapped in an unsatisfactory life or relationship
Î Ï Ð Ñ Ò 21. Being looked at or noticed by others in a critical way
Î Ï Ð Ñ Ò 22. Acting inappropriately in public
Î Ï Ð Ñ Ò 23. Your own mortality
Î Ï Ð Ñ Ò 24. The mortality of your family and friends
Î Ï Ð Ñ Ò 25. Your children not being your own
Î Ï Ð Ñ Ò 26. Other:

VI. SUPERSTITIOUS OR MAGICAL OBSESSIONS

Î Ï Ð Ñ Ò 1. Having bad luck

Î Ï Ð Ñ Ò 2. Bad luck happening to someone else
Î Ï Ð Ñ Ò 3. Lucky or unlucky numbers or their multiples
Î Ï Ð Ñ Ò 4. Lucky or unlucky colors
Î Ï Ð Ñ Ò 5. Lucky or unlucky objects or possessions
Î Ï Ð Ñ Ò 6. The possibility that thinking or hearing of bad events can make them occur to yourself
others
Î Ï Ð Ñ Ò 7. Certain words names, or images being able to cause bad luck
Î Ï Ð Ñ Ò 8. Certain actions or behaviors being able to cause bad luck
Î Ï Ð Ñ Ò 9. Being possessed
Î Ï Ð Ñ Ò 10. Places, objects or people associated with unlucky occasions causing bad luck by contact
Î Ï Ð Ñ Ò 11. The need to perform certain activities a special number of times
Î Ï Ð Ñ Ò 12. Lucky or unlucky mental arrangements of things
Î Ï Ð Ñ Ò 13. Other:

VII. HEALTH AND BODY-FOCUSED OBSESSIONS

Î Ï Ð Ñ Ò 1. Parts of your body are ugly or disfigured in some way

Î Ï Ð Ñ Ò 2. Your body gives off a bad odor (e.g., breath, armpits, genital, etc)
Î Ï Ð Ñ Ò 3. Your body has scars or marks
Î Ï Ð Ñ Ò 4. Question how certain parts of your body work or function
Î Ï Ð Ñ Ò 5. A part of your body does not work properly or functions differently than it used to
Î Ï Ð Ñ Ò 6. Parts of your body are asymmetrical
Î Ï Ð Ñ Ò 7. Part(s) of your body is (are) too large or small
Î Ï Ð Ñ Ò 8. You are overweight or underweight
Î Ï Ð Ñ Ò 9. You will choke or vomit accidentally
Î Ï Ð Ñ Ò 10. You are going bald or have thinning hair
OBSESSIVE CONCERNS CHECKLIST PAGE 5

Î Ï Ð Ñ Ò 11. Part(s) of your body is (are) aging prematurely

Î Ï Ð Ñ Ò 12. Clothing does not fit certain parts of your body correctly (too loose or too tight)
Î Ï Ð Ñ Ò 13. You have brain damage or your mental faculties are impaired
Î Ï Ð Ñ Ò 14. You have undiagnosed serious illnesses. Which ones:
Î Ï Ð Ñ Ò 15. Other:

VIII. PERFECTIONISTIC OBSESSIONS

Î Ï Ð Ñ Ò 1. Questioning whether you have said, done, or thought certain things perfectly
Î Ï Ð Ñ Ò 2. Questioning whether others perfectly understand what you have said
Î Ï Ð Ñ Ò 3. Wanting to do, think, or say everything (or certain things) perfectly
Î Ï Ð Ñ Ò 4. Wanting to have a perfect appearance
Î Ï Ð Ñ Ò 5. Wanting your clothes to fit perfectly
Î Ï Ð Ñ Ò 6. Questioning whether you have told the truth perfectly
Î Ï Ð Ñ Ò 7. Making or keeping your home or possessions perfectly clean or pristine
Î Ï Ð Ñ Ò 8. Keeping your possessions in perfect order
Î Ï Ð Ñ Ò 9. Ordering things or making them symmetrical
Î Ï Ð Ñ Ò 10. Wanting to know everything about a specific subject or topic
Î Ï Ð Ñ Ò 11. Perfectly understanding what you have read
Î Ï Ð Ñ Ò 12. Perfectly communicating your thoughts through writing
Î Ï Ð Ñ Ò 13. Other:

IX. NEUTRAL OBSESSIONS

Î Ï Ð Ñ Ò 1. Sounds, words, or music

Î Ï Ð Ñ Ò 2. Nonsense or trivial images
Î Ï Ð Ñ Ò 3. Counting for no special reason
Î Ï Ð Ñ Ò 4. Repetitive questions for which there are no answers or which are unimportant
Î Ï Ð Ñ Ò 5. The excessive awareness of your own thought processes
Î Ï Ð Ñ Ò 6. The awareness of specific things in your environment (sounds, colors, objects, etc.)
Î Ï Ð Ñ Ò 7. Excessive awareness of normal body functioning (breathing, eyes blinking, heart, etc.)
Î Ï Ð Ñ Ò 8. Excessive awareness of abnormal body functioning (ringing in ears, aches, stiffness,
pains, etc)
Î Ï Ð Ñ Ò 9. Other: